October 12, 2001

Osteoporosis typically is thought of as a problem for older women, but the bone-thinning condition also affects men. One of the fastest-growing osteoporosis risk groups consists of men suffering from prostate cancer who receive androgen-deprivation therapy to lower testosterone levels. In the Sept. 27 issue of the New England Journal of Medicine, MGH researchers describe how the drug pamidronate can prevent bone loss in prostate cancer patients treated with what are called gonadotropin-releasing hormone (GnRH) agonists.

It is well known that testosterone and other male hormones called androgens stimulate the growth of prostate cancer. As a result, treatments that suppress levels of such hormones have become a mainstay of therapy for advanced prostate cancer. GnRH agonists, which lower testosterone levels, have been so successful in improving treatment of metastatic cancer that they now are commonly used earlier in the course of the disease. This makes understanding and treating any side effects an important endeavor. Osteoporosis is among these drugs' most significant side effects.

Matthew R. Smith, MD, PhD, of the MGH Hematology/ Oncology Unit, the study's first author, notes: "Most men with advanced prostate cancer suffer serious skeletal complications, which can be exacerbated by osteoporosis. The expanding use of hormone-blocking therapies, with some patients staying on them for years, means that the problem of bone loss is becoming crucial."

Joel Finkelstein, MD, of the MGH Endocrine Unit, the study's senior author, adds, "The problems of bone loss and fracture due to hormonal suppression therapy for prostate cancer are often not appreciated by clinicians." The researchers say that this study--the first to show a safe and effective way to prevent bone loss among men receiving androgen-deprivation therapy--should be followed by investigations of other bone-preserving agents.

The study's co-authors are: Francis McGovern, MD; Anthony Zeitman, MD; Mary Anne Fallon, LPN; Douglas Hayden, MA; and David Schoenfeld, PhD, all of the MGH, and Philip Kantoff, MD, of Dana-Farber Cancer Institute.