Navigate Up

UPMC/University of Pittsburgh Schools of the Health Sciences
Patients and medical professionals may call 1-800-533-UPMC (8762) for more information.

Common Prostate Cancer Treatment May Cause Severe Bone Loss, According To Researchers at the University of Pittsburgh and Beth Israel Deaconess Medical Center

PITTSBURGH, June 4, 2001 — Men may be losing bone at an alarming rate as a result of a commonly used treatment for prostate cancer, according to researchers at the University of Pittsburgh Medical Center (UPMC) and Beth Israel Deaconess Medical Center. The findings, published in the June issue of the Journal of Clinical Endocrinology and Metabolism, suggest that gonadotropin-releasing hormone agonists (GnRH-a), a frequently used treatment for prostate cancer, causes severe drops in bone mass and results in an increased risk of fracture in men.

“We were surprised to find that men who were treated with GnRH-a for prostate cancer experienced up to a decade's worth of bone loss within the first year of therapy,” said senior author Susan Greenspan, M.D., professor, divisions of endocrinology and geriatric medicine, department of medicine, University of Pittsburgh; and director, Osteoporosis Prevention and Treatment Center, UPMC.

GnRH-a works by depriving the body of testosterone, an androgen hormone that increases the growth of prostate tumors. However, testosterone also is essential to maintaining bone mass in men. While doctors have been using GnRH-a for more than a decade in treating men with late-stage metastatic prostate cancer, they have begun using it more recently in men with earlier-stage disease and for longer periods of time.

“In treating men with this therapy earlier and for longer periods of time, we are putting them in a menopause-equivalent condition and subjecting them to severe osteoporosis -- a disease that may have more serious consequences than early-stage prostate cancer,” said Dr. Greenspan. “With close to 200,000 men being diagnosed with prostate cancer each year, we could be facing an enormous increase in the incidence of debilitating bone fractures in men.”

In this study, investigators compared bone mineral densities (BMD), biochemical markers of bone turnover and body composition in 60 men with prostate cancer -- 19 of whom were on GnRH-a and 41 who were not -- and BMD in 197 healthy men.

While the prostate cancer patients who had not been treated with GnRH-a had BMDs that were similar to those of the healthy controls, the scores of men treated with GnRH-a showed dramatically different results in several categories.

The treated men had BMD levels that were up to 17 percent lower than those of untreated men, putting the treated men at a markedly higher risk for fracture. Treated men also had nearly double the levels of urinary NTx, a marker for bone resorption, indicating that their bones were disintegrating twice as quickly as the bones of untreated men. In addition, they had significantly lower blood counts and levels of estradiol, a hormone that is needed, along with testosterone, for bone health. Treated men also showed an increase in total body fat and loss of muscle mass.

“Clearly, cutting off testosterone production in men through the administration of GnRH-a has some very serious consequences related to skeletal integrity and overall health,” continued

Dr. Greenspan. “This is particularly troubling because the greatest degree of bone loss appears to occur with the initiation of treatment.”

Dr. Greenspan is currently recruiting patients for a study to determine whether bisphosphonate, an anti-resorptive therapy, can prevent or abate bone loss in men who are being treated with GnRH-a for prostate cancer.

For more information about participating in this study, please call the UPMC Osteoporosis Prevention and Treatment Center at 412-692-2220.

©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com