Role of BMD studies, bisphosphonates in men on ADT

This article reviews the current state of knowledge of the incidence and pathophysiology of bone loss and skeletal events in patients with prostate cancer who are on ADT.

Key Points

Effect of ADT on bone loss

In fact, it is thought that the incidence of osteopenia and osteoporosis in men treated with ADT exceeds that observed in postmenopausal women (Urology 2002; 60:79-85). Further, even before ADT or the occurrence of bone metastases, patients with prostate cancer already have reduced BMD compared to healthy controls. The presence of other risk factors, such as hypogonadism, decreased vitamin D and calcium intake, and heredity could explain this observation.

Such considerations imply that prophylactic and therapeutic measures similar to those being practiced in postmenopausal women could be applicable in men with prostate cancer, whether they are on or off ADT.