Contemporary hormone therapy with LHRH agonists for prostate cancer: avoiding osteoporosis and fracture
Author(s)
Wilson H, Shah I, Abel P, Price P, Honeyfield L, Edwards S,
Type
Journal Article
Abstract
© 2015 Polish Urological Association. All Rights Reserved.Introduction Prostate cancer is a large clinical burden across Europe. It is, in fact, the most common cancer in males, accounting for more than 92,300 deaths annually throughout the continent. Prostate cancer is androgen-sensitive; thus an androgen deprivation therapy (ADT) is often used for treatment by reducing androgen to castrate levels. Several ADT agents have achieved benefits with effective palliation, but, unfortunately, severe adverse events are frequent. Contemporary ADT (Luteinising Hormone Releasing Hormone agonist - LHRHa injections) can result in side effects that include osteoporosis and fractures, compromising quality of life and survival. Methods In this review we analysed the associated bone toxicity consequent upon contemporary ADT and based on the literature and our own experience we present future perspectives that seek to mitigate this associated toxicity both by development of novel therapies and by better identification and prediction of fracture risk. Results Preliminary results indicate that parenteral oestrogen can mitigate associated osteoporotic risk and that CT scans could provide a more accurate indicator of overall bone quality and hence fracture risk. Conclusions As healthcare costs increase globally, cheap and effective alternatives that achieve ADT, but mitigate or avoid such bone toxicities, will be needed. More so, innovative techniques to improve both the measurement and the extent of this toxicity, by assessing bone health and prediction of fracture risk, are also required.
Date Issued
2015
Date Acceptance
2015-02-01
Citation
Central European Journal of Urology, 2015, 68 (2), pp.165-168
ISSN
2080-4873
Publisher
Polish Urological Association
Start Page
165
End Page
168
Journal / Book Title
Central European Journal of Urology
Volume
68
Issue
2
Copyright Statement
© 2015 Polish Urological Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
00513
Subjects
androgen deprivation therapy
fracture imaging
luteinising hormone releasing hormone agonist
osteoporosis
prostate cancer
Publication Status
Published