Men's Osteoporosis Support GroupFracture risk in androgen deprivation therapy Can J Urol. 2009 Dec;16(6):4908-14. Fracture risk in androgen deprivation therapy: a Canadian population based analysis. Lau YK and others. PMID: 20003666. This Canadian study used a database of 4696 men with prostate cancer, with or without androgen deprivation therapy (ADT), to test the hypothesis that ADT increases the risk of fractures of the hip, vertebra, or wrist in men aged 50 years and older. They concluded that, without ADT, there was no association between prostate cancer and fracture risk. However, with ADT, "The adjusted ORs for current and past ADT usage were 1.71 (95% CI: 1.13 - 2.58) and 2.42 (95% CI: 1.42-4.12) respectively." The authors concluded: "Our findings suggest that prostate cancer itself does not increase the risk of fracture and corroborate published results demonstrating an association between ADT and fractures." Editor's comments: Go to this Update for a review article on this topic. The Lau and others study isn't ground breaking, but it does confirm in a very large database of men with prostate cancer who were on ADT that there is a greater risk of fracture than when men have prostate cancer and don't need ADT. The Update review article cites fracture risk increases four times normal for men on ADT, while the Lau and others study found about 2.5 times the risk with ADT. Either risk factor is too high if it can be eliminated with preventive measures such as FDA-approved osteoporosis medications along with calcium and vitamin D supplements. So men about to undergo ADT should request an evaluation by an osteoporosis specialist and/or be certain that proper preventive measures are taken to avoid osteoporosis and increased fracture risk.
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