Complications of ADT for prostate cancer: Osteoporosis and the risk of fracture

Abstract

Patients with advanced disease usually receive hormonal therapy, such as androgen deprivation therapy (ADT). Although ADT is initially very effective for prostate cancer, long-term ADT is known to be associated with various side effects. Among them ADT is associated with the deterioration of bone health, including an increased risk of fracture from osteoporosis and the development of bone metastasis. For patients with conditions associated with fragility, such as osteoporosis in patients treated with ADT, it is important to estimate the risk of fracture. In order to identify the patients who require bone-supportive treatment for osteoporosis, the bone mineral density is assessed by dual-energy X-ray absorptiometry. The Fracture Risk Assessment Tool (FRAX) has been developed to evaluate the risk of fracture, and likely improves the assessment of the risk of fracture through the inclusion of patient characteristics. The maintenance of bone health is very important for achieving long survival because skeletal fractures are associated with shortened survival. Clinicians must pay attention to bone health and provide specific management for osteoporosis in prostate cancer patients.