In what is believed to be the first study to describe the impact on men with a 'high' risk of bone fracture who are receiving long-term androgen deprivation therapy (ADT) for prostate cancer, new research from The Cancer Institute of New Jersey shows this population to have a higher fracture incidence following treatment completion. The findings, published in the latest online version of BJU International (doi:10.1111/j.1464-410X.2012.11758.x), also show that men who experienced a fracture had a 1.38-fold higher mortality risk than those who did not. The Cancer Institute of New Jersey is a Center of Excellence of the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School (RWJMS).
Men with localized prostate cancer who have underlying health conditions often receive this type of therapy with the hope to shrink or delay growth of their cancer, because they are considered inappropriate candidates for more aggressive therapies such as surgery or radiation. Previous studies have shown an association between the receipt of ADT for prostate cancer and an increased risk of bone fracture and other skeletal complications, such as a decrease in bone mineral density. The investigators at The Cancer Institute of New Jersey further explored the impact of this treatment on men already deemed to be at high risk for fracture prior to receiving therapy.
Using the population-based Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database, researchers reviewed information on demographics and tumor characteristics from 75,994 men aged 66 and older who were diagnosed as having localized prostate cancer from 1992 to 2007. All of the SEER registries hold the highest level of certification of data quality. A risk assessment scale for baseline skeletal complications - including fracture - was created, utilizing the presence of certain conditions within one year prior to cancer diagnosis. These conditions included diabetes, alcohol and cigarette use, paralysis, and liver disease.