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Contemporary hormone therapy with LHRH agonists for prostate cancer: avoiding osteoporosis and fracture
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 treat...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Polish Urological Association
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526606/ https://www.ncbi.nlm.nih.gov/pubmed/26251735 http://dx.doi.org/10.5173/ceju.2015.513 |
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author | Wilson, Hannah C.P. Shah, Syed I.A. Abel, Paul D. Price, Patricia Honeyfield, Lesley Edwards, Steve Abel, Richard L. |
author_facet | Wilson, Hannah C.P. Shah, Syed I.A. Abel, Paul D. Price, Patricia Honeyfield, Lesley Edwards, Steve Abel, Richard L. |
author_sort | Wilson, Hannah C.P. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4526606 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Polish Urological Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-45266062015-08-06 Contemporary hormone therapy with LHRH agonists for prostate cancer: avoiding osteoporosis and fracture Wilson, Hannah C.P. Shah, Syed I.A. Abel, Paul D. Price, Patricia Honeyfield, Lesley Edwards, Steve Abel, Richard L. Cent European J Urol Review Paper 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. Polish Urological Association 2015-04-20 2015 /pmc/articles/PMC4526606/ /pubmed/26251735 http://dx.doi.org/10.5173/ceju.2015.513 Text en Copyright by Polish Urological Association http://creativecommons.org/licenses/by-nc-nd/3.0/ 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. |
spellingShingle | Review Paper Wilson, Hannah C.P. Shah, Syed I.A. Abel, Paul D. Price, Patricia Honeyfield, Lesley Edwards, Steve Abel, Richard L. Contemporary hormone therapy with LHRH agonists for prostate cancer: avoiding osteoporosis and fracture |
title | Contemporary hormone therapy with LHRH agonists for prostate cancer: avoiding osteoporosis and fracture |
title_full | Contemporary hormone therapy with LHRH agonists for prostate cancer: avoiding osteoporosis and fracture |
title_fullStr | Contemporary hormone therapy with LHRH agonists for prostate cancer: avoiding osteoporosis and fracture |
title_full_unstemmed | Contemporary hormone therapy with LHRH agonists for prostate cancer: avoiding osteoporosis and fracture |
title_short | Contemporary hormone therapy with LHRH agonists for prostate cancer: avoiding osteoporosis and fracture |
title_sort | contemporary hormone therapy with lhrh agonists for prostate cancer: avoiding osteoporosis and fracture |
topic | Review Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526606/ https://www.ncbi.nlm.nih.gov/pubmed/26251735 http://dx.doi.org/10.5173/ceju.2015.513 |
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