Cancer and Metastasis Reviews

, Volume 21, Issue 2, pp 159–166

Osteoporosis and Other Adverse Body Composition Changes during Androgen Deprivation Therapy for Prostate Cancer

  • Matthew R. Smith

DOI: 10.1023/A:1020840311573

Cite this article as:
Smith, M.R. Cancer Metastasis Rev (2002) 21: 159. doi:10.1023/A:1020840311573


Osteoporosis and other body composition changes are important complications of androgen deprivation therapy (ADT) for prostate cancer. Bilateral orchiectomy and gonadotropin-releasing hormone agonist treatment decrease bone mineral density and increase fracture risk. Other factors including diet and lifestyle may contribute to bone loss in men with prostate cancer. Estrogens play an important role in male bone metabolism. Androgen deprivation therapy with estrogens probably causes less bone loss than bilateral orchiectomy or gonadotropin-releasing hormone agonist treatment. Bicalutamide monotherapy increases serum estrogen levels and may also spare bone. Lifestyle modification including smoking cessation, moderation of alcohol use, and regular weight bearing exercise are recommended to decrease treatment-related bone loss. Supplemental calcium and vitamin D are also recommended. Pamidronate (Aredia®), an intravenous bisphosphonate, prevents bone loss during ADT. Other bisphosphonates are probably effective but have not been studied in hypogonadal men. Androgen deprivation therapy increases fat mass and decreases muscle mass. These body composition changes may contribute to treatment-related decreases in physical capacity and quality of life.

androgen deprivation therapybicalutamideboneestrogenfatfracturegonadotropin-releasing hormone agonistmuscleosteoporosisprostate cancer

Copyright information

© Kluwer Academic Publishers 2002

Authors and Affiliations

  • Matthew R. Smith
    • 1
  1. 1.Massachusetts General HospitalBostonUSA