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Prevalence of osteoporosis in prostate cancer survivors II: a meta-analysis of men not on androgen deprivation therapy

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Abstract

The prevalence of osteoporosis in men with prostate cancer (PCa) on androgen deprivation therapy (ADT) is well documented, with up to 53 % affected by this bone condition. However, there has been less emphasis on the burden of severe bone loss in men with PCa but not undergoing ADT. Therefore, the purpose of this meta-analysis is to compile evidence from the literature on the bone health of hormone-naïve PCa patients and to compare it to the bone health of men with PCa on ADT. Three databases were searched for the relevant literature published from 1990 until January 2014. The pooled prevalence of osteoporosis, low bone mass, and normal bone mass were estimated for this patient group and compared with similar subgroups from a previously published meta-analysis. The prevalence of osteoporosis varies from 4 to 38 % in hormone-naïve PCa patients, and men with more advanced disease have a higher prevalence of osteoporosis. Men with PCa on ADT have poorer bone health than their hormone-naïve counterparts, but the trend toward poorer bone health with metastatic disease remains. In conclusion, it was found that men with PCa experience poor bone health prior to treatment with ADT. These results suggest that all men with PCa should have regular bone health monitoring, whether they commence ADT or not, in order to prevent or indeed minimize the morbidity that accompanies osteoporosis.

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References

  1. C.S. Higano, Side effects of androgen deprivation therapy: monitoring and minimizing toxicity. Urology 61(2), 32–38 (2003). doi:10.1016/S0090-4295(02)02397-X

    Article  PubMed  Google Scholar 

  2. L.G. Taylor, S.E. Canfield, X.L. Du, Review of major adverse effects of androgen-deprivation therapy in men with prostate cancer. Cancer 115(11), 2388–2399 (2009). doi:10.1002/cncr.24283

    Article  PubMed  Google Scholar 

  3. S.L. Greenspan, P. Coates, S.M. Sereika, J.B. Nelson, D.L. Trump, N.M. Resnick, Bone loss after initiation of androgen deprivation therapy in patients with prostate cancer. J. Clin. Endocrinol. Metab. 90(12), 6410–6417 (2005). doi:10.1210/jc.2005-0183

    Article  CAS  PubMed  Google Scholar 

  4. S.M. Alibhai, L. Yun, A.M. Cheung, L. Paszat, Screening for osteoporosis in men receiving androgen deprivation therapy. JAMA 307(3), 255–256 (2012). doi:10.1001/jama.2011.2022

    Article  CAS  PubMed  Google Scholar 

  5. National comprehensive cancer network: NCCN guidelines for prostate cancer (version 2.2014). http://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf (2014). Accessed 14 Apr 2014

  6. M. Grossmann, E.J. Hamilton, C. Gilfillan, D. Bolton, D.L. Joon, J.D. Zajac, Bone and metabolic health in patients with non-metastatic prostate cancer who are receiving androgen deprivation therapy. Med. J. Aust. 194(6), 301–306 (2011)

    PubMed  Google Scholar 

  7. D.E. Bailey, M. Wallace, M.H. Mishel, Watching, waiting and uncertainty in prostate cancer. J. Clin. Nurs. 16(4), 734–741 (2007). doi:10.1111/j.1365-2702.2005.01545.x

    Article  PubMed  Google Scholar 

  8. J.L. Oliffe, B.J. Davison, T. Pickles, L. Mróz, The self-management of uncertainty among men undertaking active surveillance for low-risk prostate cancer. Qual. Health Res. 19(4), 432–443 (2009). doi:10.1177/1049732309332692

    Article  PubMed  Google Scholar 

  9. J.H. Littell, J. Corcoran, V.K. Pillai, Systematic reviews and meta-analysis. Pocket guides to social work research methods (Oxford University Press, Oxford, 2008)

    Book  Google Scholar 

  10. D. Moher, A. Liberati, J. Tetzlaff, D.G. Altman, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J. Clin. Epidemiol. 62(10), 1006–1012 (2009). doi:10.1016/j.jclinepi.2009.06.005

    Article  PubMed  Google Scholar 

  11. A.-C.M. Lassemillante, S.A. Doi, J.D. Hooper, J.B. Prins, O.R. Wright, Prevalence of osteoporosis in prostate cancer survivors: a meta-analysis. Endocrine 45(3), 370–381 (2014). doi:10.1007/s12020-013-0083-z

    Article  CAS  PubMed  Google Scholar 

  12. D. Hoy, P. Brooks, A. Woolf, F. Blyth, L. March, C. Bain, P. Baker, E. Smith, R. Buchbinder, Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J. Clin. Epidemiol. 65(9), 934–939 (2012). doi:10.1016/j.jclinepi.2011.11.014

    Article  PubMed  Google Scholar 

  13. J.A. Kanis, L.J. Melton, C. Christiansen, C.C. Johnston, N. Khaltaev, The diagnosis of osteoporosis. J. Bone Miner. Res. 9(8), 1137–1141 (1994). doi:10.1002/jbmr.5650090802

    Article  CAS  PubMed  Google Scholar 

  14. E.M. Lewiecki, C.M. Gordon, S. Baim, M.B. Leonard, N.J. Bishop, M.-L. Bianchi, H.J. Kalkwarf, C.B. Langman, H. Plotkin, F. Rauch, B.S. Zemel, N. Binkley, J.P. Bilezikian, D.L. Kendler, D.B. Hans, S. Silverman, International Society for Clinical Densitometry 2007 adult and pediatric official positions. Bone 43(6), 1115–1121 (2008). doi:10.1016/j.bone.2008.08.106

    Article  PubMed  Google Scholar 

  15. S.A. Doi, L. Thalib, A quality-effects model for meta-analysis. Epidemiology 19(1), 94–100 (2008)

    PubMed  Google Scholar 

  16. S.A.R. Doi, J.J. Barendregt, E.L. Mozurkewich, Meta-analysis of heterogeneous clinical trials: an empirical example. Contemp. Clin. Trials 32(2), 288–298 (2011). doi:10.1016/j.cct.2010.12.006

    Article  PubMed  Google Scholar 

  17. H. Noma, Confidence intervals for a random-effects meta-analysis based on Bartlett-type corrections. Stat. Med. 30(28), 3304–3312 (2011). doi:10.1002/sim.4350

    Article  PubMed  Google Scholar 

  18. S.E. Brockwell, I.R. Gordon, A comparison of statistical methods for meta-analysis. Stat. Med. 20(6), 825–840 (2001). doi:10.1037/1082-989X.3.3.354

    Article  CAS  PubMed  Google Scholar 

  19. R.C. Overton, A comparison of fixed-effects and mixed (random-effects) models for meta-analysis tests of moderator variable effects. Psychol. Methods 3(3), 354 (1998). doi:10.1037/1082-989X.3.3.354

    Article  Google Scholar 

  20. J.P. Hunter, A. Saratzis, A.J. Sutton, R.H. Boucher, R.D. Sayers, M.J. Bown, In meta-analyses of proportion studies, funnel plots were found to be an inaccurate method of assessing publication bias. J. Clin. Epidemiol. 67(8), 897–903 (2014). doi:10.1016/j.jclinepi.2014.03.003

    Article  PubMed  Google Scholar 

  21. A.A. Onitilo, S.A.R. Doi, J.J. Barendregt, Meta-analysis I.I, in Methods of Clinical Epidemiology, Springer Series on Epidemiology and Public Health, ed. by S.A.R. Doi, G.M. Williams (Springer, Berlin Heidelberg, 2013), pp. 253–266

    Chapter  Google Scholar 

  22. Epigear International: MetaXL. Version 2.0 (2014)

  23. T. Yuasa, S. Maita, N. Tsuchiya, S. Takahashi, K. Hatake, I. Fukui, T. Habuchi, Relationship between bone mineral density and androgen-deprivation therapy in Japanese prostate cancer patients. J. Urol. 183(4), e335 (2010). doi:10.1016/j.urology.2009.10.075

    Article  Google Scholar 

  24. J.H. Deng, L.P. Yang, L.S. Wang, D.F. Zhou, Effect of androgen deprivation therapy on bone mineral density in prostate cancer patients. Asian J. Androl. 6(1), 75–77 (2004)

    PubMed  Google Scholar 

  25. W. Wang, T. Yuasa, N. Tsuchiya, S. Maita, T. Kumazawa, T. Inoue, M. Saito, Z. Ma, T. Obara, H. Tsuruta, S. Satoh, T. Habuchi, Bone mineral density in Japanese prostate cancer patients under androgen-deprivation therapy. Endocr. Relat. Cancer 15(4), 943–952 (2008). doi:10.1677/erc-08-0116

    Article  CAS  PubMed  Google Scholar 

  26. A.H. Panju, H. Breunis, A.M. Cheung, M. Leach, N. Fleshner, P. Warde, S. Duff-Canning, M. Krahn, G. Naglie, I. Tannock, G. Tomlinson, S.M.H. Alibhai, Management of decreased bone mineral density in men starting androgen-deprivation therapy for prostate cancer. BJU Int. 103(6), 753–757 (2009). doi:10.1111/j.1464-410X.2008.08156.x

    Article  CAS  PubMed  Google Scholar 

  27. J. Planas, J. Morote, A. Orsola, C. Salvador, E. Trilla, L. Cecchini, C.X. Raventos, J.P. Morin, The relationship between daily calcium intake and bone mineral density in men with prostate cancer. BJU Int. 99(4), 812–815 (2007). doi:10.1111/j.1464-410X.2006.06695.x

    Article  CAS  PubMed  Google Scholar 

  28. E.Y. Yu, K.F. Kuo, R. Gulati, S. Chen, T.E. Gambol, S.P. Hall, P.Y. Jiang, P. Pitzel, C.S. Higano, Long-term dynamics of bone mineral density during intermittent androgen deprivation for men with nonmetastatic, hormone-sensitive prostate cancer. J. Clin. Oncol. 30(15), 1864–1870 (2012). doi:10.1200/jco.2011.38.3745

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  29. J.T. Wei, M. Gross, C.A. Jaffe, K. Gravlin, M. Lahaie, G.J. Faerber, K.A. Cooney, Androgen deprivation therapy for prostate cancer results in significant loss of bone density. Urology 54(4), 607–611 (1999). doi:10.1016/S0090-4295(99)00301-5

    Article  CAS  PubMed  Google Scholar 

  30. J. Morote, J.P. Morin, A. Orsola, J.M. Abascal, C. Salvador, E. Trilla, C.X. Raventos, L. Cecchini, G. Encabo, J. Reventos, Prevalence of osteoporosis during long-term androgen deprivation therapy in patients with prostate cancer. Urology 69(3), 500–504 (2007). doi:10.1016/j.urology.2006.11.002

    Article  PubMed  Google Scholar 

  31. F.A. Conde, L. Sarna, R.K. Oka, D.L. Vredevoe, M.B. Rettig, W.J. Aronson, Age, body mass index, and serum prostate-specific antigen correlate with bone loss in men with prostate cancer not receiving androgen deprivation therapy. Urology 64(2), 335–340 (2004). doi:10.1016/j.urology.2004.03.036

    Article  PubMed  Google Scholar 

  32. A. Berruti, L. Dogliotti, C. Terrone, S. Cerutti, G. Isaia, R. Tarabuzzi, G. Reimondo, M. Mari, P. Ardissone, S. De Luca, G. Fasolis, D. Fontana, S.R. Rossetti, A. Angeli, Gruppo Onco Urologico Piemontese, R.O.P., Changes in bone mineral density, lean body mass and fat content as measured by dual energy X-ray absorptiometry in patients with prostate cancer without apparent bone metastases given androgen deprivation therapy. J. Urol. 167(6), 2361–2367 (2002). doi:10.1016/S0022-5347(05)64985-3

    Article  PubMed  Google Scholar 

  33. S.A. Hussain, R. Weston, R.N. Stephenson, E. George, N.J. Parr, Immediate dual energy X-ray absorptiometry reveals a high incidence of osteoporosis in patients with advanced prostate cancer before hormonal manipulation. BJU Int. 92(7), 690–694 (2003). doi:10.1046/j.1464-410X.2003.04471.x

    Article  CAS  PubMed  Google Scholar 

  34. M.R. Smith, F.J. McGovern, M.A. Fallon, D. Schoenfeld, P.W. Kantoff, J.S. Finkelstein, Low bone mineral density in hormone-naive men with prostate carcinoma. Cancer 91(12), 2238–2245 (2001). doi:10.1002/1097-0142(20010615)91

    Article  CAS  PubMed  Google Scholar 

  35. A. Cheung, D. Pattison, I. Bretherton, R. Hoermann, D. Lim Joon, E. Ho, T. Jenkins, E. Hamilton, K. Bate, I. Chan, Cardiovascular risk and bone loss in men undergoing androgen deprivation therapy for non-metastatic prostate cancer: implementation of standardized management guidelines. Andrology 1(4), 583–589 (2013). doi:10.1111/j.2047-2927.2013.00093

    Article  CAS  PubMed  Google Scholar 

  36. S. Alibhai, H. Mohamedali, H. Gulamhusein, A. Panju, H. Breunis, N. Timilshina, N. Fleshner, M. Krahn, G. Naglie, I. Tannock, Changes in bone mineral density in men starting androgen deprivation therapy and the protective role of vitamin D. Osteoporos. Int. 24(10), 2571–2579 (2013). doi:10.1007/s00198-013-2343-4

    Article  CAS  PubMed  Google Scholar 

  37. S. Ziaran, F.M. Goncalves, J.B. Sn, Complex metabolic and skeletal changes in men taking long-term androgen deprivation therapy. Clin. Genitourin. Cancer 11(1), 33–38 (2013). doi:10.1016/j.clgc.2012.08.005

    Article  PubMed  Google Scholar 

  38. A.C. Looker, E.S. Orwoll, C.C. Johnston, R.L. Lindsay, H.W. Wahner, W.L. Dunn, M.S. Calvo, T.B. Harris, S.P. Heyse, Prevalence of low femoral bone density in older US adults from NHANES III. J. Bone Miner. Res. 12(11), 1761–1768 (1997). doi:10.1359/jbmr.1997.12.11.1761

    Article  CAS  PubMed  Google Scholar 

  39. W. Demark-Wahnefried, D.J. Bowen, J.M. Jabson, E.D. Paskett, Scientific bias arising from sampling, selective recruitment, and attrition: the case for improved reporting. Cancer Epidemiol. Biomarkers Prev. 20(3), 415–418 (2011). doi:10.1158/1055-9965.epi-10-1169

    Article  PubMed  Google Scholar 

  40. T.V. Nguyen, J.R. Center, J.A. Eisman, Osteoporosis in elderly men and women: effects of dietary calcium, physical activity, and body mass index. J. Bone Miner. Res. 15(2), 322–331 (2000). doi:10.1359/jbmr.2000.15.2.322

    Article  CAS  PubMed  Google Scholar 

  41. R.C. Percival, G.H. Urwin, S. Harris, A.J. Yates, J.L. Williams, M. Beneton, J.A. Kanis, Biochemical and histological evidence that carcinoma of the prostate is associated with increased bone resorption. Eur. J. Surg. Oncol. 13(1), 41–49 (1987)

    CAS  PubMed  Google Scholar 

  42. G.H. Urwin, R.C. Percival, S. Harris, M.N. Beneton, J.L. Williams, J.A. Kanis, Generalised increase in bone resorption in carcinoma of the prostate. Br. J. Urol. 57(6), 721–723 (1985). doi:10.1111/j.1464-410X.1985.tb07040.x

    Article  CAS  PubMed  Google Scholar 

  43. P. Garnero, N. Buchs, J. Zekri, R. Rizzoli, R.E. Coleman, P.D. Delmas, Markers of bone turnover for the management of patients with bone metastases from prostate cancer. Br. J. Cancer 82(4), 858–864 (2000). doi:10.1054/bjoc.1999.1012

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  44. T.A. Guise, G.R. Mundy, Cancer and Bone. Endocr. Rev. 19(1), 18–54 (1998). doi:10.1210/edrv.19.1.0323

    CAS  PubMed  Google Scholar 

  45. T.H. Diamond, C.S. Higano, M.R. Smith, T.A. Guise, F.R. Singer, Osteoporosis in men with prostate carcinoma receiving androgen-deprivation therapy. Cancer 100(5), 892–899 (2004). doi:10.1002/cncr.20056

    Article  PubMed  Google Scholar 

  46. C.J. Logothetis, S.H. Lin, Osteoblasts in prostate cancer metastasis to bone. Nat. Rev. Cancer 5(1), 21–28 (2005). doi:10.1038/nrc1528

    Article  CAS  PubMed  Google Scholar 

  47. K.N. Weilbaecher, T.A. Guise, L.K. McCauley, Cancer to bone: a fatal attraction. Nat. Rev. Cancer 11(6), 411–425 (2011). doi:10.1038/nrc3055

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  48. R. Murray, V. Grill, N. Crinis, P. Ho, J. Davison, P. Pitt, Hypocalcemic and normocalcemic hyperparathyroidism in patients with advanced prostatic cancer. J. Clin. Endocrinol. Metab. 86(9), 4133–4138 (2001)

    Article  CAS  PubMed  Google Scholar 

  49. D.J. DiGirolamo, T.L. Clemens, S. Kousteni, The skeleton as an endocrine organ. Nat. Rev. Rheumatol. 8(11), 674–683 (2012). doi:10.1038/nrrheum.2012.157

    Article  CAS  PubMed  Google Scholar 

  50. M. Reuss-Borst, U. Hartmann, C. Scheede, J. Weiß, Prevalence of osteoporosis among cancer patients in Germany. Osteoporos. Int. 23(4), 1437–1444 (2012). doi:10.1007/s00198-011-1724-9

    Article  CAS  PubMed  Google Scholar 

  51. H.W. Daniell, J.C. Clark, S.E. Pereira, Z.A. Niazi, D.W. Ferguson, S.R. Dunn, M.L. Figueroa, P.T. Stratte, Hypogonadism following prostate-bed radiation therapy for prostate carcinoma. Cancer 91(10), 1889–1895 (2001). doi:10.1002/1097-0142(20010515)91

    Article  CAS  PubMed  Google Scholar 

  52. T.O.M. Pickles, P. Graham, What happens to testosterone after prostate radiation monotherapy and does it matter? J. Urol. 167(6), 2448–2452 (2002). doi:10.1016/S0022-5347(05)65002-1

    Article  CAS  PubMed  Google Scholar 

  53. C. Fiorino, R. Valdagni, T. Rancati, G. Sanguineti, Dose–volume effects for normal tissues in external radiotherapy: Pelvis. Radiother. Oncol. 93(2), 153–167 (2009). doi:10.1016/j.radonc.2009.08.004

    Article  PubMed  Google Scholar 

  54. V.B. Shahinian, Y.F. Kuo, J.L. Freeman, J.S. Goodwin, Risk of fracture after androgen deprivation for prostate cancer. N. Engl. J. Med. 352(2), 154–164 (2005). doi:10.1056/NEJMoa041943

    Article  CAS  PubMed  Google Scholar 

  55. A.K. Morgans, M.R. Smith, A.J. O’Malley, N.L. Keating, Bone density testing among prostate cancer survivors treated with androgen-deprivation therapy. Cancer 119(4), 863–870 (2013). doi:10.1002/cncr.27830

    Article  PubMed Central  PubMed  Google Scholar 

  56. A.C. Ross, J.E. Manson, S.A. Abrams, J.F. Aloia, P.M. Brannon, S.K. Clinton, R.A. Durazo-Arvizu, J.C. Gallagher, R.L. Gallo, G. Jones, C.S. Kovacs, S.T. Mayne, C.J. Rosen, S.A. Shapses, The 2011 report on dietary reference intakes for calcium and vitamin d from the institute of medicine: what clinicians need to know. J. Clin. Endocr. Metab. 96(1), 53–58 (2011). doi:10.1210/jc.2010-2704

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  57. M.F. Holick, N.C. Binkley, H.A. Bischoff-Ferrari, C.M. Gordon, D.A. Hanley, R.P. Heaney, M.H. Murad, C.M. Weaver, Evaluation, treatment, and prevention of vitamin d deficiency: an endocrine society clinical practice guideline. J. Clin. Endocr. Metab. 96(7), 1911–1930 (2011). doi:10.1210/jc.2011-0385

    Article  CAS  PubMed  Google Scholar 

  58. National Osteoporosis Foundation, Clinician’s guide to prevention and treatment of osteoporosis (National Osteoporosis Foundation, Washington, 2014)

    Google Scholar 

  59. Australian Cancer Network Management of Metastatic Prostate Cancer Working Party, Clinical practice guidelines for the management of locally advanced and metastatic prostate cancer (Cancer Council Australia and Australian Cancer Network, Sydney, 2010)

    Google Scholar 

  60. National Collaborating Centre for Cancer, Prostate cancer: diagnosis and treatment. NICE Guidelines CG175 (National Institute for Health and Care Excellence, London, 2014)

    Google Scholar 

  61. H. Rhee, J.H. Gunter, P. Heathcote, K. Ho, P. Stricker, N.M. Corcoran, C.C. Nelson, Adverse effects of androgen deprivation therapy in prostate cancer and their management. BJU Int. (2014). doi:10.1111/bju.12964

    Google Scholar 

  62. J.A. Kanis, A. Oden, H. Johansson, F. Borgström, O. Ström, E. McCloskey, FRAX® and its applications to clinical practice. Bone 44(5), 734–743 (2009). doi:10.1016/j.bone.2009.01.373

    Article  PubMed  Google Scholar 

  63. J. Kanis, O. Johnell, A. Odén, H. Johansson, E. McCloskey, FRAX™ and the assessment of fracture probability in men and women from the UK. Osteoporos. Int. 19(4), 385–397 (2008). doi:10.1007/s00198-007-0543-5

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  64. P.J. Saylor, D.S. Kaufman, M.D. Michaelson, R.J. Lee, M.R. Smith, Application of a fracture risk algorithm to men treated with androgen deprivation therapy for prostate cancer. J. Urol. 183(6), 2200–2205 (2010). doi:10.1016/j.juro.2010.02.022

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  65. R.A. Adler, F.W. Hastings, V.I. Petkov, Treatment thresholds for osteoporosis in men on androgen deprivation therapy: T-score versus FRAX®. Osteoporos. Int. 21(4), 647–653 (2010). doi:10.1007/s00198-009-0984-0

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Centre for Dietetics Research (C-DIET-R), School of Human Movement and Nutrition Science, The University of Queensland, St Lucia, QLD, 4072, Australia

    Annie-Claude M. Lassemillante & Olivia R. L. Wright

  2. Mater Research Institute, University of Queensland, Kent Street, Woolloongabba, QLD, 4102, Australia

    Annie-Claude M. Lassemillante, John D. Hooper, John B. Prins & Olivia R. L. Wright

  3. Clinical Epidemiology Unit, School of Population Health, The University of Queensland, Herston, QLD, 4006, Australia

    Suhail A. R. Doi

  4. The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, QLD, 4102, Australia

    John B. Prins

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Lassemillante, AC.M., Doi, S.A.R., Hooper, J.D. et al. Prevalence of osteoporosis in prostate cancer survivors II: a meta-analysis of men not on androgen deprivation therapy. Endocrine 50, 344–354 (2015). https://doi.org/10.1007/s12020-015-0536-7

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