Multidisciplinary Consensus on the Prevention and Treatment of Osteoporosis and Fragility Fractures in Patients with Prostate Cancer Receiving Androgen-Deprivation Therapy
Patients with prostate cancer (PCa) on androgen-deprivation therapy (ADT) are at high risk of osteoporosis and fragility fractures. We aimed to provide some practical insights into the delivery of optimal bone health care for PCa patients, particularly those on ADT. An interdisciplinary group of e...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Sexual Medicine and Andrology
2022-01-01
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| Series: | The World Journal of Men's Health |
| Subjects: |
| Summary: | Patients with prostate cancer (PCa) on androgen-deprivation therapy (ADT) are at high risk of osteoporosis and fragility fractures.
We aimed to provide some practical insights into the delivery of optimal bone health care for PCa patients, particularly
those on ADT. An interdisciplinary group of experts, including urologists and rheumatologists developed recommendations
based on their expertise, current evidence and guidelines. The multidisciplinary group’s main recommendations are: fragility
fracture risk should be assessed in all PCa patient, especially, in those under ADT. FRAX® tool may be incorporated into clinical
practice to identify patients at high risk of fracture. Bone mineral density (BMD) should be measured routinely by dual
energy X-ray absorptiometry in all patients scheduled for or on ADT. Thoracic and lumbar spine X-ray may be performed at
the initial evaluation of patients with the diagnosis of osteoporosis and in case of suspected clinical vertebral fracture. Basic
laboratory tests are recommended to exclude secondary osteoporosis. Treatment with bisphosphonates or denosumab should
be considered in patients on ADT with fragility fracture, osteoporosis (BMD T-score ≤-2.5), or high risk of fracture according
to FRAX®. Referral to a bone metabolism specialist should be contemplated in some cases. The recommendations provided
in this document, tailored for clinicians treating PCa patients, may be of help to identify and treat patients at high risk of fracture. |
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| ISSN: | 2287-4208 2287-4690 |