Are doctors are doing enough to protect the bones of patients on ADT?

Bisphosphonate prescriptions in men with androgen deprivation therapy use. By Gulamhusein et al 2015

 

Key sentence from the paper: “[B]isphosphonate prescriptions among men receiving ADT remained low during the study period, even for those at high risk of subsequent fractures.

 

For the full abstract, see: http://www.ncbi.nlm.nih.gov/pubmed/25462000

 

Commentary: This short paper by our colleagues in Toronto suggests that physicians are not doing enough to protect patients from getting bone fractures when on ADT. ADT is well known to cause not just osteoporosis, but is also associated with significant increased incidence of fractures.  The number of fractures can be reduced with a class of drugs known as bisphosphonates.

Bisphosphonates are not without their own side effects, which patients should be aware of, but clearly prostate cancer patients on ADT with a prior history of osteoporosis and fractures need some bone protection. The authors of this study, which includes data on over 35,000 men in Ontario in a timeline going back to 1995, show that less than 10% of the men on ADT were prescribed these bone protecting agents.  

    

Gulamhusein H, Yun L, Cheung AM, Sutradhar R, Paszat L, Warde P, Alibhai SM. 2014. Bisphosphonate prescriptions in men with androgen deprivation therapy use. JAMA 312(21):2285-2286.