Dr. Paul Sieber, from the Urological Association of Lancaster, on Managing Bone Health After the Introduction of ADT.
Paul R. Sieber, MD, Urological Association of Lancaster, explains that the initial burst of activity following the introduction of androgen-deprivation therapy (ADT) is severe and may result in as much as a 10% loss in bone density. To add perspective, he notes that this degree of bone loss is 3 to 5 times what is lost during menopause in women.
Bone loss may continue in men as they continue to receive ADT, which makes managing and controlling bone health extremely important.
A number of agents are available to help manage bone health for prostate cancer patients. Sieber notes that the only agent with a direct FDA approval in prostate cancer is denosumab, a monoclonal antibody that binds to RANK ligand. Other agents, such as zoledronic acid (Zometa) and bisphosphonates are approved to treat bone metastases, but Sieber believes denosumab is superior to these agents.