Testosterone recovery and changes in bone mineral density after stopping long-term luteinizing hormone-releasing hormone analogue therapy in osteoporotic patients with prostate cancer
Article first published online: 24 MAR 2005
Volume 95, Issue 6, pages 776–779, April 2005
How to Cite
Weston, R., Hussain, A., George, E. and Parr, N. J. (2005), Testosterone recovery and changes in bone mineral density after stopping long-term luteinizing hormone-releasing hormone analogue therapy in osteoporotic patients with prostate cancer. BJU International, 95: 776–779. doi: 10.1111/j.1464-410X.2005.05399.x
- Issue published online: 24 MAR 2005
- Article first published online: 24 MAR 2005
- Accepted for publication 1 November 2004
- prostate carcinoma;
- hormone therapy
To investigate the rate of testosterone recovery and changes in bone mineral density in patients found to be osteoporotic while receiving luteinizing hormone-releasing hormone (LHRH) analogues after changing to antiandrogen monotherapy in an attempt to reduce further demineralization.
PATIENTS AND METHODS
Fifteen patients receiving LHRH analogue therapy for ≥ 1 year were identified as osteoporotic by distal forearm dual X-ray densitometry. They were then converted to antiandrogen monotherapy, and prostate specific-antigen (PSA) and total testosterone monitored at 3-monthly intervals. The forearm densitometry was repeated at 1 year.
All patients had some testosterone recovery; the mean (range) duration to initial detectable testosterone was 12.8 (6–22) months. Six patients had a normal testosterone level after a mean of 17.5 (14–30) months. In the year after stopping LHRH analogue therapy the mean bone mineral density (t-score) decreased by 7.2%.
Osteoporotic patients, after stopping LHRH analogues, continue to have suppressed levels of testosterone which have a detrimental effect on bone mineral density. We therefore would not advocate conversion to antiandrogen monotherapy to improve bone density, and suggest alternative therapeutic intervention e.g. bisphosphonate therapy, for these patients.