Hormone drugs may increase the chances of a broken bone.
THE QUESTION In women, low levels of the hormone estrogen contribute to loss of bone density, increasing the chances of a fracture. Might something similar occur in men who take drugs to suppress hormones such as testosterone to control and shrink the tumors of prostate cancer?
THIS STUDY examined the medical records of 50,613 men, aged 66 and older, diagnosed with prostate cancer, comparing those who received hormone therapy within a year with men who did not. About five years after their diagnoses, 19 percent of those in the hormone-therapy group had broken a bone, compared with 13 percent of those who did not take the drugs. The risk of fracture increased as the number of doses increased: Men who took one to four doses were 7 percent more likely to break a bone than those who took none of the drugs; five to eight doses, 22 percent; and nine or more doses in a year meant a 45 percent increased chance of fracture. Men who had surgery to remove one or both testicles, which produce testosterone, were 54 percent more likely to break a bone.
WHO MAY BE AFFECTED BY THESE FINDINGS? Men with prostate cancer. An estimated 220,000 men in the United States are diagnosed with this cancer each year; about 40 percent of them are treated with hormone-suppressing drugs.
CAVEATS The study determined risk only for drugs given during the first year after diagnosis; whether longer-term use of hormone-suppressing drugs would yield different results remains unknown. The study was not randomized.
BOTTOM LINE Men with prostate cancer may want to talk with an oncologist about the risks associated with hormone therapy before deciding on a particular treatment.
FIND THIS STUDY Jan. 13 issue of the New England Journal of Medicine; abstract available online at www.nejm.org.
LEARN MORE ABOUT hormone therapy for prostate cancer at www.urologyhealth.organd www.cancer.gov.
Folate may help some women avoid high blood pressure.
THE QUESTION Too much weight, too little activity, too much salt in the diet or too little potassium: All can make high blood pressure more likely. Does consumption of the vitamin folate also have an effect?