Mohamad Nur-Vaizura, Soelaiman Ima-Nirwana, Chin Kok-Yong
Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia.
Endocr Metab Immune Disord Drug Targets. 2017 Nov 16;17(4):276-284. doi: 10.2174/1871530317666170919112757.
Prostate cancer is the most prevalent non-cutaneous cancer in men, which causes significant mortality among the patients. Since prostate cancer cells are stimulated by androgen, effective androgen ablation in men is one of the essential strategies in the management of prostate cancer.
Several treatment options are available for different stages of prostate cancer. Hormone therapy known as androgen deprivation therapy (ADT) is the first line treatment used to treat advanced prostate cancer. Chemical castration by gonadotropin-releasing hormone agonists suppresses lutenizing hormone production, which in turn inhibits the production of testosterone and dihydrotestosterone. This will prevent the growth of prostate cancer cells. However, ADT causes deleterious effects on bone health because the androgens are essential in preserving optimal bone health in men.
Various observational studies showed that long-term ADT for advanced or metastatic prostate cancer was associated with decreased bone mineral density, as well as altered body composition that might affect bone health. Considering the potential impact of osteoporotic fracture, interventions to mitigate these skeletal adverse effects should be considered by physicians when initiating ADT on their patients.
前列腺癌是男性中最常见的非皮肤癌，导致患者中相当高的死亡率。由于前列腺癌细胞受雄激素刺激，男性有效的雄激素去除是前列腺癌治疗的重要策略之一。
前列腺癌不同阶段有多种治疗选择。称为雄激素剥夺疗法（ADT）的激素疗法是用于治疗晚期前列腺癌的一线治疗方法。促性腺激素释放激素激动剂进行化学去势可抑制促黄体生成素的产生，进而抑制睾酮和双氢睾酮的产生。这将阻止前列腺癌细胞的生长。然而，ADT对骨骼健康有有害影响，因为雄激素对维持男性最佳骨骼健康至关重要。
各种观察性研究表明，晚期或转移性前列腺癌的长期ADT与骨密度降低以及可能影响骨骼健康的身体成分改变有关。考虑到骨质疏松性骨折的潜在影响，医生在对患者开始ADT时应考虑采取干预措施以减轻这些骨骼不良反应。
