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Prostate Cancer - Bone Complications Issues
Ernest H. Rosenbaum, MD
Bone complications are not uncommon (approximately 80%) with advancing prostate cancer. Skeletal complications, such as fractures, are not uncommon, and this does affect the outcome in conjunction with the other side-effects of ADT.
With longer-term follow up, five to fifteen percent develop androgen-resistant metastatic cancer with spinal cord compression, and early observation and diagnosis, often requiring surgery which can be effective.
Prolonged exposure to ADT promotes the osteoporotic fracture risk. Fractures were noted in 76% and vertebral fractures in 18% of ADT-treated patients. Costs for the LHRH hormonal treatments can also be a problem, depending on the patient's insurance - up to $3-5,000.00 every three months with additional costs for bisphosphonate treatments.
Recent reports have verified that bisphosphonate treatment side-effects caused osteonecrosis (bone damage) of the jaw and renal insufficiency.
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