title: Testosterone recovery and changes in bone mineral density after stopping long-term luteinizing hormone-releasing hormone analogue therapy in osteoporotic patients with prostate cancer.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Fifteen patients receiving LHRH analogue therapy for > or = 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.
  
  
  RESULTS
  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%.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Arrowe Park Hospital, Wirral NHS Trust, Liverpool, UK. robin.weston1@btopenworld.com
authors.forename: Robin
authors.initials: R
authors.lastname: Weston
authors.forename: Asad
authors.initials: A
authors.lastname: Hussain
authors.forename: Emmanuel
authors.initials: E
authors.lastname: George
authors.forename: Nigel J
authors.initials: NJ
authors.lastname: Parr
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects; D017273:Goserelin / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced* / Q000378:metabolism; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D013739:Testosterone / Q000378:metabolism*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D017273:Goserelin; D013739:Testosterone; D017430:Prostate-Specific Antigen