title: The role of bisphosphonates in the treatment of prostate cancer: recommendations from an expert panel.
abstract: In this study, we provide consensus guidelines for the use of bisphosphonates in men with prostate cancer. To this end, an expert panel composed of urologists, medical oncologists, radiation oncologists, and endocrinologists met to review current clinical evidence for the use of bisphosphonates in patients with different stages of prostate cancer to derive consensus recommendations. Physicians should be proactive in monitoring bone loss in patients receiving long-term androgen-deprivation therapy for prostate cancer. Further study is needed before recommending the routine use of bisphosphonates in men with nonmetastatic prostate cancer. However, if a patient has clinically significant bone loss, use of a bisphosphonate to prevent further compromise of bone integrity should be strongly considered, regardless of hormonal and metastatic status. Bone scans are the preferred method for the identification of bone metastases. In patients with hormone-refractory prostate cancer and bone metastases, zoledronic acid is the only bisphosphonate indicated for the prevention of skeletal complications. In conclusion, patients with prostate cancer are at high risk for skeletal morbidity. Bisphosphonates have been shown to prevent cancer treatment-induced bone loss in men receiving androgen-deprivation therapy as well as skeletal complications in men with bone metastases. However, further study of the use of bisphosphonates across the clinical spectrum of prostate cancer is needed.
authors.affiliation: Universite de Montreal, Quebec, Canada. fred.saad@ssss.gouv.qc.ca
authors.forename: Fred
authors.initials: F
authors.lastname: Saad
authors.forename: Celestia S
authors.initials: CS
authors.lastname: Higano
authors.forename: Oliver
authors.initials: O
authors.lastname: Sartor
authors.forename: Marc
authors.initials: M
authors.lastname: Colombel
authors.forename: Robin
authors.initials: R
authors.lastname: Murray
authors.forename: Malcolm D
authors.initials: MD
authors.lastname: Mason
authors.forename: Andrea
authors.initials: A
authors.lastname: Tubaro
authors.forename: Claude
authors.initials: C
authors.lastname: Schulman
mesh_terms: D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D004164:Diphosphonates / Q000627:therapeutic use*; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008297:Male; D017410:Practice Guidelines as Topic; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid