Prostate cancer therapy linked to falls

By Martha Kerr

NEW YORK (Reuters Health) - Older men with prostate cancer who are on long-term hormone therapy often become weaker physically, leading to an increased risk of falls and injury, researchers report.

Hormone therapy, also known as "androgen deprivation therapy," involves the use of medications or other treatments to reduce body levels of testosterone and related hormones, which have been shown to stimulate the growth of prostate cancer.

"Although research has shown that androgen deprivation therapy can lead to lean muscle mass loss and decreased strength, more research is needed to determine if older patients are at a higher risk for falling as a result of androgen deprivation therapy," Dr. Supriya G. Mohile commented to Reuters Health.

To investigate this issue, Mohile at the University of Rochester, New York, and colleagues conducted functional and physical assessments of 50 men, aged 70 or older, who were receiving androgen deprivation therapy for prostate cancer.

Impairment in activities of daily living was found in 24 percent of the patients, 56 percent had abnormal physical performance findings, and 22 percent reported falls during the previous 3 months, the investigators report in the journal medical journal Urology.

Deficits occurred in all components of performance, including balance, walking, and chair stands.

"This study as well as recent research from other investigators really highlights the fact that a significant proportion of older men receiving (androgen deprivation therapy) have deficits in physical performance and either are falling or are at risk for falling," Mohile told Reuters Health.

"Falls in older patients are associated with the development of fractures...and an increased risk of mortality."

There is an increased recognition for the need to screen older men for osteoporosis before they begin androgen deprivation therapy, and to provide treatment if needed. Currently, "the assessment of fall risk and physical performance is not commonly performed in the clinical setting," Mohile observed.

A "comprehensive geriatric assessment should be a key part of the treatment approach for older cancer patients (especially aged 70 and over) and can help detect these underlying fall risks and physical performance," Mohile advised.

SOURCE: Urology, August 2008.