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How can hormone treatments for cancer cause osteoporosis?

David Slovik, MD
Endocrinology Diabetes & Metabolism
There is a growing awareness that hormone treatments for breast and prostate cancers can harm bone health. Hormones can trigger the growth of certain kinds of cancer cells. By reducing levels of particular hormones, the treatments in question slow the growth of the cancer. But because some of these same hormones help keep bones healthy, blocking them also increases the risk of osteoporosis. 
 
Aromatase inhibitors, which block estrogen production, have been found to reduce deaths from certain types of breast cancer and are more effective than tamoxifen in preventing the cancer from recurring. That makes them a compelling treatment option. But because estrogen slows bone resorption, lowering levels of this hormone can speed bone loss. As a result, women taking these drugs are at greater risk of spinal and other fractures. 
 
Similarly, men with prostate cancer who undergo androgen deprivation therapy, which lowers levels of male hormones, are at greater risk of bone loss and fractures. As a result, anyone on these therapies should talk to his or her doctor about protecting bone health with regular screenings and appropriate preventive measures, such as calcium and vitamin D supplementation or perhaps medication to prevent bone loss.

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