A standard treatment for advanced prostate cancer is to suppress testosterone production by removal of the testes. Swedish researchers now report that men who undergo the procedure face an increased risk of hip fractures due to the bone-thinning disease osteoporosis.

Because of this, Dr. Gunnar Steineck of the Karolinska Institute, Stockholm, told Reuters Health that if “osteoporosis prevention is going to instituted, it should be started directly after castration.”

Steineck’s group used population-based registries in Sweden to examine the rate of bone fractures in more than 17,000 men diagnosed with prostate cancer who underwent testicular removal.

Fractures of the hip were most common, the authors report in the Journal of Urology, and the men also had double the normal rate of fractures of the spine, pelvis, thigh, and lower leg.

Twelve percent of men treated with castration had hip fractures in the 10 years following diagnosis, compared with a 5-percent rate over 10 years among men free of prostate cancer.

On the other hand, prostate cancer patients who did not undergo the procedure had a hip fracture rate only slightly higher than that of men without prostate cancer.

SOURCE: Journal of Urology, December 2004.