(ChemotherapyAdvisor) – Recommended doses of vitamin D and calcium are inadequate to prevent bone loss in men with metastatic prostate cancer who have been treated with androgen deprivation therapy, according to researchers from Wake Forest Baptist Medical Center, Winston-Salem, NC. This conclusion is based on a review article entitled “Calcium and Vitamin D Supplementation during Androgen Deprivation Therapy for Prostate Cancer: A Critical Review,” which was published in the July issue of The Oncologist.
Prostate cancer that has metastasized to bone is a major source of morbidity and mortality in men. The condition is often treated with androgen deprivation therapies such as leuprolide (Lupron®, Viadur®, Eligard®), goserelin (Zoladex®), triptorelin (Trelstar®), and histrelin (Vantas®). A major side effect of this therapy is loss of bone mineral density, which leads to severe bone fractures in these patients. Consequently, supplementation with calcium and/or vitamin D is recommended.
To further understand the clinical impact of this recommendation, the authors of this article “reviewed guidelines for calcium and vitamin D supplementation and the results of clinical trials of calcium and vitamin D supplementation on bone mineral density in men with prostate cancer undergoing androgen deprivation therapy.” Based on the review of 12 clinical trials, the authors found despite the fact that men undergoing androgen deprivation receive the daily recommended doses of 500 to 1,000 mg calcium and 200 to 500 IU vitamin D per day, they still lose bone mineral density.
Based on this observation, the authors drew the following conclusions. “The doses of calcium and vitamin D that have been tested are inadequate to prevent loss of bone mineral density in men undergoing androgen deprivation therapy,” they wrote. “In light of evidence that high levels of dietary calcium and calcium supplement use are associated with higher risks for cardiovascular disease and advanced prostate cancer, intervention studies should evaluate the safety as well as the efficacy of calcium and vitamin D supplementation in these men.”