ADT and Fractures?

[PrettyUnhappyGuy]

I saw some data today that after six months of ADT, the risk of hip fracture increases by 50%. This sounds alarming to me, but I can't find any data on how many men, out of 100, actually break their hip in their lifetime.

If it's 2 out of 100 and ADT increases the risk to 3 it's very different (and minor) then if it's 20 out of 100 and ADT increases it to 30. Anyone know the stats for this?

All I can find online is a rate of 9 per 1,000 person years, but this would mean 9 out of 12 men break their hip since living 80 years would mean 12 men would make up the 1,000 and this sounds awfully high and would make the rate for ADT above 100% which also doesn't make sense.

Anyone know anything about this? Thanks

[Tall_Allen]

If the average ADT duration is 20 years, 9 of 50 (=1000/20) men (18%) would break their hips while on ADT. What % break their hips in the same 20-year span while not taking ADT? If that represents a 50% increase, 12% of men would break their hips in the same 20-year span if not taking ADT.

[MarkS]

I have a slightly low bone mass density in my left hip, accoding to a DEXA scan. My 10 year hip fracture risk is 1.5% according to the report. If that increases to 2.25% as I'm on ADT for 2-3 years, I'm not too worried.

As a precaution, I have stopped cycling as a fall of my bike when I'm cleated in is a risk. Cycling is also not great for bone strengthening. Instead I'm exercising harder at the gym including jumping exercises and weight lifting.

[cancerfox in reply to MarkS]

Have you tried using toe clips with straps instead of the cleats? You can disengage from them fairly easily. 🦊

[MarkS in reply to cancerfox]

Yes, I started off with straps, but kept having zero speed topples, when I'm stopped but can't get my feet out in time and I get that horrible feeling that I'm going to fall and can't do anything about it! Personally, I find cleats better, particularly on my road bike where they are easier. On my mountain bike, where they are a bit tighter despite my best efforts to loosen them, I caught the side of a flooded pothole (we have lots of those in England!) and slammed straight down. I'll get back to it once I've stopped the ADT in a year.

[maley2711]

I saw some credible study the other day.....ADT over 12 months reduced BMD by 5%. Don't believe that study answered your question though. Before ADT, my T score indicated 4% hip fracure risk in next 10 years. However, using the FRAX calculator, and including fact of Mom's hip fracture, FRAX gave me an alarmingly high risk of both "major fracture" and hip fracture...which is worse, higher risk of PCa death with fewer months of ADT, or higher risk of hip fracture with more ADT????? Then ther is the 1-3% risk of a jaw problem if taking a bisphosphonate to combat the bone loss with ADT.

I think the most common fracture for PCa men is vertebral ?

[janebob99]

If you take supplemental estradiol, you can prevent osteoporosis from ADT and grow bone.

BMD vs time for estraiol vs Lupron ADT

[fast_eddie]

If you engage in regular weight training exercise you will strengthen your bones and reduce the risk of what I would call 'casual' hip fractures. I was on ADT for 6 months starting at age 66 . I continued the workouts I had been doing for more than 20 years prior to that while I was on ADT. I discontinued the ADT after that one time shot. 8 years later and I've had no problems with my hips or other joints.