Preventing bone complications in patients with prostate cancer: The emerging role of zoledronic acid

Objective: Advances in early detection of disease progression and treatment of advanced disease have prolonged the survival of patients with prostate cancer. However, these patients develop significant skeletal morbidity as a result of bone metastases, and treatment-related bone loss undermines skeletal integrity. This paper reviews the role of bisphosphonates in the treatment of prostate cancer during different stages of the disease. Methods: Published studies were identified through MEDLINE searches, review of bibliographies of relevant articles, and review of abstracts from Scientific meetings. Results: Skeletal complications arising from bone loss occur during several stages of prostate cancer. Zoledronic acid has been shown to increase bone mineral density in men receiving androgen deprivation therapy and is the only bisphosphonate that has demonstrated statistically significant reduction in skeletal morbidity in patients with bone metastases. Recently, an algorithm was developed recommending the use of zoledronic acid for the prevention of skeletal complications arising across the continuum of skeletal complications from treatment-induced bone loss and bone metastases. Conclusions: Zoledronic acid is the only bisphosphonate that has demonstrated effectiveness for increasing bone mass and preventing skeletal complications in patients with prostate cancer. Zoledronic acid should be considered for the treatment and prevention of skeletal morbidity related to prostate cancer. (C) 2004 Published by Elsevier B.V.