Steve - My understanding could very well be off, but my impression has
been that loss of bone mineral density is what's generally referred to
as "bone loss," inasmuch as it creates porosity (osteoporosis) where
bone was, which leads to weakening, fractures, etc.

Here's an excerpt from a study report published in CANCER, January 19,
2004:
  "In their study, Diamond and his colleagues reviewed all the
literature related to ADT and osteoporosis and fractures from 1986 to
2000. Their conclusions are based on nine studies that included a total
of 208 patients, according to their report in the Jan. 19 online issue
of Cancer.
   Diamond notes that, in some studies, bone mineral density
measurements were up to 17 percent lower in men with prostate cancer
treated with ADT than in men not receiving the hormone therapy. In
other studies, after only 12 months of ADT therapy, ADT contributed to
bone loss of up to 8 percent from the mid-spine and up to 6.5 percent
from the neck of the femur -- the thigh bone. These losses in bone
density may increase with time, Diamond says. In addition, the
researchers found fractures were more common among men receiving ADT
compared with men not receiving ADT.
   However, Diamond's team found drugs that prevent bone breakdown,
called bisphosphonates, such as pamidronate and zoledronate can prevent
bone loss and may even increase bone mass in these patients. Diamond
advises that since osteoporosis is usually a silent disorder, patients
should request a full osteoporotic evaluation from their doctor before
starting ADT. The evaluation should include bone density tests and
X-rays. If necessary, patients should be treated with bone-building
drugs, he adds.
   Diamond's team is beginning a study of 1,000 men with prostate
cancer receiving ADT. In the study, the men will be given either
zoledronate or a dummy drug. "This study will determine the 'true'
fracture risk in these high-risk patients, as well as the efficacy of
zoledronate for preventing bone loss and fractures," Diamond says.
   Dr. Clifford Rosen, a professor of nutrition at the University of
Maine, agrees that "fractures due to rapid bone loss from ADT is a
significant cause of problems in men with prostate cancer." Preventive
therapy with bone-building drugs and calcium and vitamin D is essential
to prevent painful fractures, he says. "Although more work needs to be
done, it is conceivable that the bisphosphonates may also reduce the
risk of subsequent bone cancer, another serious complication of
prostate cancer," he adds."

...end of quoted report segment...

You mentioned Steve Strum. He wrote in LIFE EXTENSION, updated
7/13/2004, "The mechanism of progressive bone loss during ADT relates
to the fact that androgens are known inhibitors of osteoclast function.
During ADT, this inhibition is lost and osteoclasts are activated,
allowing for promotion of bone loss (resorption). Testosterone,
therefore, is an anabolic steroid for bone, muscle and other tissues.
The deprivation of androgens pushes the balance towards catabolism or
breakdown.

...end of quote...

I agree that this recent study was redundant and perhaps akin to "How
to determine when to pull your finger away from a flame." I posted it
in an effort to counteract what seems to be a pervasive misconception
about ADT's relatively benign side effects.

Several months ago, I posted on this newsgroup my experience of severe
hot flashes (every five to seven minutes, 24 hours a day), muscle
weakness, fatigue, impaired concentration, etc. Megace (which itself
has some serious problems), Efexor, black cohosh and a half a dozen
other "natural remedies," provided no relief.

I mentioned that bone loss is "ONE of" the many side effects. Again,
quoting Steve Strum...

"..., there is a spectrum of side effects that may be seen with the use
of ADT. These untoward effects are highly variable from man to man.
Some men have no significant clinical symptomatology associated with
the use of ADT, while others state they cannot function with a
reasonable quality of life. The supportive care of the patient by the
physician in using ADT is vital to the acceptability of this very
important modality used in the treatment of prostate cancer. We can
improve the therapeutic index of ADT by finding solutions to the
problems that may occur as part of the androgen deprivation syndrome,
or ADS.

These are possible findings that may occur in men receiving ADT. Many
of these issues can be prevented, lessened, or resolved as part of the
supportive care directed to the PC patient. This improves the
therapeutic index of ADT. The PC patient and his partner, as a result,
have an improved quality and quantity of life.

- Sexual Decrease in libido;
- Decrease in erectile ability Penile shrinkage;
- Testicular atrophy
- Psycho-social Mood "swings;"
- Easy crying Depression;
- Hostility
- Endocrine Hot flashes;
- Poor blood sugar control in patients with diabetes
- Gynecomastia (breast enlargement)
- Musculo-skeletal Loss of energy, feeling weak;
- Aaches and pains in joints and muscles
- Decrease in strength and endurance;
- Muscle atrophy;
- Chronic fatigue-like symptoms;
- Osteoporosis
- Increased dryness and thinning of skin;
- Nails brittle and break easily
- Body mass weight increase due to increased body fat;
- Blood pressure control more difficult
- Central nervous system Decrease in short-term memory
- Alzheimer's-like symptoms (severe short-term memory
difficulties,inability to concentrate, etc.)
- Hematologic Anemia unrelated to blood loss, iron deficiency or
- Bone marrow involvement
- Chronic anemia
- Urinary decrease or increase in urinary symptoms
- Lipids increase in LDL cholesterol and/or triglyceride levels

... end of quote...

It's important that men and their partners are aware of the side
effects, because most physicians haven't a clue. NONE of the
oncologists and urologists who had twice prescribed Lupron and Casodex,
had cautioned me about ANY side effects other than "the Lupron shot
stings a bit at the injection site."

I'm doing my best to get the word out that ADT is not even close to
benign. It's a 40-year-old prescription that needs updating.
Significantly more research money must be secured to at least catch up
to much greater funding, and resultant successes, that breast cancer
research is enjoying.

Ken

Steve Jordan wrote...snip...

Hi Steve...I seem to recollect that studies have shown that men with
PCa have a predisposition towards low BMD, even prior to beginning
HT...Happy holidays, Ron