MONDAY, April 27 (HealthDay News) -- Though proven effective, treating prostate cancer with the testosterone-lowering treatment known as androgen deprivation therapy may raise men's risk for developing bone fractures and fatal cardiovascular disease, a new study suggests.

The likelihood of developing either side effect remains low, the researchers noted. But the study shines fresh light on the question of how best to weigh the potential benefits of androgen deprivation therapy (ADT) against the potentially serious complications that can ensue.

"It is important to point out that these adverse outcomes due to ADT are all preventable, so it's up to a patient's doctor to be vigilant of changes in either cardiovascular or skeletal health that might develop as a result of the therapy," said the study's lead author, Lockwood Taylor, a doctoral candidate in the division of epidemiology and disease control at the University of Texas Health Science Center in Houston.

The findings will appear in the June 1 issue of Cancer.

To assess side effects from ADT, Taylor and his colleagues reviewed 14 studies from 1966 to 2008 that focused on skeletal and cardiovascular side effects linked to ADT among men battling prostate cancer.

They found that ADT boosted the risk for overall fracture by 23 percent relative to men with prostate cancer not undergoing treatment.

Similarly, the chances of dying from heart disease were 17 percent higher among men with cancer on ADT than those not on ADT.

They also pointed to two large studies that had indicated a substantial increase in the risk for developing diabetes among ADT patients.

"It would certainly be important to point out that, although we observed some statistically significant increases in the relative risk for these side effects, the absolute risks are still very low," Taylor stressed.

"But I would say that doctors should certainly monitor their patients on ADT for changes in bone mineral density, and, if they see a decrease, then they should consider some preventive therapies," he advised. "They should also be vigilant for abnormal lipo [blood fat] profiles, in terms of cholesterol levels and serum levels of insulin, which are markers for both cardiovascular and skeletal fracture."

He said that doctors could prescribe statin drugs to help lower cholesterol, while encouraging lifestyle changes to improve diet and physical activity.

Dr. Nelson Neal Stone, a clinical professor of urology and radiation oncology at the Mount Sinai School of Medicine in New York City, said that the findings "reinforce what we already know".

"It's been well known for a while that ADT boosts a patient's risk for fracture, just like it happens among women who go on anti-estrogen therapy for breast cancer," Stone noted. "And there have been several studies published in the last three to five years that find that men who go on the therapy are at an increased risk for all sorts of cardiovascular issues."

"While we all know that this therapy is needed to prevent the progression of metastases, it is true that while you are preventing a serious event on the one hand you are potentially putting the patient at risk," Stone said.

"So the bottom-line is that we have to be careful about who we put on ADT," he said. And research into preventive techniques needs to continue, he said, "because the therapy obviously entails some potentially severe side effects."

More information

The American Cancer Society has more on prostate cancer  .

MONDAY, April 20 (HealthDay News) -- A new study delivers a lifesaving message to older men about the potentially deadly skin cancer known as melanoma: If you can't examine your own back, have a loved one take a look, and if there's something suspicious, see a doctor.

"We were trying to understand why it is that when a doctor finds a melanoma, it usually is thinner compared to a person finding it by himself," said Alan C. Geller, a senior research scientist at the Harvard School of Public Health, and a co-author of one of two reports on melanoma in older men that appears in the April issue of the Archives of Dermatology.

Detecting a melanoma early, while it is thin, is an essential first step in surviving the skin cancer, said Dr. June K. Robinson, editor of the journal and a professor of clinical dermatology at the Northwestern University Feinberg School of Medicine, who wrote an accompanying editorial.

"The numbers are startling," she said. "If it is diagnosed at an early stage, the chance of survival is 90 percent. At a later stage, it is 20 percent."

There will be more than 62,000 cases of melanoma diagnosed in the United States this year, the U.S. National Cancer Institute estimates, and 8,420 Americans will die of the cancer. Half of those deaths will be in white men over the age of 50.

So, a group led by Dr. Susan M. Swetter of Stanford University interviewed 227 men aged 40 and older within three months after they had been diagnosed with melanoma. A quarter of them had tumors more that two millimeters thick -- about a third of the thickness of a pencil eraser, but enough to mark a dangerous borderline for effective treatment.

Analysis of the data by a group led by Geller found that men whose melanomas were detected by physicians tended to be older, and that 46 percent of the physician-detected melanomas were on the back.

"The back is the place that should be examined by a doctor and by the person himself," Geller said. "We found that one of the major reasons for doctors finding thinner melanomas was that they were more carefully examining the back. If you do it yourself and see something unusual, go to a doctor and say, 'Give me a referral to a dermatologist.' "

Dermatologists are trying to publicize that message because "of cancers in general in the United States, the only one in which the mortality rate is not dropping is melanoma," Geller said.

This is one appropriate occasion for a man to turn his back on his wife, Robinson said. "Most men in Western society depend on the women in their lives to mediate medical care -- nagging, scolding, reminding," she said. "And the places where melanoma occur more readily are hard for the man to see -- the back, the top of a bald head, behind the ears. With women, melanoma is more likely to occur on the lower leg."

When the inspection is made, "they should be asking the spouse to check for moles with border irregularity, color variation over the surface and with greater than six millimeter diameter," Robinson said. "You don't have to run to a doctor immediately. They grow at their own rate of speed. If you think you see suspicious features, come back in a month, and if it changes, go to the doctor."

One reason why doctors found the melanomas earlier was that they looked for them, said Dr. Steven Wang, director of dermatologic surgery and dermatology at Memorial Sloan-Kettering Cancer Center in Basking Ridge, N.J.

"It's very important for middle-aged and older men to see a physician for a total body examination," Wang said. "We don't have any effective cure for late-stage melanoma. Only early diagnosis followed by complete removal can improve the prognosis."

The study "highlighted what we suspected," Wang said. "This population, middle-aged and older men who might be more cavalier about their medical care, needs to be more aware of the danger associated with undiagnosed and untreated melanoma."

More information

The complete story on melanoma is told by the U.S. National Cancer Institute.