Immediate dual energy X-ray absorptiometry reveals a high incidence of osteoporosis in patients with advanced prostate cancer before hormonal manipulation.
OBJECTIVE
To examine the incidence of osteoporosis in patients with advanced prostate cancer (using forearm densitometry) before commencing androgen deprivation therapy (ADT), as osteoporotic fractures are more frequent in patients with prostate cancer who have undergone either medical or surgical castration, because of rapid loss of bone mass.


METHODS
In all, 174 patients (mean age 74.6 years, range 46-90) with advanced prostate cancer presented over 2 years. Their forearm bone densitometry values were compared with those from 106 age-matched controls (mean age 74.3 years, range 66-90).


RESULTS
Of the 174 patients, 73 (42%) were osteoporotic (t score <or=- 2.5) and 65 (37%) were osteopenic (t score - 1 to - 2.4). This compares with a 27% incidence of osteoporosis in the control group (P = 0.022). There were also no significant correlations between prostate specific antigen levels, Gleason score, tumour stage, biochemical markers and the presence or absence of osteoporosis risk factors.


CONCLUSIONS
Patients with advanced prostate cancer requiring ADT have a high incidence of osteoporosis before treatment. In addition, osteoporosis in these men cannot be predicted from clinical or biochemical values. Therefore, bone densitometry should be used in all patients with advanced cancer requiring ADT, as the results have implications for the choice of cancer therapy and the prophylaxis for osteoporosis.
Hussain
S A
SA
Department of Urology, Wirral Hospitals NHS Trust, Wirral, UK.
Weston
R
R
Stephenson
R N
RN
George
E
E
Parr
N J
NJ
D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D015519:Bone Density / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D011471:Prostatic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal