Bone Mineral Density in Patients with Metastatic Prostate Cancer with or without Androgen Deprivation Therapy

Abstract

Prostate cancer commonly metastatize to skeletal sites. Androgen deprivation therapy (ADT), the primary treatment of metastatic prostate cancer, may result in osteoporosis. Bone mineral density evaluation during androgen deprivation therapy can detect patients at risk of osteoporotic fractures. Objectives: 1-To determine BMD (T-score) in patients with metastatic prostate cancer with or without androgen deprivation therapy. 2-To compare BMD in metastatic prostate cancer patients with age matched controls.  Study Design:  case-control study. Setting: Urology Department, Allied Hospital Faisalabad. Materials and Methods:  BMD of patients with metastatic prostate cancer (30 with ADT, 30 without ADT sampled with non-probability convenience method) were compared with age matched control group of 60 subjects. Inclusion criteria. Group-I:  60-80 years aged consecutive patients of carcinoma prostate who have been taking anti androgen therapy at least six months. Group-II: 60-80 years consecutive patients with metastatic prostate cancer who have not started any antidrogen deprivation therapy.

Group-III: 60-80 years aged healthy men from general population (preferably   from patient’s family) without prostate cancer. Exclusion criteria: From all groups, men taking for any reason, chemotherapy , radiation thyroxin, warfarin, corticosteroids, methrotrexate, anticonvulsants, post organ transplant therapy, chronic heparin, antipsychotic medications, long term lithium therapy and calciuretic diuretics  were not included in the study. Results: Out of 120 subjects, 31% had normal BMD, 27% osteopenia, 42% osteoporosis. In metastatic prostate cancer patients taking ADT (n=30), 7% subjects had normal BMD, 37% osteopenia and 56% osteoporosis. In metastatic prostate cancer patients without ADT (n=30), 13% subjects had normal BMD, 63% osteopenia, 24% osteoporosis. In healthy controls (n=60), 52% subjects had normal BMD, 33% osteopenia, 15% osteoporosis. Conclusions: BMD is affected by prostate cancer and its treatment. Bisphosphonates use should be rationalized according to the patients need.