Immediate dual energy X-ray absorptiometry reveals a high incidence of osteoporosis in patients with advanced prostate cancer before hormonal manipulation

Authors


Mr N.J. Parr, Department of Urology, Ward 14, Arrowe Park Hospital, Wirral CH49 5PE, UK.
e-mail: nigelparr@dsl.pipex.com

Abstract

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.

PATIENTS AND 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 ≤− 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.

CONCLUSION

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.

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