Turkish Journal of Geriatrics 2003 , Vol 6, Issue 4
THE EFFECT OF ANDROGEN DEPRIVATION THERAPY ON BONE MINERAL DENSITY IN PATIENTS WITH ADVANCED PROSTATE CANCER
Sertaç YAZICI, Murat KOŞAN, Onur KAYGISIZ, Mesut TÜL, Öztuğ ADSAN
Ankara Numune Eğitim ve Araştırma Hastanesi, 2. Üroloji Kliniği, Ankara Osteoporosis is an important complication of androgen deprivation therapy (ADT). ADT by either orchiectomy or treatment with a gonadotropin releasing hormone agonist decreases bone mineral density (BMD) and increases fracture risk. We assess the efficacy of different types of ADT on BMD in patients with advanced prostate cancer without bone metastases. Patients with M0 prostate cancer, no treatment of any kind of hormone therapy and PSA levels below 100ng/ml were enrolled the study. Sixteen patients were randomized into two groups. Nine patients in group I had undergone orchiectomy and received an antiandrogen (biculatamide 50 mg/day) while 7 patients were treated with a long-acting LHRH (luteinizing hormone-releasing hormone) agonist plus biculatamide subsequently. Age-matched 16 otherwise healthy men were selected as a control group. BMD was determined at baseline and 6th month from each patient. The L1-L4 lumbar spines, right hip and femoral neck were measured using a dual energy x-ray absorptiometer (DEXA). For statistical analysis we used nonparametric Kruskal-Wallis test. P values < 0.05 were considered statistically significant. At month 6 bone mineral density decreased significantly at all areas in patients undergoing ADT. Bone loss was greater in patients undergoing bilateral orchioectomy than those treated with LHRH agonist but this did not reach statistical significance (p<0.05). The results of the current study indicate that men with prostate carcinoma who are treated with ADT have a significantly increased risk of low bone density independently types of ADT. Risk of fracture due to osteoporosis during ADT in prostate cancer is increased because of decreased levels of BMD. Keywords : Prostate cancer, Androgen deprivation therapy, osteoporosis