Abstract
Androgen deprivation therapy (ADT) decreases bone mineral density (BMD) and increases the risk of fracture in men with prostate cancer. Smith has stated that prostate cancer patients show a degradation of BMD prior to ADT. We, therefore, studied the bone dynamics in Japanese prostate cancer patients prior toADT. BMD of the total hip, femoral neck, lumbar spine and forearm were measured by dual-energy x-ray absorptiometry (DEXA) before treatment in 53 prostate cancer patients without bone metastasis and in 16 patients with bone metastasis. Bone metabolism measurements of serum NTX and serum BAP were also carried out before treatment in 62 prostate cancer patients without bone metastasis and 22 patients with bone metastasis. Measurements in the total hip of nine of the 53 patients without bone metastasis indicated osteoporosis. Measurements of the femoral neck in eleven of the 53 patients indicated osteoporosis. Results show that Japanese prostate cancer patients without bone metastasis do not suffer from bone density degradation prior to ADT; only the Z score of the forearm showed a minus value. Serum NTX and BAP were significantly elevated in prostate cancer patients with bone metastasis compared with those without bone metastasis. No screening guidelines currently exist; however, patients at risk of decreased BMD should be screened and treated to prevent consequent fractures. Serum NTX and BAP monitoring of prostate cancer patients might facilitate the timely diagnosis of bone metastasis.
