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Prospective Evaluation of Bone Mineral Density after Orchiectomy in Northern Indian Patients of Advanced Carcinoma Prostate

Harvinder Singh Pahwa* , Harvinder Singh Pahwa* , Jitendra Kumar Kushwaha** , Awanish Kumar** , Saumya Singh*** , Amit Singh**** , Gunjeet Kaur*****

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New Indian Journal of Surgery 7(3):p 219-225, Sept - Dec 2016. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.7316.1

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Abstract

 The prostate is an androgen­dependent organ. Prostate cancer, the second leading cause of death for men, is androgen dependent so androgen suppression remains the mainstay of treatment for advanced and metastatic disease. Cancer treatment induced bone loss is one of the complications associated with androgen deprivation therapy (ADT) in prostate cancer patients. It is of particular concern because it can lead to osteoporosis and bone fractures, which not only negatively impact patient quality of life but also overall survival. However, these studies were performed in western countries; moreover study of Japanese men with prostate cancer found that they had a low prevalence of osteoporosis that was not increased by ADT. Evaluation of bone mineral density changes along with biochemical markers was done on patients of carcinoma prostate undergoing androgen deprivation therapy in form of castration. Sixteen patients of carcinoma prostate who have under gone androgen deprivation therapy were enrolled in the study.They were followed within the period of 1 year to study BMD changes by dual­energy X­ray absorptiometry (DEXA) scan. BMD was measured at 0, 1, 3 & 6 months during follow­up after excluding bony metastasis in thelumbar spineand femoral neck. We found statistically significant loss of BMD after orchiectomy with BMD decreasing up to 2% at 1 month, up to 5% at 6 month at lumbar spine and a decrease of 2.2% at 1 months & 6.7% at 6 month at femoral neck (p< 0.001), resulting in an increased incidence of osteoporosis from 24% pre operatively to 48% 6 months after orchiectomy.


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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.7316.1

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