Prostate Cancer Patients Have Higher Osteoporosis, Osteopenia Risk

Patients with prostate cancer may benefit from bone mineral density screenings prior to initiation of therapy, researchers concluded.

The results of a recent study suggest that prostate cancer is a risk factor for osteoporosis and osteopenia, particularly in patients who tend to be slender.

The study, published in the February 2014 edition of Urology, suggests that testing bone mineral density prior to initiating, and throughout, therapy may be beneficial in patients with prostate cancer.

Researchers performed a retrospective analysis on medical records of patients diagnosed with prostate cancer, and of matched controls. The initial assessment included various health markers for participants in each group, including bone mineral density before and after treatment for participants diagnosed with prostate cancer.

Prior to matching the participants based on propensity scores, participants in the prostate cancer group tended to be older, to have lower levels of serum testosterone, and to have higher prostate-specific antigen levels than participants without prostate cancer.

When researchers matched 502 participants in the prostate cancer group to 502 participants in the control group, researchers found no statistically significant differences in basic health characteristics. They did, however, note higher prostate-specific antigen levels and lower neck femur bone mineral density in participants in the prostate cancer group.

The prevalence of osteoporosis and osteopenia was 9.4% and 25.7%, respectively, among participants in the osteoporosis group, and 3.4% and 27.7%, respectively, in the control group. Prior to propensity score matching, prostate cancer correlated significantly to osteoporosis as well, achieving an odds ratio of 2.96, the researchers noted.

When assessing the significance of each variable according to its propensity score, the researchers found a significant correlation between prostate cancer and osteoporosis.

Bone metastasis and low body mass index were independent predictors of osteoporosis in participants with prostate cancer, according to multivariate analysis.

Although there is no consensus regarding the baseline bone mineral density prior to treatment for prostate cancer, the researchers suggest performing bone mineral density screenings prior to initiating prostate cancer therapy, and periodically throughout treatment.

“Because bone mineral density is the most important predictor of osteoporotic fracture, it seemed prudent to recommend that all patients diagnosed with prostate cancer and initiating androgen deprivation therapy undergo a baseline bone mineral density measurement, which is to be repeated every 6 to 12 months for patients with baseline osteopenia or osteoporosis, and every 1 to 2 years for patients with normal baseline bone mineral density,” the authors wrote. “… The findings of our study suggest that consideration should be given to performing baseline bone mineral density in men with prostate cancer, and the measurement of bone mineral density is a logical first step in the clinical strategy to avoid or minimize potential bone-related complications.”