Exploring the Skeletal Impact: Androgen Deprivation Therapy and Bone Health in Metastatic Prostate Carcinoma Patients

Androgen deprivation therapy (ADT) is the standard of care in the management of advanced prostate cancer or as an adjunct therapy. However, ADT is associated with a deleterious effect on bone health, resulting in a decrease in bone mineral density (BMD) and an increased risk for fracture. Our study is a prospective observational study that included 75 patients with metastatic ca prostate not on any osteoporotic treatment. Thirty-nine patients opted for hormonal treatment and 36 opted for orchidectomy. Parameters like Sr. Calcium, PTH, and PSA were analyzed before and 1 year after the treatment or surgery. All patients underwent DEXA screening, and T score for AP spine, left femur, and right femur were analyzed before and after 1 year of treatment or surgery accordingly. The change in Sr calcium, PTH, PSA, and the T score of AP spine and dual femur before and after the treatment was not dependent on age or grade of the disease or number of bony metastases. PSA and T scores were significantly decreased after both modalities, and there was no significant difference in the decrement of bone mineral density when both groups of medical (Hormonal) and surgical castration were compared. T scores of AP spine and dual femur are significantly reduced after initiation of hormonal therapy or after undergoing orchidectomy, reflecting that bone health is affected equally by both the modalities, and also the PSA shows a significant reduction, showing equal effectiveness of both the modalities.