This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Background:Prostate cancer is one of the most common malignancies among men and tumor growth is influenced by testosterone levels. Medications to lower serum testosterone called androgen deprivation therapies (ADT) are being used increasingly in the treatment of patients with locally advanced prostate cancer without metastatic disease (MO). Multiple studies have demonstrated accelerated bone loss among prostate cancer patients receiving ADT. Most of these studies have assessed the effects of long-term ADT (>6 months) on bone health. An increasingly common practice is to use short-term ADT (3-6 months) with GnRH agonists such as leuprolide in patients with MO prostate cancer. The impact of shorter courses of ADT on bone health is unclear.
Specific Aims :1) To establish a cohort of at least 60 prostate cancer patients without distant metastasis (MO) receiving short-term ADT (3-6 months).2) To determine the impact of short-term ADT in this cohort as measured by Dual Energy X-ray Absorptiometry (DXA), Quantitative Computed Tomography (QCT), and biochemical measures of bone remodeling.3) To compare the agreement/sensitivity of QCT and DXA for evaluating loss of bone mineral density (BMD) in these patients.4) To determine the influence of ethnicity on loss of BMD among MO prostate cancer patients receiving ADT.Hypotheses:1) Short-term ADT will lead to a >6% decline in BMD in MO prostate cancer patients over a 6 month period.2) QCT will not be strongly correlated with DXA (ro <0.4) for identifying low BMD in MO prostate cancer patients receiving short-term ADT.3) African American patients with MO prostate cancer receiving short-term ADT will have a significantly lower rate of BMD decline than Caucasian patients receiving similar therapy.Methods:Subjects:60 MO prostate cancer patients receiving short-term ADT (3-6 months) recruited from the Divisions of Urology and Radiation Oncology at UAB, and the Birmingham medical community with a goal of an approximately equal number of African-American and Caucasian subjects.Inclusion Criteria:1.) Consecutively seen newly diagnosed MO prostate cancer before initiation of short-term ADT (3-6 months) or within one month of initiation of short-term ADT.2.) Age > 40Exclusion Criteria:1.) History of primary or secondary osteoporosis (Lumbar/total hip T<-2.5)2.) History of metabolic bone disease (ie - Paget's)3.) Hyperthyroidism4.) Renal failure (serum creatinine > 2 mg/dL)5.) Glucocorticoid use within 6 months of enrollment6.) Bisphosphonate use within 6 months of enrollment7.) Chronic liver disease
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