Compromission de la masse osseuse et de la motricité chez des malades traités par blocage androgénique

Therapeutic androgen suppression induces hypogonadism with effects on the patient’s locomotor system. We tried to verify these effects on a group of patients with prostate cancer presenting a prolonged life expectancy. Thirty six patients treated by radical prostatectomy (mean PSA: 7.2±1.3 ng/ml) had stage pT3 cancer in 24 cases and pT2c in 12 cases. The first group was treated by radiotherapy and androgen suppression and the second group was treated by androgen suppression alone after surgery. After 24–36 months (mean=28.4 months), staging was performed by CT scan, bone scintigraphy, PSA and testosterone assays, and bone densitometry. An identical assessment was repeated an average of 53.1 months after starting treatment. Staging never demonstrated disease recurrence; PSA was between 0.01 and 0.4 ng/ml (mean: 0.11 ± 0.96 ng/ml) and the mean plasma testosterone was 0.4 ng/ml. The first bone densitometry revealed osteopenia: T score =?1.71±0.91; Ward score=?2.22±0.917; BMD (bone density) =0.879±0.126. The second bone densitometry showed progression to osteoporosis and a significant 6% reduction of the BMD: T Score=?1.95±0.84; Ward score=?2.4±0.87; BMD=0.819±0.12. During this time interval, 3 patients developed a fracture of the femur and a fourth patient fractured two ribs after physical exertion. All patients compalined of decreased physical strength and very marked fatigability. We can conclude that androgen suppression causes an alteration of locomotor function and quality of life of patients treated for prostate cancer and presenting a long life expectancy.