Osteoporosbehandling och frakturrisk i samband med kastration vid prostatacancer

Abstract

Master thesis, Programme in Medicine. TITLE: Osteoporosis treatment and fracture risk associated with castration in prostate cancer. Background Approximately 10,000 people are diagnosed with prostate cancer every year in Sweden. For those with a metastasised disease castration through orchiectomy or chemically by LHRH agonist might be an option. It has previously been shown that this treatment increases the risk of osteoporosis and fractures for this group of patients. This paper is a retrospective study of medical records regarding the prevention and treatment of osteoporosis associated with castration through LHRH agonist and orciectomy in patients with prostate cancer. Aim To investigate the extent to which patients at Sahlgrenska hospital got fractures and which patients are treated for osteoporosis in connection with castration treatment through LHRH agonist or orchiectomy. To see how osteoporosis is diagnosed and treated and whether there are any predispositional factors that could help identify patients that would benefit from osteoporosis prophylaxis. Method Studying the medical records of 316 patients who underwent castration treatment through LHRH agonist or orchiectomy at Sahlgrenska in 2007 or 2008. The amount and type of fractures, whether the patients have undergone examinations such as bone densitometry scans and/or bone scintigraphy as well as the patients’ overall health and use of medications. Result Osteoporosis was prevented or treated in connection with castration treatment in just seven out of 316 cases at Sahlgrenska in 2007 and 2008. The risk of fracture after castration is considerably higher than in the normal population in the corresponding age group, 24,9 per 1000 person years in this material compared to 9 per 1000 person years. At present no specific guidelines for treatment and prevention of osteoporosis in connection with castration are in place at Sahlgrenska. Conclusion There is scope to co-­‐ordinate the criteria for prevention of osteoporosis and thereby an opportunity to lower the fracture rate in those patients. As this is a retrospective study of medical records with relatively limited material more research could be carried out in this area.