Document Detail

Hypocalcemic and normocalcemic hyperparathyroidism in patients with advanced prostatic cancer.
MedLine Citation:
PMID:  11549639     Owner:  NLM     Status:  MEDLINE    
PTH and ionized calcium levels were measured in 131 patients with advanced prostate cancer, all of whom had received at least first-line hormone therapy. Patients were classified into those in remission, those with stable disease, or those with progressive disease according to their prostate-specific antigen response and their clinical status. Thirty-four percent of all patients had PTH levels above the upper level of normal for controls of similar age (7.0 pmol/liter), and in 44% of these patients this was associated with a normal ionized calcium. Patients with proven bone metastases had significantly higher PTH levels than those without. (7.3 +/- 0.5 vs. 4.3 +/- 0.4 pmol/liter, P < 0.0005). There was evidence for a difference in the PTH levels between the three response groups. The PTH levels tended to be higher in patients with progressive disease. Thirty-seven of 65 patients (57%) with both progressive disease and proven bone metastases had elevated PTH levels. Mean levels of urinary deoxypyridinoline and cAMP were significantly greater in patients with high PTH than in those with a normal PTH. Treatment with oral calcium supplements in 32 patients with a high PTH seemed to have only a transient effect on elevated PTH or low ionized calcium levels. These data show that secondary hyperparathyroidism occurs frequently in patients with advanced prostate cancer, particularly in those with both progressive disease and bone metastases. The increased PTH levels are associated with an increase in bone resorption markers. These findings raise important questions about the role of PTH in progression of prostatic cancer in bone and the potential limitations of the use of bisphosphonates in patients with a raised PTH or low serum calcium.
R M Murray; V Grill; N Crinis; P W Ho; J Davison; P Pitt
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  86     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-10     Completed Date:  2001-10-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4133-8     Citation Subset:  AIM; IM    
Peter MacCallum Cancer Institute, Melbourne 3002, Australia.
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MeSH Terms
Aged, 80 and over
Amino Acids / urine
Bone Neoplasms / secondary
Calcium / blood*
Chemiluminescent Measurements
Cyclic AMP / urine
Hyperparathyroidism / blood,  etiology*
Hypocalcemia / blood,  etiology*
Middle Aged
Parathyroid Hormone / blood
Prostatic Neoplasms / blood*,  complications*,  pathology
Reg. No./Substance:
0/Amino Acids; 0/Parathyroid Hormone; 60-92-4/Cyclic AMP; 7440-70-2/Calcium; 90032-33-0/deoxypyridinoline
Comment In:
J Clin Endocrinol Metab. 2002 Apr;87(4):1910-1; author reply 1911   [PMID:  11932346 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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