Which strategies have been demonstrated to be effective in managing bone loss in breast and prostate cancer survivors post hormone therapy, and how well are they employed in clinical practice? — ASN Events
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Which strategies have been demonstrated to be effective in managing bone loss in breast and prostate cancer survivors post hormone therapy, and how well are they employed in clinical practice? (#324)

Rachel Roberts 1 , Michelle Miller 1 , Bogda Koczwara 2
  1. Department of Nutrition and Dietetics, Flinders University, Adelaide, SA
  2. Department of Medical Oncology, Flinders University, Flinders Medical Centre & Flinders Centre for Innovation in Cancer, Adelaide, SA

Aim

Aromatase inhibitors and androgen deprivation therapy, as hormone therapy treatment for breast and prostate cancer respectively, increase risk of osteoporosis in cancer survivors due to accelerated bone loss. A literature review was conducted to examine evidence supporting bone health management strategies and identify current practice patterns in implementing these strategies.

Method

Cochrane, MEDLINE, PubMed and Scopus were searched for relevant literature.

Results

Randomised controlled trials on third generation bisphosphonates were reviewed. Participants in these trials who received alendronate, risedronate or zoledronic acid had significant increases to bone mineral density compared to those on placebo. The loss of bone mineral density for those taking placebo was despite standard procedure of calcium and vitamin D supplementation. Observational studies on bone health management adherence were also reviewed. Suboptimal care was provided in the form on bone mineral density screening, nutritional supplementation advice and bisphosphonate prescription.

Conclusion

Further research into the safety and efficacy of bisphosphonates from studies of longer duration are required, which may inform on fracture prevention. Easily accessible guidelines and strategies to address barriers to improved bone health management of breast and prostate cancer patients are required.

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