Background
Prostate cancer is the most common cancer diagnosed in Australian men1. Androgen deprivation therapy (ADT) is an important treatment with improved disease control and mortality benefits2. However there are well recognised adverse effects especially increased bone loss leading to osteoporosis and fracture3. Despite this recognised outcome bone health remains poorly investigated and managed in this population4.
Aims
The John Hunter Re-fracture Prevention service partnered with Osteoporosis Australia to establish a pilot clinic to trial screening and management for bone health in men receiving ADT for prostate therapy.
Method
Patients who had been on in the past or were currently receiving ADT for prostate cancer were referred. On initial visit, fracture risk, medical history and medication exposure were reviewed. BMD and screening bloods were arranged. Lifestyle factors were reviewed and education given. Follow up was in person or via phone and results and options for management were discussed.
Results
52 men were reviewed in clinic. Average age was 71.8yrs. On review of risk factors for osteoporosis, 13% had previously had falls in the past 2 years and 11% had suffered minimal trauma fractures. Vitamin D prescription increased by 12% after clinic review and 1 in 4 men were identified to benefit from anti-resorptives. Patient health knowledge was assessed. 79% were not aware of bone risks with ADT however bone health was rated as very important on visual analogue scale (88% rated 9 or 10/10).
Conclusion
This pilot clinic has demonstrated that a focused prostate cancer ADT clinic may be a useful strategy to improve low screening and treatment rates for osteoporosis and improve patient knowledge. Future research to assess fracture rate and outcomes between men who attended the clinic and those who did not will be important.