Trends in preventative bone health measures in prostate cancer: A cross-sectional study of patients at Calderdale and Huddersfield NHS foundation trust

Abstract

Background

There have been significant advances within the treatment of prostate cancer in recent years, which have had a positive impact on what has been historically a poor prognosis disease with limited treatment options. However, no treatment is without risk and adverse effects many of the treatment options are known to cause osteoporosis, fractures, and a reduction in bone mineral density.

Methods

A retrospective cross-sectional observational study involving secondary data analysis of 414 patients was used. Patients were split into three cohorts, cohort one- locally advanced prostate cancer treated with radiotherapy and 3 years of androgen deprivation therapy, cohort two- oligometastatic disease who receive first line radiotherapy and cohort three- metastatic prostate cancer encompassing hormone sensitive and castrate resistant disease.

Results

Analysis demonstrated the differing bone health interventions given or prescribed to prostate cancer: lifestyle advice, calcium and vitamin D supplements and bisphosphonates. Patients in cohort one had an overall prevalence of 21.8% given lifestyle advice, 15.2% prescribed calcium and vitamin D supplements and 7.3% prescribed bisphosphonates. Patients in cohort two had an overall prevalence of 2.4% given lifestyle advice, 22% prescribed calcium and vitamin D supplements and 7.3% prescribed bisphosphonates. Patients in cohort three had an overall prevalence of 9.6% given lifestyle advice, 67.3% prescribed calcium and vitamin D supplements and 43.8% prescribed bisphosphonates.

Conclusion

The study showed gaps in current cancer management when compared to the clinical recommendations. Having professional bodies clinical consensus on the topic would create clear guidance for clinicians to provide a more holistic overview.