Management of decreased bone mineral density in men starting androgen-deprivation therapy for prostate cancer
| Autor: | Neil Fleshner, Ian F. Tannock, Gary Naglie, Padraig Warde, Sarah Duff-Canning, Murray Krahn, Marc Leach, Henriette Breunis, Abbas H. Panju, Angela M. Cheung, George Tomlinson, Shabbir M.H. Alibhai |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Longitudinal study Urology Osteoporosis Article Androgen deprivation therapy Fractures Bone Prostate cancer Absorptiometry Photon Bone Density Internal medicine medicine Vitamin D and neurology Humans Vitamin D Life Style Aged Aged 80 and over Bone mineral Bone Density Conservation Agents Diphosphonates business.industry Prostatic Neoplasms Cancer Androgen Antagonists Middle Aged medicine.disease Surgery Osteopenia Bone Diseases Metabolic Calcium Epidemiologic Methods business |
| Zdroj: | BJU International. 103:753-757 |
| ISSN: | 1464-410X 1464-4096 |
| DOI: | 10.1111/j.1464-410x.2008.08156.x |
| Popis: | OBJECTIVE To determine whether clinicians discuss bone-specific side-effects with patients on androgen-deprivation therapy (ADT) for prostate cancer, or prescribe lifestyle and pharmacological interventions for low bone mineral density (BMD), as decreased BMD is a common side-effect of ADT, leading to increased risk of fracture. PATIENTS AND METHODS Sixty-six men (mean age 70.6 years) with non-metastatic prostate cancer and starting continuous ADT were enrolled in a prospective longitudinal study. BMD was determined by dual X-ray absorptiometry (DXA) at baseline. Patients were interviewed to obtain their medical histories, and charts were reviewed to determine whether clinicians documented potential bone side-effects in clinic notes, and made lifestyle and/or medication recommendations. Both were done at the start of ADT, and 3 and 6 months later. Patients were classified based on DXA T-score as having normal BMD, as osteopenic, or osteoporotic. RESULTS At baseline, 53% of patients had osteopenia and 5% had osteoporosis. Within 6 months of starting ADT, general side-effects and bone-specific side-effects of ADT were documented as being discussed with 26% and 15%, respectively. Clinicians recommended lifestyle interventions to 11% of patients. Pharmacological interventions (calcium, vitamin D, and/or bisphosphonates) were recommended to 18% of all patients within 6 months of starting ADT, and to 26% and 67% of osteopenic and osteoporotic patients, respectively. CONCLUSIONS A minority of patients is being informed of bone-specific side-effects of ADT. Lifestyle and drug interventions to prevent declines in BMD were recommended uncommonly. Practices around bone health for men starting ADT are suboptimal. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|