Poster Presentation Clinical Oncology Society of Australia 2014 Annual Scientific Meeting

Bone health management of breast and prostate cancer survivors receiving hormonal therapy (#323)

Rachel Roberts 1 , Michelle Miller 1 , Michael O'Callaghan 2 , Bogda Koczwara 3
  1. Department of Nutrition and Dietetics, Flinders University, Adelaide, SA
  2. SA Health, Repatriation General Hospital, Urology Unit; South Australian Prostate Cancer Clinical Outcomes Collaborative; University of Adelaide, School of Paediatrics and Reproductive Health, Adelaide, SA
  3. Department of Medical Oncology, Flinders University, Flinders Medical Centre & Flinders Centre for Innovation in Cancer, Adelaide, SA

Aim
Breast and prostate cancer survivors, receiving aromatase inhibitors or androgen deprivation therapy respectively, are at increased risk of bone loss. The aim of this study was to investigate patterns of care and barriers to management of bone health in breast and prostate cancer survivors.

Method
We conducted two retrospective case note audits of breast and prostate cancer survivors between 1st July 2011 and 30th June 2012. Patients were being treated for curative intent at a metropolitan tertiary referral hospital.  An online national survey of health care providers managing breast or prostate cancer patients was also conducted.

Results
Forty-two women commenced hormone therapy. Fourteen women commenced an aromatase inhibitor; all received a bone mineral density scan. Nine (32%) of the 28 women who received Tamoxifen had a scan. Eleven (26%) were found to have osteopenia and four (9.5%), osteoporosis. Zoledronic acid was commenced by four. Six men received androgen deprivation therapy, with none receiving a Dual Energy X-ray Absorptiometry scan.
Forty-one health care providers responded to the online survey, an 11% response rate. Lack of time, training and reimbursement were identified as main barriers to bone health care delivery.

Conclusion
Bone health management for breast and prostate cancer survivors is variable and in some cases suboptimal. Diverse barriers to care delivery have been identified by providers.