As survival rates of patients with breast and prostate cancer increase, the need to address long-term adverse effects of cancer treatment on skeletal health is a priority to long-term survivorship. An individualised approach to assessment and management of all patients receiving endocrine therapy includes a baseline fracture risk assessment and ongoing surveillance. Targeted lifestyle changes and pharmacological therapies can help optimise skeletal health.
- Endocrine therapies for breast and prostate cancer are effective at reducing cancer recurrence but may have adverse skeletal effects that need to be appropriately assessed and managed to optimise benefit.
- Screening, surveillance and management of skeletal health should be tailored to the individual and involve a multidisciplinary team consisting of oncologists, endocrinologists, GPs, physiotherapists and exercise physiologists.
- Adequate dietary calcium, vitamin D and targeted exercise are recommended for all patients receiving endocrine therapy.
- For suitable patients, antiresorptive therapies have been shown to reduce bone mineral density loss, with some evidence of fracture risk reduction.