Feature Article

Optimising bone health during endocrine therapy for hormone sensitive cancer

Feature Article

Optimising bone health during endocrine therapy for hormone sensitive cancer

Sabashini K. Ramchand, Nicholas Russell, Mathis Grossmann

Figures

© prostock-studio/ stock.adobe.com model used for illustrative purposes only
© prostock-studio/ stock.adobe.com model used for illustrative purposes only

Abstract

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.

Key Points

  • 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.