Comprehensive care for bone health
Why is bone health important in ADT management?
Men with prostate cancer tend to be older and at elevated risk for bone mineral density (BMD) loss, regardless of ADT use.1
BMD loss occurs most quickly over the first 12 months of ADT and can continue thereafter
2.5% BMD decrease at total hip in first year2
4.0% BMD decrease at lumbar spine in first year1
It’s important that patients are educated on the effects ADT can have on bone health and are aware of how to optimize bone health.
Recommendations for healthcare providers managing bone health during ADT3
- Evaluate patient’s bone health and provide counseling
- Calculate 10-year fracture risk with country-specific FRAX® algorithm and evaluate vitamin D status (serum 25[OH]D) at baseline and annually
- Order DEXA scan within 1-6 months of starting ADT and every 1-3 years thereafter
- Counsel patients on ADT about calcium and vitamin D intake, smoking cessation, and physical activity such as resistance and high-impact training
- Mitigate risk of fracture for those with low BMD or those at risk
- Counsel patients on the importance of weight-bearing physical activity to reduce fracture risk and regular dental care if bone agents will be implemented
- Assess the patient’s fall risk and comfort with and safety of exercising
- Consider referring the patient for bone health agents such as denosumab, zoledronic acid, and alendronate as well as exercise physiology
Don’t overlook bone health during ADT —it’s important to mitigate BMD loss for optimal results during therapy
