Changes in bone health and skeletal-related events following implementation of a multidisciplinary consensus statement guiding surveillance and treatment of men undergoing androgen deprivation therapy for prostate cancer

Abstract

Purpose. Androgen deprivation therapy (ADT) is a cornerstone for inhibiting progression of prostate cancer (CAP) and improving survival. After previously establishing that men with CAP treated with ADT at our institution had significant skeletal morbidity, we evaluate the effectiveness of a multidisciplinary consensus statement (MCS) to improve outcomes.Materials and methods. We reviewed the records of men treated with ADT in our clinic. Only 38% of men had BMD studies, and 81% of those men had bone loss. Twenty-four percent of men had skeletal-related events (SREs). A minority of men were being treated for bone loss. We decided not to initiate therapy soon enough, and implemented an MCS to guide surveillance and treatment.Results. Four years after implementing the MCS, half of the men were still being treated with ADT and the average treatment length doubled. Significantly more men were being screened, bone loss remained stable, and there was a trend towards decreased SREs. Significantly more men were being treated for bone loss.Conclusions. After implementing an MCS we show stable bone mineral density and a trend towards decreased SREs despite doubling of the treatment length. We document significant improvement in our practice pattern.