WSLHD research finds 80% of prostate cancer patients are missing crucial bone health assessments

Every man commencing hormone therapy for prostate cancer should have a bone mineral density (DXA) scan to assess bone health before starting treatment, according to new research from Western Sydney Local Health District (WSLHD) in Westmead Health Precinct.

The study found that only 20 per cent of men were being referred for a bone density scan, despite it being recommended for all patients starting hormone therapy.

Androgen deprivation therapy (ADT), also known as hormone therapy, is a highly effective treatment for prostate cancer but it can result in thinning of the bones, or osteoporosis, as a side effect.

This increases the risk of fractures and other complications. A bone mineral density scan (BMD) (dual x-ray energy absorptiometry scan or DXA scan) – is a simple, widely available and painless test that can assess bone thickness and guide treatment to strengthen and thicken bones if required.

The WSLHD team leading the study involved collaboration between the Rheumatology, Radiation Oncology and Medical Oncology Departments at Westmead Hospital.

Lead researcher Associate Professor Peter Wong, Head of the Department of Rheumatology at WSLHD, said: “Osteoporosis or thin bones is often thought of as a disease of women after the menopause. However, thin bones can be caused by hormone therapy used to treat prostate cancer”.

“As the treatments for prostate cancer are getting more and more effective – and as such, men are living longer (which is good!) –  the implications of poor bone health are going to become more important. Poor bone health leads to thin bones and fractures.”

The study used data from national databases to assess the frequency of bone density scans in men starting hormone therapy for prostate cancer.

The results showed that only 20 per cent of men were being referred for a DXA scan, despite the fact that the scan is widely available in Australia, covered under Medicare and recommended for all men starting hormone therapy.

“We want the public to know about this finding so all men starting hormone therapy for prostate cancer have a bone health assessment which includes a bone mineral density (DXA) scan,” A/Professor Wong said.

The study was published in the Medical Journal of Australia this year.