Awareness, concern, and communication between physicians and patients on bone health in nonmetastatic prostate cancer.

246 Background: Little is known about physicians' (MDs) and prostate cancer (PC) patients' (pts) levels of awareness or concern about bone health or how/when MDs discuss bone health with at-risk pts. An online survey was conducted to explore these issues and evaluate knowledge levels and attitudes about cancer treatment-induced bone loss (CTIBL). METHODS: A total of 4,403 oncologists and 4,961 urologists randomly selected from the American Medical Association master physician list, 533 oncologists from the Harris Physician Panel, and 3,400 pts from Harris' Chronic Illness Panel were invited to participate in the survey. Surveys lasted on average 10 minutes; MD and pt surveys were weighted to be representative of the populations of interest. Descriptive statistical analyses were used. RESULTS: Of those invited, 113 urologists and 63 oncologists completed the survey. The 186 PC pts who answered the survey (median age, 74 yrs; median time since PC diagnosis, 88 mos.) included 96 pts with nonmetastatic disease. Current or prior ADT was reported by 96% of pts. Of these pts, 48% were aware of CTIBL, 23% of whom were concerned about it and 55% of whom had discussed it with their MD. As many as 46% of pts obtained information on bone health exclusively from their healthcare team, rather than seeking information from other sources. Both oncologists and urologists (98% and 90%) considered CTIBL to be a serious issue for their patients, however, more oncologists than urologists perceived that their pts were concerned about CTIBL (71% vs 36%). More oncologists than urologists expressed concern about fractures due to CTIBL (58% vs 46%), and indicated that treatment-induced fractures would require additional intervention (91% vs 76%), treatment interruption (61% vs 43%), or change in treatment (55% vs 42%). CONCLUSIONS: Bone health is considered a serious issue for patients with nonmetastatic PC treated with ADT by both oncologists and urologists. However, there remains a gap in physician-patient communication regarding CTIBL and its clinical consequences. As primary sources of information for pts, MDs should proactively educate pts on CTIBL, its consequences, appropriate monitoring, and treatment options.

Duke Scholars

Author Judd Wendell Moul Urology