To evaluate bone health in cancer survivors.
A total of 79 cancer survivors enrolled in prospective study evaluating bone health were included. Fracture risk of was evaluated by dual-energy x-ray absorptiometry densitometry (DEXA) scan. Parameters evaluated were T score, Z score, BMD and BMC. Risk of fracture was evaluated by age, height, body mass index, weight, type of cancer, treatment by chemotherapy, radiotherapy, hormonal therapy, exercise, performance status and ability to perform house hold activities. Pearson's chi-squared test was used to evaluate factors effecting osteoporosis. A p value of ≤ 0.05 was considered significant. All analyses were performed using the IBM SPSS statistics version 22.0 software package (SPSS Inc., Chicago, IL, USA).
Median age was 53 yrs (range 26-79yrs). The study included 46 patients with gynecological malignancies and 23 patients with breast cancer. Eight two percent received chemotherapy, 89% were subjected to radiotherapy, 25% received hormonal therapy. Median BMI was 23.83 kg/m2 (16.4-36.4 kg/m2), median weight was 58 Kg (35-83 Kg), median height was 151 cms (131-166 cms). Median performance status was 80 (range 60-100). Brisk walking >30 minutes per day was done by 20%, 53% were actively performing house-hold work. T score spine median was -2.6 (range 0 to -5.9), Z score spine median -1.5 (range 0.7 to -4.3), median BMD spine 0.76 (range 0.40-1.05) and median BMC spine was 39.02 (range 19.12-66.65). T score femur neck was median -1.4 (range 2.5 to -3.9), Z score femur neck median-0.6 (range 2.7 to -3.7), BMD femur neck median 0.72 (range 0.41-3.8) and median BMC femur neck was 3.64 (range 0.83-51.09). Sixty six per cent of cancer survivors had osteoporosis, 25% had osteopenia and 9% had normal bone health. Factors significantly associated with osteoporosis included weight 60yrs (p = 0.002), non breast cancer primary (p = 0.031).
In the study 91% of patients had impaired bone health. Every 2 out of 3 survivors had osteoporosis and 1 out of 4 had osteopenia. Only 20% survivors were routinely brisk walking >30 minutes. Findings within our study lay emphasis on lifestyle modification, nutrition and pharmacological interventions to improve bone health in cancer survivors in this part of the subcontinent.
Clinical trial identification
Legal entity responsible for the study
Dr Aman Sharma
All authors have declared no conflicts of interest.