Prevention And Treatment Of Osteoporosis In Post-Menopausal Breast Cancer Survivors

2.50
Hdl Handle:
http://hdl.handle.net/10755/165645
Category:
Abstract
Type:
Presentation
Title:
Prevention And Treatment Of Osteoporosis In Post-Menopausal Breast Cancer Survivors
Author(s):
Waltman, Nancy
Author Details:
Nancy Waltman, Associate Professor, University of Nebraska Medical Center, College of Nursing, Lincoln, Nebraska, USA, email: nwaltman@unmc.edu
Abstract:
Breast cancer survivors are at increased risk for osteoporosis because of early menopause induced by chemotherapy and because they are not candidates for hormone replacement therapy (HRT). This pilot study examines the feasibility and effectiveness of a 1 year multi-component intervention for osteoporosis prevention and treatment in breast cancer survivors. The intervention consists of home based strength/weight training exercises; calcium; vitamin D; alendronate; education on osteoporosis; and facilitative strategies (including goal setting, coaching, and feedback, organized around Prochaska’s Transtheoretical model). An experimental group of 30 postmenopausal breast cancer survivors from one mid-western state are receiving all components of the intervention, and a comparison group of 13 breast cancer survivors (matched by body mass index and time since menopause) are receiving all components except the strength/weight training exercises. Feasibility is assessed by % adherence to each of the components of the intervention, and effectiveness by measures of bone mineral density (BMD) at hip, spine, and forearm over time (baseline, 6, and 12 months). This presentation will only include data on experimental subjects and will focus on adherence data and changes in bone mineral density 6 months into the study. At baseline, 88% of the 30 women had measurable bone loss (either osteopenia or osteoporosis), and bone loss correlated with decreased body weight and decreased body mass index. At 6 months, 6 of the 30 women had withdrawn from the study, and reasons for withdrawal included recurrence of breast cancer (n=2); normal BMD and not perceiving need for study (n=1); side effects of alendronate (n=1); cost of alendronate (n=1); and work or family stressors that interfered with study (n=1). At 6 months and for the 24 women remaining in the study, mean percent adherence for calcium and vitamin D supplements was 96.3%; alendronate, 96.5%; and arm and leg exercises, 96%. After 6 months of intervention, mean BMD (gm/cm2) had improved for the hip (.85 to .86) and spine (.96 to .97); however, there was measurable bone loss in the forearm (.52 to .49). For future studies: a) exercises will be added for the wrist and forearm; b) subjects will be encouraged to increase hand and ankle weights more rapidly; c) after 20 lbs, subjects will use machine rather than free form weights; d) future studies will be longer in duration; and e) biomarkers will be used to record early changes in bone formation and resorption. Breast cancer survivors should not have to suffer the consequences of osteoporosis just because they cannot take HRT; there are treatments besides HRT available. Breast cancer survivors should be targeted as a population at risk for osteoporosis and more emphasis should be placed on early diagnosis and treatment in this special population of women.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2001
Conference Name:
26th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
San Diego, California, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titlePrevention And Treatment Of Osteoporosis In Post-Menopausal Breast Cancer Survivorsen_GB
dc.contributor.authorWaltman, Nancyen_US
dc.author.detailsNancy Waltman, Associate Professor, University of Nebraska Medical Center, College of Nursing, Lincoln, Nebraska, USA, email: nwaltman@unmc.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/165645-
dc.description.abstractBreast cancer survivors are at increased risk for osteoporosis because of early menopause induced by chemotherapy and because they are not candidates for hormone replacement therapy (HRT). This pilot study examines the feasibility and effectiveness of a 1 year multi-component intervention for osteoporosis prevention and treatment in breast cancer survivors. The intervention consists of home based strength/weight training exercises; calcium; vitamin D; alendronate; education on osteoporosis; and facilitative strategies (including goal setting, coaching, and feedback, organized around Prochaska’s Transtheoretical model). An experimental group of 30 postmenopausal breast cancer survivors from one mid-western state are receiving all components of the intervention, and a comparison group of 13 breast cancer survivors (matched by body mass index and time since menopause) are receiving all components except the strength/weight training exercises. Feasibility is assessed by % adherence to each of the components of the intervention, and effectiveness by measures of bone mineral density (BMD) at hip, spine, and forearm over time (baseline, 6, and 12 months). This presentation will only include data on experimental subjects and will focus on adherence data and changes in bone mineral density 6 months into the study. At baseline, 88% of the 30 women had measurable bone loss (either osteopenia or osteoporosis), and bone loss correlated with decreased body weight and decreased body mass index. At 6 months, 6 of the 30 women had withdrawn from the study, and reasons for withdrawal included recurrence of breast cancer (n=2); normal BMD and not perceiving need for study (n=1); side effects of alendronate (n=1); cost of alendronate (n=1); and work or family stressors that interfered with study (n=1). At 6 months and for the 24 women remaining in the study, mean percent adherence for calcium and vitamin D supplements was 96.3%; alendronate, 96.5%; and arm and leg exercises, 96%. After 6 months of intervention, mean BMD (gm/cm2) had improved for the hip (.85 to .86) and spine (.96 to .97); however, there was measurable bone loss in the forearm (.52 to .49). For future studies: a) exercises will be added for the wrist and forearm; b) subjects will be encouraged to increase hand and ankle weights more rapidly; c) after 20 lbs, subjects will use machine rather than free form weights; d) future studies will be longer in duration; and e) biomarkers will be used to record early changes in bone formation and resorption. Breast cancer survivors should not have to suffer the consequences of osteoporosis just because they cannot take HRT; there are treatments besides HRT available. Breast cancer survivors should be targeted as a population at risk for osteoporosis and more emphasis should be placed on early diagnosis and treatment in this special population of women.en_GB
dc.date.available2011-10-27T12:22:24Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:22:24Z-
dc.conference.date2001en_US
dc.conference.name26th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationSan Diego, California, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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