Management of bone health in patients with cancer: a survey
of specialist nurses

.

Background Patients with cancer can experience bone metastases and/or cancer treatment induced bone loss (CTIBL), and the
resulting bone complications place burdens on patients and healthcare provision. Management of bone complications is becoming
increasingly important as cancer survival rates improve. Advances in specialist oncology nursing practice benefit patients
through better management of their bone health, which may improve quality of life and survival.
Methods An anonymised online quantitative survey asked specialist oncology nurses about factors affecting their provision of
support in the management of bone metastases and CTIBL.
Results Of 283 participants, most stated that they worked in Europe, and 69.3% had at least 8 years of experience in oncology.
The most common areas of specialisation were medical oncology, breast cancer and/or palliative care (20.8 50.9%). Awareness
of bone loss prevention measures varied (from 34.3% for alcohol intake to 77.4%for adequate calcium intake), and awareness of
hip fracture risk factors varied (from 28.6% for rheumatoid arthritis to 74.6% for age > 65 years). Approximately one-third
reported a high level of confidence in managing bone metastases (39.9%) and CTIBL (33.2%). International or institution
guidelines were used by approximately 50% of participants. Common barriers to better specialist care and treatment were
reported to be lack of training, funding, knowledge or professional development.
Conclusion This work is the first quantitative analysis of reports from specialist oncology nurses about the management of bone
metastases and CTIBL. It indicates the need for new nursing education initiatives with a focus on bone health management.