Bone Loss and Fracture Risk Associated with Cancer Therapy

Abstract

Background. Cancer patients experience osteoporosis resulting from accelerated loss of bone mineral density (BMD) caused by their treatment. Such bone loss greatly increases the risk for fracture and can have other serious effects on quality of life.Methods. In the current report, the author focuses on studies of cancer therapy-associated bone loss, its prevalence and pathogenesis, and resulting clinical impact. Options for management and prevention are also reviewed, including treatment guidelines where available.Results. A variety of cancer therapies, including hormonal therapy, chemotherapy, and glucocorticoids, affect gonadal hormone production, which increases bone resorption and decreases BMD. Such bone loss occurs more rapidly and to a greater degree than normal age-related osteoporosis, increases the risk for fracture

Prevalence of and Factors Associated with Osteoporosis among Korean Cancer Survivors: A Cross-Sectional Analysis of the Fourth and Fifth Korea National Health and Nutrition Examination Surveys

“…As the number of cancer survivors has increased, evaluating and managing their other health-related problems have become important issues (Moon et al, 2013). One of the most common long-term health effects in cancer survivors is bone loss, including osteoporosis (Guise, 2006;Saad et al, 2008). Bone loss in cancer survivors is generally known to be more rapid and severe than that in non-cancer population with normal age-related osteoporosis (Stava et al, 2009).…”

“…Such decline in bone density greatly increase the risk of bone fracture and can have other serious effects on the quality of life (Guise, 2006). Appropriate screening, lifestyle interventions, and osteoporosis therapy for cancer survivors can prevent the morbidity and mortality associated with bone loss.…”

Molecular Stress-inducing Compounds Increase Osteoclast Formation in a Heat Shock Factor 1 Protein-dependent Manner

“…Such bone loss is associated with decreased bone strength and, thus, an increased fracture risk, particularly in the spine, hip, and wrist, with any resulting fractures ultimately leading to a severely diminished quality of life and increased rate of mortality, particularly in elderly patients (10). Localized rapid bone loss may also cause pain and hypercalcemia (4).…”

“…It is increasingly recognized that chemotherapeutic agents have a major negative impact upon bone by increasing bone loss and fracture risk more rapidly and severely than seen in normal age-related bone loss (4,6). Although both hormonal and nonhormonal cancer therapies promote bone loss by inducing hypogonadism, chemotherapeutics can also directly impact osteoclasts (as well as the bone-forming osteoblasts) to cause loss of bone mass and structural integrity, although the mechanisms that underlie this have still to be fully elucidated (4,(11)(12)(13).…”

Salud ósea en pacientes sometidos a trasplante de precursores hematopoyéticos: un nuevo problema a considerar

“…Este éxito no ha estado libre de complicaciones asociadas, ya que estos pacientes tienen un alto riesgo de eventos cardiovasculares y de un segundo cáncer, entre otros problemas 1 .…”