Osteoporosis and Cancer

Abstract

Cancer is a major risk factor for bone loss and fractures. This is due both to direct effects of cancer cells on the skeleton and to deleterious effects of cancer-specific therapies on bone cells. Marked improvements in survival for many cancers mean that strategies to limit bone loss and reduce fracture risk must be incorporated into the care plans for nearly all patients with cancer. The vast majority of effort thus far has focused on bone loss in patients with breast and prostate cancers, with comparatively few studies in other malignancies. Anti-resorptive therapies have proven nearly universally effective for limiting bone loss in cancer patients, although few studies have been powered sufficiently to include fractures as primary endpoints, and patients are frequently neither identified nor treated according to published guidelines. Non-pharmacologic approaches to limit falls, particularly in elderly patients, are also likely important adjunctive measures for most cancer patients.

Geriatric assessment as an aide to understanding falls in older adults with cancer

“…Falls among older adults with a cancer diagnosis are of added concern because cancer itself and certain cancer treatments can compromise bone health and physical function which, in turn, increase the risk for falls and fractures [8]. Several studies of community-dwelling older adults have found significant differences in fall rates between elderly persons with and without a cancer diagnosis, with one study reporting 26.4 vs 21.9 % (odds ratio, OR=1.17, p ≤0.001) [9] and another reporting 33 vs 26 % (OR=1.16, p =0.03) [10].…”

Considerations for Exercise Prescription in Patients With Bone Metastases: A Comprehensive Narrative Review

“…Osteoporosis and osteopenia are a common sequela for patients with bone metastases. This is due to the direct effects of cancer cells on the skeleton and to deleterious effects of cancer‐specific therapies on bone cells [37]. In a case controlled analysis of 174 hormone‐naive men with advanced prostate cancer, 42% were osteoporotic and 37% were osteopenic at diagnosis compared with a 27% incidence of osteoporosis amongst peer‐matched controls ( P = .02) [38].…”

Crosstalk between Cytokine RANKL and AhR Signalling in Osteoclasts Controls Bone Homeostasis

“…The skeleton is a dynamic tissue whose constant remodeling depends upon the balance of osteoclast-mediated bone resorption and osteoblast-mediated bone formation. Various diseases have been related to an osteoblast-osteoclast imbalance, including osteoporosis, rheumatoid arthritis, gum disease, and metastatic bone cancer [14,15].…”