Cancer Treatment and Bone Health

Calcif Tissue Int. 2018 Feb;102(2):251-264. doi: 10.1007/s00223-017-0369-x. Epub 2018 Jan 20.

Abstract

Considerable advances in oncology over recent decades have led to improved survival, while raising concerns about long-term consequences of anticancer treatments. In patients with breast or prostate malignancies, bone health is a major issue due to the high risk of bone metastases and the frequent prolonged use of hormone therapies that alter physiological bone turnover, leading to increased fracture risk. Thus, the onset of cancer treatment-induced bone loss (CTIBL) should be considered by clinicians and recent guidelines should be routinely applied to these patients. In particular, baseline and periodic follow-up evaluations of bone health parameters enable the identification of patients at high risk of osteoporosis and fractures, which can be prevented by the use of bone-targeting agents (BTAs), calcium and vitamin D supplementation and modifications of lifestyle. This review will focus upon the pathophysiology of breast and prostate cancer treatment-induced bone loss and the most recent evidence about effective preventive and therapeutic strategies.

Keywords: BMD; Breast cancer; Cancer treatment; Osteoporosis; Prostate cancer.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Activins / physiology
  • Androgens / physiology
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Bone and Bones / drug effects*
  • Bone and Bones / physiology
  • Bone and Bones / physiopathology
  • Breast Neoplasms / complications*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / physiopathology
  • Estrogens / physiology
  • Female
  • Gonadotropin-Releasing Hormone / agonists
  • Humans
  • Inhibins / physiology
  • Male
  • Osteoporosis / chemically induced*
  • Osteoporosis / physiopathology
  • Practice Guidelines as Topic
  • Prostatic Neoplasms / complications*
  • Prostatic Neoplasms / drug therapy
  • Prostatic Neoplasms / physiopathology

Substances

  • Androgens
  • Antineoplastic Agents
  • Estrogens
  • Activins
  • Gonadotropin-Releasing Hormone
  • Inhibins