Asian Oncol Nurs.  2013 Sep;13(3):103-112. 10.5388/aon.2013.13.3.103.

Recent Advances in Management of Cancer Treatment-induced Bone Loss (CTIBL) in Patients with Breast or Prostate Cancer

• Kim SH
• Hong S
• Song Y
• Song H

• KMID: 2220750
• DOI: http://doi.org/10.5388/aon.2013.13.3.103

Abstract

PURPOSE
Bone loss resulting from cancer treatment is an emerging problem among cancer survivors. However, the mechanism and treatment of cancer treatment-induced bone loss (CTIBL) is not fully understood. The purpose of this article was to review the recent advances in CTIBL.
METHODS
A comprehensive review of the literature was conducted.
RESULTS
Risk factors for CTIBL that are unique to or commonly found in cancer survivors include chemotherapy-induced menopause, anti-estrogen and anti-androgen therapies, gonadotropin-releasing hormone suppression of gonadal function, and use of glucocorticoids. Assessment of CTIBL is performed using dual X-ray absorptiometry testing for measurement of BMD levels, Fracture Risk Assessment Tool, and bone turnover markers. Initial strategies for prevention of CTIBL include lifestyle modifications such as exercise, an adequate intake of calcium and vitamin D, avoiding tobacco use, and limiting alcohol intake. Pharmacologic therapy should be considered for patients at high risk for bone loss or fracture.
CONCLUSIONS
Prevention of CTIBL may be the best way to decrease morbidity and financial costs associated with osteoporosis and/or fractures. Oncology nurses should be well prepared to identify cancer survivors at risk of CTIBL, and to provide them with education regarding prevention and treatment of CTIBL.

Keyword

Osteoporosis; Bone Fractures; Breast Neoplasms; Prostatic Neoplasms; Health Promotion

MeSH Terms

Absorptiometry, Photon
Breast Neoplasms
Breast*
Calcium
Education
Female
Fractures, Bone
Glucocorticoids
Gonadotropin-Releasing Hormone
Gonads
Health Promotion
Humans
Life Style
Menopause
Osteoporosis
Prostate*
Prostatic Neoplasms*
Risk Assessment
Risk Factors
Survivors
Tobacco
Vitamin D
Calcium
Glucocorticoids
Gonadotropin-Releasing Hormone
Vitamin D

Figure

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  Fig. 1 Algorithm for management of bone health of cancer patients in the United States Reprinted with premission: Gralow JR, Biermann JS, Farooki A, Fornier MN, Gagel RF, Kumar RN, et al. NCCN task force report: Bone health in cancer care. J Natl Compr Canc Netw. 2009;3:S1-32.

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