Skeletal sequelae of cancer and cancer treatment

Stava, Charles; Jiménez, Camilo; Hu, Mimi I.; Vassilopoulou‐Sellin, Rena

doi:10.1007/s11764-009-0083-4

Cited by 53 publications

(37 citation statements)

References 145 publications

(177 reference statements)

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“…The incidence of osteoporosis in cancer survivors are known to be associated with side effects of cancer treatment and health behaviors as well as general risk factor of osteoporosis. The oncologic treatment such as surgery, radiation therapy, chemotherapy, hormone suppressive therapy may have detrimental longterm effects on bone health including significant bone loss and increased risk of fracture (Miro and Orecchia, 2002;Smith, 2002;Fontanges et al, 2004;Olmos Martinez and Gonzalez Macias, 2007;Brown and Guise, 2009;Stava et al, 2009). And, various other causal factors such as low body mass index (BMI), lack of exercise, and an unhealthy lifestyle is also known be risk factors of osteoporosis among cancer survivors (Ryan et al, 2007;Grossmann et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…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).…”

Section: Introductionmentioning

confidence: 99%

“…Risk for osteoporosis is increased in cancer patients, and damage to bone health can be exacerbated by cancer itself as well as treatments such as chemotherapy, radiation, and hormone therapy (Brown and Guise, 2009;Stava et al, 2009;Ding et al, 2013). 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).…”

Section: Introductionmentioning

confidence: 99%

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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

Choi

Park

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: Identifying and managing osteoporosis among cancer survivors is an important issue, yet little is known about the bone health of cancer survivors in Korea. This study was designed to measure the prevalence of osteoporosis and to assess related factors among Korean cancer survivors. Materials and Methods: This study was designed as a cross-sectional analysis. Data were obtained from dual energy X-ray absorptiometry measurement of the lumbar vertebrae and femoral neck, and from standardized questionnaires among 556 cancer survivors and 17,623 non-cancer controls who participated in the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (2008-2011). We calculated adjusted proportions of osteoporosis in non-cancer controls vs. cancer survivors, and we performed multivariate logistic regression analysis. Results: The prevalence of osteoporosis among cancer survivors was significant higher than that of the non-cancer controls after adjusting for related factors. Furthermore, osteoporosis among cancer survivors was higher in elderly subjects (60-69 years : adjusted odds ratio (aOR) 3.04, 95% CI : 1.16-8.00, ≥70 years : aOR 6.60, 95% CI 2.20-19.79), in female cancer survivors (aOR: 7.03, 95% CI: 1.88-26.28), and in a group with lower monthly income (aOR: 3.38, 95% CI: 1.31-8.71). In male cancer survivors, underweight and lower calcium intake were risk factors. Conclusions: These data suggest that the osteoporosis among cancer survivors varies according to non-oncologic and oncologic factors. Effective screening should be applied, and a sufficient and comprehensive management should be matched to individual cancer survivors early after cancer treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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

Choi

Park

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…A BMD decrease of about 6 %/ year is observed in patients on GnRH agonists with a recovery of bone mass after discontinuation. GnRH agonists may not increase the risk of fragility fractures in women with normal BMD [43].In men with hormone-sensitive prostate cancer, castration or ADT can be induced surgically or medically with GnRH agonists or antagonists and a combination of GnRH agonist with androgen biosynthetic blockade. ADT is effective in reducing tumour extension, growth and improving survival [74].…”

mentioning

confidence: 99%

“…Prolonged exposure to corticosteroids is the third leading cause of osteoporosis, after hypogonadism and advancing age [95,96]. The risk of fracture increases by 50-100 % in recipients of oral corticosteroids [97].Other indirect effects of cancer therapies-There are other indirect effects on bone health that result from cancer therapies [43]. These effects include hypovitaminosis D, cachexia (sarcopenia) and decreased mobility (Table 2).…”

mentioning

confidence: 99%

Cancer-associated bone disease

Rizzoli

Body²,

Brandi³

et al. 2013

Osteoporos Int

128

103

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Bone is commonly affected in cancer. Cancer-induced bone disease results from the primary disease, or from therapies against the primary condition, causing bone fragility. Bone-modifying agents, such as bisphosphonates and denosumab, are efficacious in preventing and delaying cancer-related bone disease. With evidence-based care pathways, guidelines assist physicians in clinical decision-making. Of the 57 million deaths in 2008 worldwide, almost two thirds were due to non-communicable diseases, led by cardiovascular diseases and cancers. Bone is a commonly affected organ in cancer, and although the incidence of metastatic bone disease is not well defined, it is estimated that around half of patients who die from cancer in the USA each year have bone involvement. Furthermore, cancer-induced bone disease can result from the primary disease itself, either due to circulating bone resorbing substances or metastatic bone disease, such as commonly occurs with breast, lung and prostate cancer, or from therapies administered to treat the primary condition thus causing bone loss and fractures. Treatment-induced osteoporosis may occur in the setting of glucocorticoid therapy or oestrogen deprivation therapy, chemotherapy-induced ovarian failure and androgen deprivation therapy. Tumour skeletal-related events include pathologic fractures, spinal cord compression, surgery and radiotherapy to bone and may or may not include hypercalcaemia of malignancy while skeletal complication refers to pain and other symptoms. Some evidence demonstrates the efficacy of various interventions including bone-modifying agents, such as bisphosphonates and denosumab, in preventing or delaying cancer-related bone disease. The latter includes treatment of patients with metastatic skeletal lesions in general, adjuvant treatment of breast and prostate cancer in particular, and the prevention of cancerassociated bone disease. This has led to the development of guidelines by several societies and working groups to assist physicians in clinical decision making, providing them with evidencebased care pathways to prevent skeletal-related events and bone loss. The goal of this paper is to put forth an IOF position paper addressing bone diseases and cancer and summarizing the position papers of other organizations. Epidemiology of cancer-associated bone disease Bone metastasisCancer affects nearly 12.7 million people and is associated with over 7 million deaths in 2008 [1]. Cancer is a rising global health burden and it is estimated that in 2030, cancer deaths will be tallied at over 13 million (World Health Organization (WHO) 2010 Global Status Report [2]). Addressing the morbidity and mortality of cancer is an important public health concern. On purpose, we are limiting our analysis to cancer bone involvement in adults and do not discuss cancer in children.Metastases from cancer are associated with 90 % of cancer deaths [3]. It was estimated that one half of people who die from cancer in the USA have bone involvement [4][5][6]. Different tumou...

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Promotion and support of physical activity among cancer survivors: a service provider perspective

et al. 2012

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Skeletal sequelae of cancer and cancer treatment

Abstract: These studies confirm that cancer survivors experience a more rapid acceleration of bone loss than their age-matched peers who were never diagnosed with cancer. Further studies are needed to better address the skeletal needs of cancer survivors.

Cited by 53 publications

References 145 publications

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

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

Cancer-associated bone disease

Promotion and support of physical activity among cancer survivors: a service provider perspective

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