Cancer Treatment induced Bone Loss

Cancer treatment induced bone loss (CTIBL) is commonly found in patients who get endocrine treatment for breast cancer or patients who get Androgen Deprivation Therapy (ADT) for prostate cancer. The treatment includes luteinizing hormone releasing hormone agonists, gonadotropin-releasing hormone, aromatase inhibitors and anti-androgens.. In CTIBL, patients suffer from severe loss of bone, and the condition is also linked to ageing and menopause in women.  It raises the risk of bone fractures in patients suffering from the problem, and the symptoms of the condition are chronic pain, low mobility and reduced survival.

The experts of bone cancer and the researchers at American Society of Clinical Oncology suggest that patients suffering from bone cancer should be given bisphosphonates to reduce the impact of CTIBL. Bisphosphonates, such as zoledronic acid, help in inhibiting bone loss and it also helps the patients suffering from prostate cancer and breast cancer to increase bone mineral density. It helps in improving bone metabolism and bone reabsorption.

Cancer treatment induced bone loss effects patients in the following ways:

• Most patients suffering from bone cancer are above the age of 65 years and are at a higher risk of osteoporosis. Certain guidelines stipulated by health management organisation advise patients in the age group of 60 to 65 years to be screened for osteoporosis. Calcium supplements and vitamin D supplements are recommended for patients to reduce the risk. There is currently no solution for the prevention of CTIBL caused by therapies. Most medical practitioners provide supplements to reduce the problem.

• Breast Cancer: More than 50 per cent of women suffering from breast cancer suffer from ovarian failure, and the risks increase due to cytotoxic chemotherapy. Women treated with methotrexate, cyclophosphamide and 5-fluorouracil are at a higher risk of experiencing ovarian failure. Women who are treated with anastrozole have a feature risk of 1.36, which means 23 fractures in 1,000 women. Similarly, other therapies have a feature risk of between 15 to 20 fractures per 1,000 women.

• Prostate Cancer: Patients suffering from prostate cancer may suffer from bone loss caused by androgen deprivation. The therapy ADT reduces the levels of oestrogen and testosterone, and it suppresses bone reabsorption. In men, risedronate and oral alendronate are given to reduce the bone loss caused due to osteoporosis. Men undergoing ADT for prostate cancer are recommended bisphosphonate therapy to prevent the condition and regular screening is also advised to reduce bone density.

Cancer treatment induced bone loss is observed in patients who take hormone therapies for cancer treatment. Hormone therapy is given to patients in early stages of breast cancer or high risk prostate cancer. The therapies provided for breast and prostate cancer lead to the reduction of circulation of oestrogen and testosterone levels in the body, which in turn affects bone metabolism, suppresses bone reabsorption  and inhibits bone formation. To treat this condition effectively, patients should be given bisphosphonates as it prevents bone loss and reduces the risks of bone fractures.