Cancer therapy can result in significant bone loss and increased risk of fragility fracture.
Chemotherapy,
aromatase inhibitors, and
gonadotropin-releasing hormone analogues contribute to increases in the rate of bone remodelling and reduce bone mineral density. Patients with
prostate cancer on
androgen deprivation
therapy experience an increase in the risk of fracture. New research has demonstrated the key role played by
bisphosphonates in preventing declines in bone density and increases in bone remodelling. Novel
antiresorptive agents targeting receptor activator of nuclear factor κB
ligand have great potential in skeletal protection and prevention of bone loss related to
cancer therapy. Early assessment of skeletal health, followed by initiation of
calcium,
vitamin D, and an exercise program are valuable in the prevention and treatment of
osteoporosis. In addition, individuals at increased risk for fracture should be offered antiresorptive
therapy. Early data have demonstrated that
bisphosphonates are able to prevent the bone loss and increased bone remodelling associated with
cancer therapy, including
aromatase inhibition and
androgen deprivation
therapy. The present paper reviews the new research and advances in the management of bone loss associated with both
cancer therapy and
estrogen deficiency in the postmenopausal female.