Optimizing health outcomes, including prevention of
osteoporotic fractures, is essential for promoting the well-being of the growing number of cancer survivors. Medical providers who participate in the care of cancer survivors should be aware that various
cancer treatments may cause bone loss, which can increase the risk of subsequent of
osteoporosis. Healthy bone remodeling is a balanced and dynamic equation between new bone formation and
bone resorption. Aging, natural menopause, and
cancer treatments such as surgical
oophorectomy,
gonadotropin-releasing hormone agonists,
chemotherapy-induced ovarian failure,
androgen deprivation
therapy, and
aromatase inhibitors can all promote bone loss. The WHO Fracture Assessment Tool can be used as a clinical aid to assess an individual's
osteoporotic fracture risk, with or without bone mineral density measurements obtained from dual-energy x-ray absorptiometry. Preventative strategies include adequate
calcium and
vitamin D supplementation and modifying risk factors such as alcohol intake, tobacco use, and lack of exercise.
Bisphosphonate therapy and
rank-ligand monoclonal antibody therapy are the most commonly used agents for management of bone loss resulting from
cancer treatment. This review will summarize the mechanisms by which
cancer treatments cause bone loss as well provide screening and treatment recommendations for the management of bone loss.