Osteoporosis

Osteoporosis is a common problem for survivors of several types of cancer syndromes, including: Lymphoma and Leukemia, Breast, Prostate, and Children

Contributing Factors to Bone Loss

Factors contributing to bone loss in Leukemia / Lymphoma

Involvement of bone marrow by cancer cells, which produce activators of bone breakdown, causes bone loss
Many treatment programs include cortisone-like drugs which cause bone loss
Patients are living longer!

Factors contributing to bone loss after Breast Cancer

Chemotherapy for premenopausal women often results in early menopause
Estrogen replacement is generally omitted
Improved diagnosis and therapy results in prolonged survival and women are living longer in the post-menopausal state

Factors contributing to bone loss in Prostate Cancer

Involvement of bone by cancer cells
Treatment strategies frequently include reduction or blockade of testosterone effects.
Testosterone deficiency increases bone loss
Prostate cancer frequently affects older patients who may already have low bone mass

Osteopenia in Young Adult Survivors of Childhood Cancer

Improved survival of children with malignant diseases is, in part, due to the application of intensive, multimodality therapies including radiotherapy, surgery, glucocorticoids and cytotoxic agents. Such interventions have the potential to induce complex hormonal, metabolic and nutritional effects which may interfere with skeletal mass acquisition during childhood cancer survivors may therefore reach adulthood with diminished peak bone mass and be at increased risk for clinically significant osteoporosis later in their life.

Osteopenia is a prominent finding in young adults who are survivors of childhood cancers; it is likely that antineoplastic treatments during childhood and adolescence, impede peak bone mass acquisition. Bone mineral density is lower than age and gender averages. Bone mineral density is especially decreased in cancer survivors with history of cranial irradiation.

We suggest that systematic attention to this potential complication is needed in order to identify what subgroups of children may require regular surveillance and what interventions are required for its prevention or treatment.