Cancer therapies and bone health

Cancer patients are at risk for adverse events involving bone. Metastasis of cancer to bone and primary bone tumors can compromise the integrity of bone. Various cancer therapies cause long-term skeletal disorders, particularly bone loss, osteomalacia, and avascular necrosis. Cancer therapies that include chemotherapy, glucocorticoids, hormonal agents, and newer targeted therapies can affect bone in several ways. With the improved effectiveness of cancer treatment, more cancer patients are surviving longer and may experience fractures as a long-term complication of bone loss. Prevention of bone loss through early detection and appropriate use of anti-osteoporosis treatment may decrease bone loss and fractures. This article reviews causative risk factors, mechanisms, and prevention and treatment strategies for cancer therapy-related bone loss in hematologic and specific solid malignancies.