DISCLOSURES: Dr. Hurria has received research funding from Abraxis BioScience and Pfizer and has acted as a consultant for Amgen and Genentech.
Aging and osteoporosis in breast and prostate cancer†
Version of Record online: 4 MAY 2011
Copyright © 2011 American Cancer Society, Inc.
CA: A Cancer Journal for Clinicians
Volume 61, Issue 3, pages 139–156, May/June 2011
How to Cite
VanderWalde, A. and Hurria, A. (2011), Aging and osteoporosis in breast and prostate cancer. CA: A Cancer Journal for Clinicians, 61: 139–156. doi: 10.3322/caac.20103
- Issue online: 12 MAY 2011
- Version of Record online: 4 MAY 2011
As people with cancer survive longer, and as the US population ages, skeletal effects of cancer treatment are becoming more pronounced. This is particularly true for breast and prostate cancer survivors because of the high average age of patients with these malignancies, the propensity of older adults in general toward the development of osteoporosis, and the wide use of therapeutic agents in these cancers that negatively impact bone health. Various therapies used in the treatment and prevention of cancer may cause decreases in bone mineral density and an increased risk of debilitating fracture, even in the absence of bone metastases. Aging is both a baseline risk factor in the development of osteoporosis and bony fracture, as well as a predictor of poor outcome after fracture. A variety of mechanisms may be responsible for the development of bone loss in patients with breast or prostate cancer. Cytotoxic chemotherapy may directly exert long-term toxic effects on bone. Chemotherapy and endocrine therapy can induce hypogonadism, leading to an increased rate of bone loss. The risk of skeletal events in older adults due to cancer therapy should be appreciated by all oncologists, geriatricians, and internists. The following review may serve as a guide to the skeletal side effects of cancer therapy in older adults with breast or prostate cancer, how to screen for treatment-related bone loss, and how to best prevent and/or treat skeletal events. CA Cancer J Clin 2011. © 2011 American Cancer Society, Inc.