AACE MENA 2025-Bone Health in Cancer Patients

Video Transcription

Video Summary

The session discusses cancer treatment-induced bone loss, focusing on hormone-responsive cancers like breast and prostate cancer. Hormone ablation therapies drastically reduce estrogen or testosterone levels, causing rapid bone density loss and increased fracture risk. Aromatase inhibitors in breast cancer significantly decrease bone density more than natural menopause, raising fracture risk. Intravenous bisphosphonates and denosumab are effective in preserving bone density and reducing fractures in these patients. In prostate cancer, androgen deprivation therapy similarly causes substantial bone loss and increased fractures; bisphosphonates and denosumab help mitigate this. Emerging data suggest immune checkpoint inhibitors may also increase bone loss and fracture risk, though evidence is preliminary. Bone health assessment through BMD and fracture risk evaluation is vital before and during treatment. Lifestyle modifications like exercise, smoking cessation, and adequate calcium and vitamin D intake are recommended. Pharmacologic treatment is advised for high-risk individuals, emphasizing the importance of preventing fragility fractures during cancer therapy.

Keywords

cancer treatment-induced bone loss

hormone-responsive cancers

aromatase inhibitors

bisphosphonates

denosumab

androgen deprivation therapy