Optimal management of cancer treatment-induced bone loss: considerations for elderly patients.

摘要: Hormone manipulation, commonly used in breast and prostate cancer, can result significant bone loss. In multiple myeloma (MM), corticosteroids play an important role therapy but increase the risk of fracture over that expected for any given mineral density. These adverse effects on skeletal system are particularly relevant elderly population, whom osteoporosis significantly affect not only quality life also survival. The associated health social care costs becoming increasingly important. Screening with dual energy x-ray absorptiometry (DXA) scans life-style advice smoking, alcohol dietary intake essential parts management patients cancer treatment-induced value exercise cannot be underestimated. A careful drug review should carried out to eliminate agents may potentially exacerbate toxicity. Therapies address toxicities include bisphosphonates, which have been shown preventing declines health. issues compliance when oral Renal toxicity osteonecrosis jaw toxicities, especially elderly. Cardiac has proven, there is evidence suggest suppression turnover seen some, although all, bisphosphonates reversed following cessation treatment. implications this finding need borne mind treating patients. possibility atypical fractures taking needs consideration, remains a rare complication. Recently, receptor activator nuclear factor-κB ligand (RANKL) antibody denosumab prevention, its subcutaneous route administration offers potential advantage. Oncologists remember tamoxifen, little effect integrity, useful multidisciplinary approach involving hospital specialist, general practitioner, nurse and, most importantly, patient, family carers ensure maximal benefit received from anti-cancer treatment, minimal cost patient. As cure rates increase, late challenging. warrants more research maximize all our patients, elderly, who at risk.