In September, 2014, The European Society for Medical Oncology (ESMO) published clinical practice guidelines for maintaining bone health in patients with cancer. The guidelines address both multidisciplinary treatments for reducing skeletal effects of metastatic disease and strategies for minimizing treatment-induced skeletal damage. The guidelines article was published in the Annals of Oncology by R. Coleman, J. J. Body, M. Aapro, P. Hadji, and J. Herrstedt on behalf of the ESMO Guidelines Working Group.*
Bone health in cancer patients is an area of critical clinical concern. Bone metastases are common in patients with solid tumors (especially those of the breast, prostate, lung, and kidney,) as well as in those with multiple myeloma. Bone metastases can cause severe pain and nerve compression, as well as leading to hypercalcemia and fractures. Many cancer treatments affect reproductive hormones, which are critical for the maintenance of normal bone remodeling. The resulting endocrine disturbance can result in accelerated bone loss and an increased risk of osteoporosis and fractures.
In the guidelines paper, the ESMO Working Group reviews the evidence showing that multidisciplinary management of bone metastases, though bone-targeted treatments, can reduce skeletal complications and bone pain, thereby increasing quality of life. Recent data also suggest that, in some cases, bone-targeted treatments can reduce bone metastases, resulting in better survival rates. The authors provide an overview and recommendations for reducing skeletal morbidity from metastatic disease and strategies for minimizing skeletal damage induced by cancer treatments. These recommendations provide a framework for maintaining bone health in patients with cancer.
*Coleman R, Body JJ, Aapro M, Hadji P, Herrstedt J; ESMO Guidelines Working Group. Bone Health in Cancer Patients: ESMO Clinical Practice Guidelines. Ann Oncol. 2014 Sep;25 Suppl 3:iii124-37. Free Full Text