title: The science and practice of bone health in oncology: managing bone loss and metastasis in patients with solid tumors.
abstract: Cancer and its treatment can compromise bone health, leading to fracture, pain, loss of mobility, and hypercalcemia of malignancy. Bone metastasis occurs frequently in advanced prostate and breast cancers, and bony manifestations are commonplace in multiple myeloma. Osteoporosis and osteopenia may be consequences of androgen-deprivation therapy for prostate cancer, aromatase inhibition for breast cancer, or chemotherapy-induced ovarian failure. Osteoporotic bone loss and bone metastasis ultimately share a pathophysiologic pathway that stimulates bone resorption by increasing the formation and activity of osteoclasts. Important mediators of pathologic bone metabolism include substances produced by osteoblasts, such as RANKL, the receptor activator of nuclear factor kappa B ligand, which spurs osteoclast differentiation from myeloid cells. Available therapies are targeted to various steps in cascade of bone metastasis.
authors.affiliation: Milton S. Hershey Medical Center, Penn State University, Hershey, PA, USA.
authors.forename: Allan
authors.initials: A
authors.lastname: Lipton
authors.forename: Robert
authors.initials: R
authors.lastname: Uzzo
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Amato
authors.forename: Georgiana K
authors.initials: GK
authors.lastname: Ellis
authors.forename: Behrooz
authors.initials: B
authors.lastname: Hakimian
authors.forename: G David
authors.initials: GD
authors.lastname: Roodman
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Smith
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000517:prevention & control* / Q000556:secondary*; D001943:Breast Neoplasms; D005260:Female; D006801:Humans; D008297:Male; D009101:Multiple Myeloma; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D010024:Osteoporosis / Q000209:etiology / Q000517:prevention & control*; D011471:Prostatic Neoplasms
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D050071:Bone Density Conservation Agents