Bisphosphonate-related osteonecrosis of the jaw in cancer patients: Implications for nurses.
OBJECTIVE
This paper reports a review of the literature with a specific focus on osteonecrosis of the jaw. Bisphosphonate drugs are commonly used in the treatment of bone disease secondary to myeloma and solid tumours, such as breast and prostate cancer. In the past few years, an uncommon but distressing condition known as osteonecrosis of the jaw (ONJ) has been detected in patients who are having bisphosphonate treatment, particularly the intravenous (IV) preparations. Osteonecrosis of the jaw results from bone exposure in the oral cavity with subsequent death of bone tissue (necrosis).


METHODS
The review searched key databases including Medline, British Nursing Index, Cochrane, and meeting abstracts to ascertain the extent of literature in this field.


RESULTS
Fourty-two articles were reviewed which described the clinical manifestations of ONJ, the reported incidence and clinical cases.


CONCLUSIONS
The results indicate there is an emerging body of evidence in this field and nurses delivering bisphosphonates need to familiarise themselves with the current guidance to ensure risks are minimised for patients.
Haematology Oncology Outpatient Department, St George's Hospital, Blackshaw Road, London SW170QT, UK. monica.morris@stgeorges.nhs.uk <monica.morris@stgeorges.nhs.uk>
Monica
M
Morris
Susanne
S
Cruickshank
D057179:Advanced Practice Nursing / Q000458:organization & administration; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000451:nursing / Q000556:secondary; D004164:Diphosphonates / Q000009:adverse effects*; D016903:Drug Monitoring; D006801:Humans; D015994:Incidence; D007571:Jaw Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000628:therapy; D024802:Nurse's Role; D009730:Nursing Assessment; D009859:Oncology Nursing / Q000458:organization & administration*; D010020:Osteonecrosis / Q000139:chemically induced* / Q000453:epidemiology / Q000628:therapy; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D011322:Primary Prevention; D012307:Risk Factors
D050071:Bone Density Conservation Agents; D004164:Diphosphonates