Cancer-associated bone disease

Patients with cancer are at risk for many events involving the skeleton, including metastatic disease of bone and treatment-related bone loss. Cancer-related therapies that can affect bone include hormonal therapy, chemotherapy, and the use of glucocorticoids. Screening for bone loss, with lifestyle modifications and the early use of anti-osteoporosis therapies such as bisphosphonates, may decrease bone loss and reduce the risk of fracture. This article reviews risk factors and mechanisms associated with cancer-related bone loss and metastases as well as strategies for the detection of bone-related complications of cancer and therapies to treat these complications. This article focuses on the more common cancers with adverse skeletal effects: breast cancer, prostate cancer, and multiple myeloma.