Children often develop fragile bones from cancer and its treatment
(10 March 2007: VIDYYA MEDICAL NEWS SERVICE) -- Research suggests that children treated for cancer are at greater risk years later for bone problems such as osteoporosis and fractures. An article in the April 1 issue of Cancer marshals evidence from a variety of studies and sources, leading its authors to conclude that "loss of bone mineral is clearly a common consequence of the treatment of cancer in children and adolescents."
A number of factors appear to contribute, argue Drs. Alessandra Sala and Ronald D. Barr of McMaster University in Hamilton, Ontario. A major factor is multiagent chemotherapy with drugs such as methotrexate and ifosfamide that "have been labeled as especially toxic to bone," yet are commonly used to treat soft tissue and bone tumors. Cranial radiation therapy for children with brain tumors and some of the leukemias and lymphomas can sometimes trigger growth hormone disorders that compromise bone formation. Acute lymphoblastic leukemia is one of the most common childhood cancers, where the disease itself may compromise bone density, and where cumulative doses of glucocorticosteroid treatments most definitely do.
In all of these situations, the heightened physical activity that usually occurs in childhood is hindered, impeding patients' ability to accumulate the bone mineral density necessary to avoid osteoporosis in adulthood.
The authors conclude that reduced bone density in "children with cancer is of multifactorial origin, requiring comprehensive strategies for amelioration and prevention." Possible agents that warrant further study are the bisphosphonates and imatinib. Other strategies include more physical exercise, limiting the total cranial radiation dose, and overcoming calcium and vitamin D dietary deficiencies.
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