Steroids, cancer and vertebral fractures: a dreaded combination

J Oncol Pharm Pract. 2011 Sep;17(3):279-81. doi: 10.1177/1078155210366492. Epub 2010 Apr 15.

Abstract

Hyporexia/anorexia is a relevant clinical problem affecting the quality of life of many cancer patients. Corticosteroids are the first drugs evaluated in placebo-controlled trials for the palliation of cancer anorexia resulting in a temporary improvement in appetite. However, this measure should be balanced with its secondary events. A frequent side effect mainly after long-term treatment with steroids is the loss of bone mass, which causes osteoporosis and vertebral fractures. But this secondary event might also appear after short courses of steroids. Percutaneous vertebroplasty is an effective treatment of painful osteoporotic compression fractures, minimally invasive and with very low morbidity, which is very useful to improve quality of life in these patients. We present here a case of a 71-year-old woman, with history of osteoporosis, who developed a painful vertebral fracture after a short course of steroids to alleviate anorexia secondary to cancer treatment.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / adverse effects*
  • Aged
  • Anorexia / chemically induced
  • Anorexia / drug therapy*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Capecitabine
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / pathology
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / adverse effects
  • Deoxycytidine / analogs & derivatives
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects*
  • Female
  • Fluorouracil / administration & dosage
  • Fluorouracil / adverse effects
  • Fluorouracil / analogs & derivatives
  • Humans
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / secondary
  • Magnetic Resonance Imaging
  • Organoplatinum Compounds / administration & dosage
  • Organoplatinum Compounds / adverse effects
  • Osteoporosis / complications
  • Oxaliplatin
  • Palliative Care
  • Quality of Life
  • Risk Factors
  • Spinal Fractures / chemically induced*
  • Spinal Fractures / diagnosis
  • Spinal Fractures / therapy
  • Time Factors
  • Treatment Outcome
  • Vertebroplasty

Substances

  • Adrenal Cortex Hormones
  • Organoplatinum Compounds
  • Oxaliplatin
  • Deoxycytidine
  • Capecitabine
  • Dexamethasone
  • Fluorouracil