Bone Health in Metastatic Cancer

Semin Oncol Nurs. 2022 Apr;38(2):151278. doi: 10.1016/j.soncn.2022.151278. Epub 2022 Apr 15.

Abstract

Objective: This article reviews the epidemiology and treatment of bone metastases. Also, it revisits the mechanism of action, indications, benefits, and complications of antiresorptive agents; discusses the adverse event profile of these agents; and addresses the prevention and management of these side effects.

Data sources: For this review, peer-reviewed articles, research publications, and relevant clinical guidelines identified from PubMed were used.

Conclusion: Bone metastases are common in advanced cancer and much more frequently than in primary bone cancer, especially in adults. Bisphosphonates and Denosumab are potent antiresorptives and significantly reduce the risk of skeletal-related events. These complications are related to poor quality of life, bone pain, functional disability, and decreased survival. Prolonged therapy with these antiresorptive agents in patients with advanced malignancy is generally well tolerated, but some side effects are potentially serious and require periodic monitoring. Furthermore, some of them can be avoided.

Implications for nursing practice: The role of health care providers and specially nurses on identifying patients at risk of complications from these antiresorptive agents, and providing information on how to prevent them, is essential for health and quality of life maintenance in these patients.

Keywords: Adverse effects; Bisphosphonates; Bone metastases; Bone-targeted agents; Denosumab.

Publication types

  • Review

MeSH terms

  • Adult
  • Bone Density
  • Bone Density Conservation Agents* / therapeutic use
  • Bone Neoplasms* / drug therapy
  • Bone Neoplasms* / secondary
  • Denosumab / adverse effects
  • Humans
  • Neoplasms, Second Primary* / chemically induced
  • Neoplasms, Second Primary* / drug therapy
  • Quality of Life

Substances

  • Bone Density Conservation Agents
  • Denosumab