Understanding and Managing Fracture Risk in Patients With Cancer: A Literature Review
Abstract
One of the most important complications of cancer and its treatments is the increased fracture risk. Fractures can have a significant impact on the patient's quality of life and may be associated with morbidity, mortality, and reduced functional status. The present study aims to investigate the mechanisms underlying the increased risk of fractures in cancer patients, the effect of cancer treatments on fracture risk, and strategies to prevent fractures in this population. This is a literature review using the PubMed - National Center for Biotechnology Information (NCBI), Web of Science, Cochrane Library, Scopus, and electronic internet databases. The search was based on the keywords "fracture risk" AND "cancer", NOT ("osteoporosis" OR "osteoporotic"). Inclusion criteria were clinical studies assessing fracture pathogenesis and prevention, along with fracture risk estimation in cancer patients. Non-human studies, pediatric studies, non-English studies, editorials, and study protocols were excluded. After the application of inclusion and exclusion criteria, 146 studies were finally included. Fracture risk is particularly increased in patients with malignancies. This is due to the direct effect of cancer cells on bone metabolism, the existence of cancer-related factors (bone metastases, hypercalcemia, malnutrition, and increased risk of falls), coexisting diseases (osteoporosis, diabetes mellitus, and rheumatoid arthritis), and the side effects of anticancer treatments…
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