Jan 25, 2023
MSNZ Group leader highlight the importance of bone health in cancer
Childhood cancer survivors have an increased risk of developing osteoporosis and fragility fractures in adulthood. This finding was recently published in the prestigious The Lancet Diabetology and Endocrinology by the Dutch LATER study group. In their study, more than 2000 survivors of childhood cancer were found to have a three to five times higher risk of obtaining fractures in adulthood.
At the University hospital Carl Gustav Carus at the TU Dresden and the National Center for Tumor Diseases Dresden (NCT/UCC), clinician scientists Tilman Rachner and Cornelia Link-Rachner and their teams study the role of signaling pathways and immune composition in cancer - amongst others with respect to bone health. In an introducing commentary to the above-mentioned study, both Mildred Scheel Early Career Center (MSNZ) group leaders highlight the clinical importance of this finding. Prior to this study, there was surprisingly little clinical evidence to underline the common assumption of a direct association between low bone mineral density and fracture risk in childhood cancer survivors. Furthermore, the study identified a number of modifiable risk factors for low bone mineral density and fractures, including hypogonadism, growth hormone deficiency, thyroid disorders, vitamin D and vitamin B12 deficiency, and low physical activity.
In order to offer optimal care for patients with cancer and a high risk for metabolic bone disorders, the special consultation “Bone health in cancer”(Knochengesundheit bei Krebs) has been established as a collaboration between the Department of Endocrinology and the NCT/UCC at Dresden’s university medicine. Responsible senior physician for this consultation service Tilman Rachner, emphasizes, that this new study clearly highlights the importance of close collaborations between oncologists and endocrinologists, especially during vulnerably periods such as the transitional phase from pediatric to adult care.
References:
van Atteveld JE, et al., Risk and determinants of low and very low bone mineral density and fractures in a national cohort of Dutch adult childhood cancer survivors (DCCSS-LATER): a cross-sectional study. Lancet Diabetes Endocrinol. 2023 ;11:21-32. doi: 10.1016/S2213-8587(22)00286-8.
Link-Rachner CS, Rachner TD. Long-term bone health in childhood cancer survivors: underappreciated and undertreated? Lancet Diabetes Endocrinol. 2023;11:2-3. doi: 10.1016/S2213-8587(22)00315-1.