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Zannetti EB, Cittadini N, Iovino P, De Maria M, D'Angelo D, Pennini A, Vellone E, Tarantino U, Alvaro R. Factors That Influence Quality of Life in Postmenopausal Osteoporotic Women With Nonvertebral Fractures: The Guardian Angel Multicenter Longitudinal Study. Orthop Nurs 2024; 43:151-157. [PMID: 38861745 DOI: 10.1097/nor.0000000000001028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/13/2024] Open
Abstract
The knowledge of variables associated with quality of life in women with nonvertebral fractures is poor. The aim of this study was to examine the independent associations between sociodemographic and clinical factors, self-care, and quality of life in this specific population. We undertook a 3-year multicenter longitudinal study on a cohort of Italian postmenopausal osteoporotic women with three follow-ups at 1, 3, and 6 months. Nurses asked women to complete questionnaires on quality of life and self-care. The sample (n = 532) had a mean age of 74.78 years. The results showed that women taking more than two medications per day (p = .026) and those with nine or more years of education (p = .036) were more likely to exhibit better quality of life levels (p < .001) than their counterparts. Both self-care and quality of life scores improved over time in all participants. This study shows positive independent associations between quality of life and polypharmacy, education, and self-care behaviors, which were improved by educational interventions to attain a better quality of life in our participants.
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Affiliation(s)
- Emanuela Basilici Zannetti
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-5330-9808 )
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0001-8862-6857 )
- Paolo Iovino, PhD, RN, Department of Health Sciences, University of Florence ( https://orcid.org/0000-0001-5952-881X )
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN, Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale ( https://orcid.org/0000-0001-9451-0885 )
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-3676-5956 )
- Ercole Vellone, PhD, RN, FAAN, FESC, Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland ( https://orcid.org/0000-0003-4673-7473 )
- Umberto Tarantino, PhD, MD, Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-0330-2189 )
- Rosaria Alvaro, MSN, FESC, FAAN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-4659-1569 )
| | - Noemi Cittadini
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-5330-9808 )
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0001-8862-6857 )
- Paolo Iovino, PhD, RN, Department of Health Sciences, University of Florence ( https://orcid.org/0000-0001-5952-881X )
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN, Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale ( https://orcid.org/0000-0001-9451-0885 )
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-3676-5956 )
- Ercole Vellone, PhD, RN, FAAN, FESC, Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland ( https://orcid.org/0000-0003-4673-7473 )
- Umberto Tarantino, PhD, MD, Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-0330-2189 )
- Rosaria Alvaro, MSN, FESC, FAAN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-4659-1569 )
| | - Paolo Iovino
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-5330-9808 )
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0001-8862-6857 )
- Paolo Iovino, PhD, RN, Department of Health Sciences, University of Florence ( https://orcid.org/0000-0001-5952-881X )
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN, Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale ( https://orcid.org/0000-0001-9451-0885 )
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-3676-5956 )
- Ercole Vellone, PhD, RN, FAAN, FESC, Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland ( https://orcid.org/0000-0003-4673-7473 )
- Umberto Tarantino, PhD, MD, Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-0330-2189 )
- Rosaria Alvaro, MSN, FESC, FAAN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-4659-1569 )
| | - Maddalena De Maria
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-5330-9808 )
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0001-8862-6857 )
- Paolo Iovino, PhD, RN, Department of Health Sciences, University of Florence ( https://orcid.org/0000-0001-5952-881X )
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN, Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale ( https://orcid.org/0000-0001-9451-0885 )
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-3676-5956 )
- Ercole Vellone, PhD, RN, FAAN, FESC, Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland ( https://orcid.org/0000-0003-4673-7473 )
- Umberto Tarantino, PhD, MD, Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-0330-2189 )
- Rosaria Alvaro, MSN, FESC, FAAN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-4659-1569 )
| | - Daniela D'Angelo
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-5330-9808 )
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0001-8862-6857 )
- Paolo Iovino, PhD, RN, Department of Health Sciences, University of Florence ( https://orcid.org/0000-0001-5952-881X )
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN, Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale ( https://orcid.org/0000-0001-9451-0885 )
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-3676-5956 )
- Ercole Vellone, PhD, RN, FAAN, FESC, Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland ( https://orcid.org/0000-0003-4673-7473 )
- Umberto Tarantino, PhD, MD, Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-0330-2189 )
- Rosaria Alvaro, MSN, FESC, FAAN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-4659-1569 )
| | - Annalisa Pennini
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-5330-9808 )
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0001-8862-6857 )
- Paolo Iovino, PhD, RN, Department of Health Sciences, University of Florence ( https://orcid.org/0000-0001-5952-881X )
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN, Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale ( https://orcid.org/0000-0001-9451-0885 )
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-3676-5956 )
- Ercole Vellone, PhD, RN, FAAN, FESC, Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland ( https://orcid.org/0000-0003-4673-7473 )
- Umberto Tarantino, PhD, MD, Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-0330-2189 )
- Rosaria Alvaro, MSN, FESC, FAAN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-4659-1569 )
| | - Ercole Vellone
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-5330-9808 )
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0001-8862-6857 )
- Paolo Iovino, PhD, RN, Department of Health Sciences, University of Florence ( https://orcid.org/0000-0001-5952-881X )
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN, Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale ( https://orcid.org/0000-0001-9451-0885 )
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-3676-5956 )
- Ercole Vellone, PhD, RN, FAAN, FESC, Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland ( https://orcid.org/0000-0003-4673-7473 )
- Umberto Tarantino, PhD, MD, Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-0330-2189 )
- Rosaria Alvaro, MSN, FESC, FAAN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-4659-1569 )
| | - Umberto Tarantino
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-5330-9808 )
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0001-8862-6857 )
- Paolo Iovino, PhD, RN, Department of Health Sciences, University of Florence ( https://orcid.org/0000-0001-5952-881X )
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN, Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale ( https://orcid.org/0000-0001-9451-0885 )
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-3676-5956 )
- Ercole Vellone, PhD, RN, FAAN, FESC, Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland ( https://orcid.org/0000-0003-4673-7473 )
- Umberto Tarantino, PhD, MD, Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-0330-2189 )
- Rosaria Alvaro, MSN, FESC, FAAN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-4659-1569 )
| | - Rosaria Alvaro
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-5330-9808 )
- Noemi Cittadini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0001-8862-6857 )
- Paolo Iovino, PhD, RN, Department of Health Sciences, University of Florence ( https://orcid.org/0000-0001-5952-881X )
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN, Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale ( https://orcid.org/0000-0001-9451-0885 )
- Annalisa Pennini, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-3676-5956 )
- Ercole Vellone, PhD, RN, FAAN, FESC, Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland ( https://orcid.org/0000-0003-4673-7473 )
- Umberto Tarantino, PhD, MD, Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0003-0330-2189 )
- Rosaria Alvaro, MSN, FESC, FAAN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy ( https://orcid.org/0000-0002-4659-1569 )
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Cao G, Hu S, Ning Y, Dou X, Ding C, Wang L, Wang Z, Sang X, Yang Q, Shi J, Hao M, Han X. Traditional Chinese medicine in osteoporosis: from pathogenesis to potential activity. Front Pharmacol 2024; 15:1370900. [PMID: 38628648 PMCID: PMC11019011 DOI: 10.3389/fphar.2024.1370900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/11/2024] [Indexed: 04/19/2024] Open
Abstract
Osteoporosis characterized by decreased bone density and mass, is a systemic bone disease with the destruction of microstructure and increase in fragility. Osteoporosis is attributed to multiple causes, including aging, inflammation, diabetes mellitus, and other factors induced by the adverse effects of medications. Without treatment, osteoporosis will further progress and bring great trouble to human life. Due to the various causes, the treatment of osteoporosis is mainly aimed at improving bone metabolism, inhibiting bone resorption, and promoting bone formation. Although the currently approved drugs can reduce the risk of fragility fractures in individuals, a single drug has limitations in terms of safety and effectiveness. By contrast, traditional Chinese medicine (TCM), a characteristic discipline in China, including syndrome differentiation, Chinese medicine prescription, and active ingredients, shows unique advantages in the treatment of osteoporosis and has received attention all over the world. Therefore, this review summarized the pathogenic factors, pathogenesis, therapy limitations, and advantages of TCM, aiming at providing new ideas for the prevention and treatment of OP.
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Affiliation(s)
- Gang Cao
- Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - ShaoQi Hu
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yan Ning
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xinyue Dou
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Chuan Ding
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lu Wang
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zeping Wang
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xianan Sang
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qiao Yang
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiangnan Shi
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Min Hao
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xin Han
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
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Zhao Y, Guo J, Mu Q, Liu R, Liu H, Xu Y, Li Y. Exploring quality evaluation markers of Fructus Psoraleae based on chemometric analysis integrated with network pharmacology. PHYTOCHEMICAL ANALYSIS : PCA 2024; 35:321-335. [PMID: 37816590 DOI: 10.1002/pca.3290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 10/12/2023]
Abstract
INTRODUCTION Fructus Psoraleae (FP) is a well-known traditional Chinese medicine for the treatment of osteoporosis. However, major quality differences were witnessed owing to its various origins, thus influencing its safety and efficacy. OBJECTIVES The study aimed to evaluate the quality of FP from different origins and predict its quality evaluation markers. METHODS Ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry was employed for tentative characterisation of the constituents in 10 batches of FP, followed by the utilisation of multivariate statistical analysis methods including principal component analysis and orthogonal partial least squares discriminant analysis for quality evaluation. Network pharmacology approaches were utilised to explore the underlying mechanism of the screened chemotaxonomic markers in treating osteoporosis. RESULTS Forty-one components in FP including, chalcones, coumarins, coumestans, flavonoids, iso-flavonoids, and phenolics, were characterised based on their fragmentation pathways. Ten batches of FP were basically divided into three categories, and eight chemotaxonomic markers including isopsoralen, calamenene, bakuchiol, psoralen, bavachinin, isoneobavaisoflavone, corylifol C, and neobavaisoflavone were screened. Network pharmacology revealed that the chemotaxonomic markers can act on targets such as AKT1, HSP90AA1, and EGFR and possess effects mainly through glycolysis and wnt/β-catenin signalling to alleviate osteoporosis. Molecular docking and molecular dynamic simulation confirmed the good binding affinity and stability between proteins and selected markers. So, eight chemotaxonomic markers were all preferentially recommended as quality evaluation markers. CONCLUSION The study not only provides a reference for the improvement of quality control of FP but also offers a theoretical basis for its further in-depth research in osteoporosis.
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Affiliation(s)
- Yuting Zhao
- School of Chinese Material Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Junfeng Guo
- College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qixuan Mu
- China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Ruojin Liu
- School of Chinese Material Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hui Liu
- School of Chinese Material Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yanyan Xu
- School of Chinese Material Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yubo Li
- School of Chinese Material Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Wu S, Ma X, Liang Z, Jiang Y, Chen S, Sun G, Chen K, Liu R. Development and validation of a nomogram for predicting osteoporosis in prostate cancer patients: A cross-sectional study from China. Prostate 2023; 83:1537-1548. [PMID: 37589478 DOI: 10.1002/pros.24612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/28/2023] [Accepted: 08/04/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND The specific risk factors contributing to the development of osteoporosis and the appropriate timing of treatment in Chinese prostate cancer (PCa) patients remain unclear. Our objective was to develop and validate a nomogram capable of predicting the occurrence of osteoporosis in PCa patients. METHODS We conducted a cross-sectional study with PCa patients attending the Second Hospital of Tianjin Medical University, collecting data from June 2021 to February 2023. The patients were divided into training and validation sets in a 7:3 ratio. The LASSO regression was used to identify the most relevant predictive variables, and the multivariable logistic regression was used to construct the nomogram. The nomogram's performance was validated through receiver operating characteristic (ROC) curves, C-index, calibration curves, and decision curve analysis (DCA) in both the training and validation sets. RESULTS We collected data from a total of 596 patients and then constructed the nomogram using age, body mass index, hemoglobin, vitamin D3, testosterone, and androgen deprivation therapy duration. The C-index of the nomogram was 0.923 in the training set and 0.859 in the validation set. The nomogram showed good consistency in both sets. DCA demonstrated the clinical benefit of the nomogram across various prediction thresholds. Furthermore, a separate nomogram was constructed to predict bone loss in patients undergoing ADT, exhibiting equally favorable diagnostic performance and clinical benefit. CONCLUSION This study constructed two reliable nomograms to predict osteoporosis and bone loss, integrating personal health information and PCa-specific treatment data. These nomograms offer an easy and individualized approach to predict the occurrence of osteoporosis and bone loss in PCa patients.
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Affiliation(s)
- Shangrong Wu
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xudong Ma
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhengxin Liang
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yuchen Jiang
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Shuaiqi Chen
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Guangyu Sun
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Kaifei Chen
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Ranlu Liu
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
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Qi W, Mei Z, Sun Z, Lin C, Lin J, Li J, Ji JS, Zheng Y. Exposure to Multiple Air Pollutants and the Risk of Fractures: A Large Prospective Population-Based Study. J Bone Miner Res 2023; 38:1549-1559. [PMID: 37341992 DOI: 10.1002/jbmr.4872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 06/22/2023]
Abstract
Atmospheric chemistry studies suggest air pollution impedes ultraviolet B photons and thus reduces cutaneous vitamin D3 synthesis. Biological evidence shows that inhaled pollutants disrupt circulating 25-hydroxyvitamin D (25[OH]D) metabolism and ultimately impact bone health. The hypothesis is that higher air pollution concentrations are associated with a higher risk of fractures, mediated by lower circulating 25(OH)D. The study included participants of the UK Biobank who were free of fracture history at enrollment (2006 to 2010) and analyzed their environmental exposure data (2007 to 2010). Air pollution measurements included the annual averages of air particulate matter (PM2.5 , PM2.5-10 , and PM10 ), nitrogen oxides (NO2 and NOx ), and a composite air pollution score. Multivariable Cox proportional hazard models were used to assess the associations of the individual pollutants and the score with fracture risks. Mediation analyses were conducted to assess the underlying role of serum 25(OH)D in such associations. Among 446,395 participants with a median of 8-year follow-up, 12,288 incident fractures were documented. Participants living in places with the highest quintile of air pollution score had a 15.3% increased risk of fractures (hazard ratio [95%CI]: 1.15[1.09,1.22]) compared to those in the lowest, and 5.49% of this association was mediated through serum 25(OH)D (pmediation < 0.05). Pollutant-specific hazard of top-to-bottom quintiles was 16% for PM2.5 , 4% for PM2.5-10 , 5% for PM10 , 20% for NO2 , and 17% for NOx , with a 4% to 6% mediation effect of serum 25(OH)D concentrations. The associations of the air pollution score with fracture risks were weaker among female participants, those who drank less alcohol, and consumed more fresh fruit than their counterparts (pinteraction < 0.05). © 2023 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Wenhao Qi
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Zhendong Mei
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Zhonghan Sun
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Chenhao Lin
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Jinran Lin
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Jialin Li
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
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6
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Huang L, Xu Z, Xie Y, Jiang S, Han W, Tang Z, Zhu Q. Comprehensive Characterization of Ageing-Relevant Subtypes Associated With Different Tumorigenesis and Tumor Microenvironment in Prostate Cancer. Front Mol Biosci 2022; 9:803474. [PMID: 35265669 PMCID: PMC8898838 DOI: 10.3389/fmolb.2022.803474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: Accumulated evidence demonstrates that ageing is a robust risk factor of prostate cancer prognosis. Herein, we conducted a systematic analysis about ageing-relevant molecules and relevant tumor microenvironment features in prostate cancer. Methods: Transcriptome data, clinical information, and mutational data of prostate cancer patients were retrospectively collected from the Cancer Genome Atlas cohort. In accordance with the expression of specific ageing-relevant genes, prostate cancer patients were clustered with consensus clustering analyses. WGCNA was adopted for determination of subtype-associated co-expression modules and genes. Thereafter, characteristic genes were further screened with random forest algorithm and a prognostic model was conducted with multivariate cox regression analyses. Tumor microenvironment-infiltrating immune cells were estimated with ssGSEA and ESTIMATE. Activities of the cancer immunity cycle and expressions of HLA and immune checkpoint molecules were then quantified across prostate cancer cases. A serious experiment was conducted to investigate the roles of EIF2S2 in prostate tumorigenesis. Results: This study characterized three ageing-relevant subtypes (C1, C2, and C3) with diverse clinical prognosis. Subtype C1 presented the features of low mutational frequency and immune activation; C2 was characterized by stromal and immune activation; and C3 showed immune suppression. An ageing-derived gene signature was conducted, which independently and robustly predicted patients’ prognosis. Additionally, this signature was in relation to immune inactivation. Among the genes in the signature, EIF2S2 triggered proliferation, invasion, and migration of LNCaP and PC-3 cells. Conclusion: Collectively, ageing-relevant molecular subtypes and gene signature might be of great significance to determine clinical outcomes and tumor microenvironment features and immunotherapeutic responses in prostate cancer.
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Affiliation(s)
- Liang Huang
- Department of Urology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital, Changsha, China
| | - Zhenzhou Xu
- Department of Urology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital, Changsha, China
| | - Yu Xie
- Department of Urology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital, Changsha, China
| | - Shusuan Jiang
- Department of Urology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital, Changsha, China
| | - Weiqing Han
- Department of Urology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital, Changsha, China
| | - Zhengyan Tang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Quan Zhu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Quan Zhu,
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7
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Ouyang L, Sun Y, Lv D, Peng X, Liu X, Ci L, Zhang G, Yuan B, Li L, Fei J, Ma J, Liu X, Liao Y. miR-29cb2 promotes angiogenesis and osteogenesis by inhibiting HIF-3α in bone. iScience 2022; 25:103604. [PMID: 35005549 PMCID: PMC8718933 DOI: 10.1016/j.isci.2021.103604] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/25/2021] [Accepted: 12/08/2021] [Indexed: 12/14/2022] Open
Abstract
Coordination between osteogenesis and angiogenesis is required for bone homeostasis. Here, we show that miR-29cb2 is a bone-specific miRNA and plays critical roles on angiogenesis-osteogenesis coupling during bone remodeling. Mice with deletion of miR-29cb2 exhibit osteopenic phenotypes and osteoblast impairment, accompanied by pronounced decreases in specific H vessels. The decrease in bone miR-29cb2 was associated with pathological ovariectomy stimuli. Mechanistically, hypoxia-inducible factor (HIF)-3α, as a target for miR-29cb2, inhibits HIF-1α activity by competitively bonding with HIF-1β. Notably, miR-29cb2 in peripheral blood (PB) nearly is undetectable in sham and significantly increases in ovariectomy mice. Further evaluation from osteoporosis patients demonstrates similar signatures. ROC analysis shows miR-29cb2 in PB has higher sensitivity and specificity for diagnosing osteoporosis when compared with four clinical biomarkers. Collectively, these findings reveal that miR-29cb2 is essential for bone remodeling by inhibiting HIF-3α and elevated bone-specific miR-29cb2 in PB, which may be a promising biomarker for bone loss.
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Affiliation(s)
- Liping Ouyang
- Department of Pharmacy, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
- Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
| | - Yingxiao Sun
- Department of Pharmacy, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
| | - Dan Lv
- Department of Pharmacy, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
| | - Xiaochun Peng
- Department of Orthopaedics, The Sixth Affiliated People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China
| | - Xiaoming Liu
- Department of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
| | - Lei Ci
- Shanghai Engineering Research Center for Model Organisms, Shanghai Model Organisms Center, INC., Shanghai 201203, China
| | - Guoning Zhang
- Department of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
| | - Bo Yuan
- Department of Pharmacy, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
| | - Ling Li
- Department of Pharmacy, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
| | - Jian Fei
- Shanghai Engineering Research Center for Model Organisms, Shanghai Model Organisms Center, INC., Shanghai 201203, China
- School of Life Science and Technology, Tongji University, Shanghai 200092, China
| | - Jun Ma
- Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
| | - Xuanyong Liu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, China
- School of Chemistry and Materials Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310024, China
| | - Yun Liao
- Department of Pharmacy, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
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Paillaud E, Caillet P, Conti C, Mebarki S. Spécificités onco-gériatriques des soins de support. Bull Cancer 2022; 109:568-578. [DOI: 10.1016/j.bulcan.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 10/19/2022]
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9
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Segovia-Mendoza M, García-Quiroz J, Díaz L, García-Becerra R. Combinations of Calcitriol with Anticancer Treatments for Breast Cancer: An Update. Int J Mol Sci 2021; 22:12741. [PMID: 34884550 PMCID: PMC8657847 DOI: 10.3390/ijms222312741] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/16/2021] [Accepted: 11/19/2021] [Indexed: 12/12/2022] Open
Abstract
Preclinical, clinical, and epidemiological studies indicate that vitamin D3 (VD) deficiency is a risk factor for the development of breast cancer. Underlying mechanisms include the ability of calcitriol to induce cell differentiation, inhibit oncogenes expression, and modify different signaling pathways involved in the control of cell proliferation. In addition, calcitriol combined with different kinds of antineoplastic drugs has been demonstrated to enhance their beneficial effects in an additive or synergistic fashion. However, a recognized adjuvant regimen based on calcitriol for treating patients with breast cancer has not yet been fully established. Accordingly, in the present work, we review and discuss the preclinical and clinical studies about the combination of calcitriol with different oncological drugs, aiming to emphasize its main therapeutic benefits and opportunities for the treatment of this pathology.
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Affiliation(s)
- Mariana Segovia-Mendoza
- Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico;
| | - Janice García-Quiroz
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Belisario Domínguez Sección XVI, Tlalpan, Ciudad de México 14080, Mexico;
| | - Lorenza Díaz
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Belisario Domínguez Sección XVI, Tlalpan, Ciudad de México 14080, Mexico;
| | - Rocío García-Becerra
- Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
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10
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Blair CK, Harding EM, Adsul P, Moran S, Guest D, Clough K, Sussman AL, Duff D, Cook LS, Rodman J, Dayao Z, Brown-Glaberman U, King TV, Pankratz VS, Servin E, Davis S, Demark-Wahnefried W. Southwest Harvest for Health: Adapting a mentored vegetable gardening intervention for cancer survivors in the southwest. Contemp Clin Trials Commun 2021; 21:100741. [PMID: 33659763 PMCID: PMC7896154 DOI: 10.1016/j.conctc.2021.100741] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/26/2020] [Accepted: 02/04/2021] [Indexed: 01/22/2023] Open
Abstract
Few diet and physical activity evidence-based interventions have been routinely used in community settings to achieve population health outcomes. Adapting interventions to fit the implementation context is important to achieve the desired results. Harvest for Health is a home-based vegetable gardening intervention that pairs cancer survivors with certified Master Gardeners from the Cooperative Extension Service with the ultimate goal of increasing vegetable consumption and physical activity, and improving physical functioning and health-related quality-of-life. Harvest for Health has potential for widespread dissemination since Master Gardener Programs exist throughout the United States. However, state- and population-specific adaptations may be needed to improve intervention adoption by other Master Gardener Programs. Our primary objective was to adapt this evidence-informed intervention that was initially incepted in Alabama, for the drastically different climate and growing conditions of New Mexico using a recommended adaptation framework. Our secondary objective was to develop a study protocol to support a pilot test of the adapted intervention, Southwest Harvest for Health. The adaptation phase is a critical first step towards widespread dissemination, implementation, and scale-out of an evidence-based intervention. This paper describes the adaptation process and outcomes, and the resulting protocol for the ongoing pilot study that is currently following 30 cancer survivors and their paired Extension Master Gardener mentors.
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Affiliation(s)
- Cindy K. Blair
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | | | - Prajakta Adsul
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Sara Moran
- Extension Plant Sciences, New Mexico State University, Las Cruces, NM, USA
| | - Dolores Guest
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Kathy Clough
- Albuquerque Area Extension Master Gardener Program, NMSU Cooperative Extension Service, Albuquerque, NM, USA
| | - Andrew L. Sussman
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Dorothy Duff
- Albuquerque Area Extension Master Gardener Program, NMSU Cooperative Extension Service, Albuquerque, NM, USA
| | - Linda S. Cook
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Joseph Rodman
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Zoneddy Dayao
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Ursa Brown-Glaberman
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Towela V. King
- School of Medicine, University of New Mexico, Albuquerque, NM, USA
| | - V. Shane Pankratz
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Eduardo Servin
- Extension Plant Sciences, New Mexico State University, Las Cruces, NM, USA
| | - Sally Davis
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Prevention Research Center, Albuquerque, NM, USA
| | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
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Battisti NML, Liposits G, De Glas NA, Gomes F, Baldini C, Mohile S. Systemic Therapy of Common Tumours in Older Patients: Challenges and Opportunities. A Young International Society of Geriatric Oncology Review Paper. Curr Oncol Rep 2020; 22:98. [PMID: 32725503 DOI: 10.1007/s11912-020-00958-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW Decision-making for systemic treatments in older patients with cancer is difficult because of concerns for decreased organ function, risk of toxicity, limited life expectancy due to comorbidities and the lack of evidence available to guide its management in this population. Here, we review the data on the role of systemic agents for the treatment of common malignancies in this age group. RECENT FINDINGS Evidence on the use of systemic treatments for older patients with cancer is increasing, especially for newer options including immune checkpoint inhibitors and targeted agents that provide comparable benefit in older and younger patients. Nonetheless, the risks for short- and long-term toxicities need to be considered. More research is warranted and represents a unique opportunity to increase the knowledge on cancer treatment for older adults. Healthy, older individuals should be considered for standard systemic treatment options, whereas those at risk based on geriatric assessments require adjusted plans. Geriatric assessments are key for decision-making.
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Affiliation(s)
- Nicolò Matteo Luca Battisti
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London, SM2 5PT, UK. .,Breast Cancer Research Division, The Institute of Cancer Research, 15 Cotswold Road, Sutton, London, SM2 5NG, UK.
| | - Gabor Liposits
- Department of Oncology, Regional Hospital West Jutland, Gl Landevej 61, 7400, Herning, Denmark
| | - Nienke Aafke De Glas
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333, Leiden, ZA, Netherlands
| | - Fabio Gomes
- Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK
| | - Capucine Baldini
- Drug Development Department, Institut Gustave Roussy, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Supriya Mohile
- Division of Hematology/Oncology, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Ave # 704, Rochester, NY, 14642, USA
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12
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New Selective Progesterone Receptor Modulators and Their Impact on the RANK/RANKL Complex Activity. Molecules 2020; 25:molecules25061321. [PMID: 32183159 PMCID: PMC7144723 DOI: 10.3390/molecules25061321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 11/25/2022] Open
Abstract
Breast cancer depends on women’s age. Its chemotherapy and hormone therapy lead to the loss of bone density and disruption of the skeleton. The proteins RANK and RANKL play a pivotal role in the formation of osteoclasts. It is also well established that the same proteins (RANK and RANKL) are the main molecules that play an important role in mammary stem cell biology. Mammary stem cells guarantee differentiation of the epithelial mammary cells, the growth of which is regulated by the progesterone-induced RANKL signaling pathway. The crosstalk between progesterone receptor, stimulated by progesterone and its analogues results in RANKL to RANK binding and activation of cell proliferation and subsequently unlimited expansion of the breast cancer cells. Therefore downstream regulation of this signaling pathway is desirable. To meet this need, a new class of selective estrogen receptor modulators (SPRMs) with anti- and mesoprogestin function were tested as potential anti-RANK agents. To establish the new feature of SPRMs, the impact of tested SPRMs on RANK-RANKL proteins interaction was tested. Furthermore, the cells proliferation upon RANKL stimulation, as well as NFkB and cyclin D1 expression, induced by tested SPRMs were analyzed. Conducted experiments proved NFkB expression inhibition as well as cyclin D1 expression limitation under asoprisnil and ulipristal treatment. The established paracrine anti-proliferative activity of antiprogestins together with competitive interaction with RANK make this class of compounds attractive for further study in order to deliver more evidence of their anti-RANK activity and potential application in the breast cancer therapy together with its accompanied osteoporosis.
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Abstract
BACKGROUND Cancer treatment-induced bone loss is an important long-term effect among breast cancer survivors. Little is known, however, about the pattern of bone loss and the factors associated with it. OBJECTIVE The aim of this study was to examine annual bone health changes and factors associated with bone loss for 3 years after diagnosis among women with breast cancer. METHODS Ninety-nine newly diagnosed women with breast cancer (mean age, 51.1 years) were enrolled in a prospective longitudinal study. Bone mineral density (BMD) was measured with dual-energy x-ray absorptiometry at baseline and yearly for 3 years. RESULTS During the 3-year follow-up, the proportion of women who had osteopenia or osteoporosis increased from 33.3% to 62.5%. The BMD of the participants significantly decreased 6.8% in the lumbar spine, 4.6% in the femur neck, and 3.5% in the total hip, with bone loss the greatest in the first year. In multiple linear regression analysis, chemotherapy was significantly associated with bone loss at all sites, and premenopausal status at diagnosis was significantly related to bone loss at the lumbar spine. We found no significant relationship between health behavior status and BMD change at any site. CONCLUSION Women newly diagnosed with breast cancer can lose up to 6.8% of BMD during a 3-year follow-up. Chemotherapy and premenopausal status are important risk factors for bone loss. IMPLICATIONS FOR PRACTICE Identification of premenopausal women at diagnosis and monitoring BMD before and after chemotherapy are key for promoting bone health in women with breast cancer.
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Hu Y, Xu R, Chen CY, Rao SS, Xia K, Huang J, Yin H, Wang ZX, Cao J, Liu ZZ, Tan YJ, Luo J, Xie H. Extracellular vesicles from human umbilical cord blood ameliorate bone loss in senile osteoporotic mice. Metabolism 2019; 95:93-101. [PMID: 30668962 DOI: 10.1016/j.metabol.2019.01.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 01/14/2019] [Accepted: 01/17/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Senile osteoporosis is one of the most common age-related diseases worldwide. Accumulating evidences have indicated that young blood can reverse age-related impairments. Extracellular vesicles (EVs) exert therapeutic effects in a variety of diseases by delivering bioactive molecules such as microRNAs (miRNAs). The aim of the study is to evaluate the therapeutic potential of EVs from human umbilical cord blood plasma (UCB-EVs) on senile osteoporosis and to preliminarily clarify the underlying mechanism. METHODS UCB-EVs were injected into the tail vein of aged (16 months old) male C57BL/6 mice. Microcomputed tomography was performed to evaluate bone mass and microarchitecture of mice. The osteogenic and osteoclastic activities were determined by quantitative real-time PCR (qRT-PCR), histological examination and western blot analysis. In vitro, qRT-PCR assay was undertaken to explore the enrichment levels of a number of miRNAs that have positive effects in reducing bone loss. The efficacy of UCB-EVs on osteoblastic differentiation of bone marrow mesenchymal stromal cells (BMSCs) and osteoclastogenesis of RAW264.7 cells were assessed by cytochemical staining. Gene and protein expression changes were detected by qRT-PCR and western blotting respectively. Meanwhile, the roles of the selected miRNA in the regulatory effects of UCB-EVs on BMSCs and RAW264.7 cells were evaluated by using specific miRNA inhibitor. RESULTS The intravenous injection of UCB-EVs for two months attenuated bone loss in old mice, as defined by increased trabecular and cortical bone mass, enhanced osteoblast formation and reduced osteoclast formation compared to the control mice. In vitro, UCB-EVs could promote the osteogenic differentiation of BMSCs and inhibit the osteoclastogenesis of RAW264.7 cells. Moreover, it was confirmed that miR-3960 was highly enriched in UCB-EVs and miR-3960 inhibitor reversed the stimulatory effect of UCB-EVs on osteoblastic differentiation of BMSCs. CONCLUSION Our findings indicate that UCB-EVs ameliorate age-related bone loss by stimulating bone formation and inhibiting bone resorption, and miR-3960 mediated the osteogenic effect of UCB-EVs on BMSCs. Thus, UCB-EVs may represent a promising agent for prevention of senile osteoporosis.
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Affiliation(s)
- Yin Hu
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Ran Xu
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Chun-Yuan Chen
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Shan-Shan Rao
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Xiangya Nursing School, Central South University, Changsha, Hunan 410013, China
| | - Kun Xia
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Jie Huang
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Hao Yin
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Zhen-Xing Wang
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Jia Cao
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Zheng-Zhao Liu
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Yi-Juan Tan
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Juan Luo
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Hui Xie
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Hunan Key Laboratory of Organ Injury, Aging and Regenerative Medicine, Changsha, Hunan 410008, China; Hunan Key Laboratory of Bone Joint Degeneration and Injury, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
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Sun C, Zhang G, Cheng S, Qian H, Li D, Liu M. URG11 promotes proliferation and induced apoptosis of LNCaP cells. Int J Mol Med 2019; 43:2075-2085. [PMID: 30864678 PMCID: PMC6443344 DOI: 10.3892/ijmm.2019.4121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 02/27/2019] [Indexed: 12/20/2022] Open
Abstract
von Willebrand factor C and EGF domain-containing protein (URG11), a cell growth regulator, is involved in the progression of a variety of types of cancer, including prostate cancer (Pca). However, the functions of the URG11 gene in Pca cells require in-depth investigation. The mRNA and protein levels of URG11 were measured by reverse transcription quantitative polymerase chain reaction (RT-qPCR) and western blot analysis. Cell Counting kit-8 (CCK-8), wound-healing and Transwell assays were used to detect cell viability, migration and invasion, respectively. Apoptosis and cell cycle analyses were performed using flow cytometry. The mRNA and protein expression levels of epithelial (E)-cadherin, vimentin, α-smooth muscle actin (α-SMA), cyclin D1 and MYC proto-oncogene protein (c-Myc) were analyzed by RT-qPCR and western blot analysis. In the present study, the mRNA and protein levels of URG11 were markedly upregulated in Pca cell lines compared with those in the normal prostate epithelial cell line. With functional experiments, the cell viability, migration and invasion of Pca cells were markedly promoted by URG11 overexpression. The cell cycle was effectively induced by URG11 and apoptosis was inhibited by the overexpression of URG11. Concomitantly, the epithelial marker E-cadherin was downregulated, and the mesenchymal markers vimentin and α-SMA were upregulated following URG11 overexpression. By contrast, genetic knockout of URG11 elicited the opposite effects. The present study also identified that the downstream effector genes of the Wnt/β-catenin signal pathway, cyclin D1 and c-Myc, were increased following the overexpression of endogenous URG11, which are known to regulate cell proliferation. In addition, the Wnt/β-catenin inhibitor FH535 ameliorated the promotive effects of URG11 on LNCaP cells viability, migration and invasion, and the Wnt/β-catenin agonist LiCl reversed the inhibitory effects of siURG11 in LNCaP cells on cell viability, migration and invasion. The present study demonstrated that URG11 served an oncogenic role in the development of Pca cells and provided evidence that URG11 has potential as a novel therapeutic target in Pca.
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Affiliation(s)
- Chenmin Sun
- Department of Anesthesiology, Tongren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China
| | - Guangming Zhang
- Department of Anesthesiology, Tongren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China
| | - Shujie Cheng
- Department of Urology, Tongren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China
| | - Haining Qian
- Department of Urology, Tongren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China
| | - Dong Li
- Department of Urology, Tongren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China
| | - Min Liu
- Department of Urology, Tongren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China
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Chang L, Weiner LS, Hartman SJ, Horvath S, Jeste D, Mischel PS, Kado DM. Breast cancer treatment and its effects on aging. J Geriatr Oncol 2019; 10:346-355. [PMID: 30078714 PMCID: PMC7062379 DOI: 10.1016/j.jgo.2018.07.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/11/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Abstract
Breast cancer is the most common cancer of women in the United States. It is also proving to be one of the most treatable. Early detection, surgical intervention, therapeutic radiation, cytotoxic chemotherapies and molecularly targeted agents are transforming the lives of patients with breast cancer, markedly improving their survival. Although current breast cancer treatments are largely successful in producing cancer remission and extending lifespan, there is concern that these treatments may have long lasting detrimental effects on cancer survivors, in part, through their impact on non-tumor cells. Presently, the impact of breast cancer treatment on normal cells, its impact on cellular function and its effect on the overall function of the individual are incompletely understood. In particular, it is unclear whether breast cancer and/or its treatments are associated with an accelerated aging phenotype. In this review, we consider breast cancer survivorship from the perspective of accelerated aging, and discuss the evidence suggesting that women treated for breast cancer may suffer from an increased rate of physical and cognitive decline that likely corresponds with underlying vulnerabilities of genome instability, epigenetic changes, and cellular senescence.
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Affiliation(s)
- Leslie Chang
- Departments of Family Medicine & Public Health, School of Medicine, University of California, San Diego, United States; Department of Internal Medicine, School of Medicine University of California, San Diego, United States
| | - Lauren S Weiner
- Departments of Family Medicine & Public Health, School of Medicine, University of California, San Diego, United States; University of California San Diego, Moores Cancer Center, La Jolla, CA, United States
| | - Sheri J Hartman
- Departments of Family Medicine & Public Health, School of Medicine, University of California, San Diego, United States; University of California San Diego, Moores Cancer Center, La Jolla, CA, United States
| | - Steve Horvath
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, United States; Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, United States
| | - Dilip Jeste
- Departments of Psychiatry & Neuroscience, University of California, San Diego, United States; Sam and Rose Stein Institute for Research on Aging, United States
| | - Paul S Mischel
- Department of Pathology, School of Medicine, University of California, San Diego, United States; Ludwig Institute for Cancer Research, University of California, San Diego, United States
| | - Deborah M Kado
- Departments of Family Medicine & Public Health, School of Medicine, University of California, San Diego, United States; Department of Internal Medicine, School of Medicine University of California, San Diego, United States; Sam and Rose Stein Institute for Research on Aging, United States.
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Kyvernitakis I, Kostev K, Hadji P. The tamoxifen paradox-influence of adjuvant tamoxifen on fracture risk in pre- and postmenopausal women with breast cancer. Osteoporos Int 2018; 29:2557-2564. [PMID: 30032359 DOI: 10.1007/s00198-018-4642-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 07/11/2018] [Indexed: 11/26/2022]
Abstract
UNLABELLED Our data demonstrate that tamoxifen does not reduce fracture risk. Close surveillance is necessary to prevent bone loss in premenopausal women with breast cancer upon treatment initiation. INTRODUCTION Endocrine treatment of breast cancer may interfere with bone turnover and influence fracture risk. METHODS Out of a cohort of almost 5 million patients in total, we identified 5520 women between 18 and 90 years of age with breast cancer receiving tamoxifen, matched them with 5520 healthy controls using the Disease Analyzer Database, and investigated the fracture risk. RESULTS We found a cumulative incidence of fractures of 6.3% in patients aged between 18 and 50 years (n = 3634) treated with tamoxifen versus a cumulative incidence of 3.6% in the control group (p < 0.001). As such, the risk of fracture was 75% higher for patients receiving tamoxifen than that for healthy controls (HR 1.75; 95% CI 1.25-2.48). With regard to patients aged between 55 and 90 years (n = 7406), the cumulative incidence of fractures in patients treated with tamoxifen was 10.1% compared to 9.3% in the control group (p = 0.740), i.e., there was no significant difference between the two groups (HR 0.97; 95% CI 0.81-1.16). CONCLUSIONS Compared to healthy controls, premenopausal women with breast cancer treated with tamoxifen showed an increased risk of fracture, while postmenopausal women on tamoxifen did not show any risk reduction.
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Affiliation(s)
- I Kyvernitakis
- Department of Obstetrics and Gynecology, Buergerhospital and Clementine Kinderhospital Frankfurt, Nibelungenallee 37-41, 60318, Frankfurt, Germany.
- Dr. Senckenberg Foundation and Goethe-University of Frankfurt, Frankfurt, Germany.
- Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany.
| | - K Kostev
- Epidemiology, IQVIA, Frankfurt, Germany
| | - P Hadji
- Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany
- Department of Bone Oncology, Gyn. Endocrinology and Reproductive Medicine, Nordwest Hospital, Frankfurt, Germany
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Bao T, Peppone LJ, Robinson P. Addressing the Unintentional Consequences of Cancer Therapy With Novel Integrative Therapeutics. Am Soc Clin Oncol Educ Book 2018; 38:822-828. [PMID: 30231327 DOI: 10.1200/edbk_201411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There are 15.5 million cancer survivors in the United States because of, in part, improvements in therapy. As a result, there will be an increased burden of long- and late-term complications of cancer care, such as metabolic alterations. These metabolic changes will include alterations in bone resorption, obesity, hypercholesterolemia, and diabetes mellitus. The majority of cancer treatment-related toxicities have focused on endocrine therapy; however, chemotherapy and supportive medications, such as steroids, contribute to the development of these disorders. Because of the chronicity of these metabolic changes and their impact on morbidity, cancer risk, and outcomes as well other negative effects, including musculoskeletal pain and vasomotor symptoms, alternative strategies must be developed. These strategies should include nonpharmacologic approaches. Here, we summarize metabolic changes secondary to cancer care and integrative approaches to help alleviate therapy-associated toxicities.
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Affiliation(s)
- Ting Bao
- From the Memorial Sloan Kettering Cancer Center, New York, NY; University of Rochester Medical Center, Rochester, NY; Loyola University Medical Center, Maywood, IL
| | - Luke J Peppone
- From the Memorial Sloan Kettering Cancer Center, New York, NY; University of Rochester Medical Center, Rochester, NY; Loyola University Medical Center, Maywood, IL
| | - Patricia Robinson
- From the Memorial Sloan Kettering Cancer Center, New York, NY; University of Rochester Medical Center, Rochester, NY; Loyola University Medical Center, Maywood, IL
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Luo F, Liu T, Wang J, Li J, Ma P, Ding H, Feng G, Lin D, Xu Y, Yang K. Bone marrow mesenchymal stem cells participate in prostate carcinogenesis and promote growth of prostate cancer by cell fusion in vivo. Oncotarget 2017; 7:30924-34. [PMID: 27129157 PMCID: PMC5058728 DOI: 10.18632/oncotarget.9045] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 04/08/2016] [Indexed: 12/30/2022] Open
Abstract
The tumor microenvironment is comprised of diverse stromal cells that contribute towards tumor progression. As a result, there has been a growing interest in the role of bone marrow derived cells (BMDCs) in cancer progression. However, the role of BMDCs in prostate cancer (PCa) progression still remains unclear. In this study, we established GFP bone marrow transplanted TRAMP and MUN-induced prostate cancer models, in order to investigate the role of BMDCs in prostate cancer progression. By tracing GFP positive cells, we observed that BMDCS were recruited into mouse prostate tissues during tumorigenesis. GFP+/Sca-1+/CD45− BMDCs were significantly increased in the MNU-induced PCa group, as compared to the citrated-treated control group (2.67 ± 0.25% vs 0.67 ± 0.31%, p = 0.006). However, there were no significant differences found in GFP+/Sca-1+/CD45+ cell populations between the two groups (0.27 ± 0.15% vs 0.10 ± 0.10%, p = 0.334). Moreover, co-grafting of bone marrow mesenchymal stem cells (BMMSCs) and RM1 cells were found to promote RM1 tumor growth in vivo, and cell fusion was observed in RM-1+BMMSCs xenografts. Therefore, the data suggests that BMDCs can be recruited to the prostate during carcinogenesis, and that BMMSCs may promote the growth of PCa.
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Affiliation(s)
- Fei Luo
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin, China.,Department of Urology, Tianjin Union Medical Center, Tianjin, China
| | - Tong Liu
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin, China
| | - Jianan Wang
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin, China
| | - Jian Li
- Department of Urology, Tianjin Union Medical Center, Tianjin, China
| | - Pengde Ma
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin, China
| | - Hao Ding
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin, China
| | - Guowei Feng
- Department of Genitourinary Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Dong Lin
- BC Cancer Research Centre, Vancouver, Canada
| | - Yong Xu
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin, China
| | - Kuo Yang
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin, China
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des Bordes JKA, Suarez-Almazor ME, Volk RJ, Lu H, Edwards B, Lopez-Olivo MA. Online Educational Tool to Promote Bone Health in Cancer Survivors. JOURNAL OF HEALTH COMMUNICATION 2017; 22:808-817. [PMID: 28922062 DOI: 10.1080/10810730.2017.1360415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Osteoporosis burden is significant in cancer survivors. Websites providing health information abound, but their development, quality, and source of information remain unclear. Our aim was to use a systematic and transparent approach to create an educational website on bone health, and to evaluate its potential to improve knowledge, self-management, and awareness in prostate cancer (PCa) and breast cancer (BCa) survivors. Guided by the Health Belief Model, we created a website using international standards and evaluated it in 10 PCa and 10 BCa survivors with self-administered questionnaire before, after, and 1 month after navigating the website. The mean scores on the knowledge questionnaire at baseline, postintervention and 1 month were, respectively, 5.1 (±2.0), 6.9 (±2.5), and 6.7 (±2.4), p < .008, in PCa and 3.4 (±2.7), 7.6 (±3.0), and 6.5 (±3.8), p = .016, in BCa survivors. Acceptability ratings ranged from 60% to 100%. Participants found the website useful, helpful, and able to raise bone health awareness. Our website improved bone health knowledge in both PCa and BCa survivors. A systematic and transparent approach to the development of online educational websites could result in a tool capable of meeting the educational needs of targeted consumers. Cancer survivors could benefit from proven online educational tools.
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Affiliation(s)
- Jude K A des Bordes
- a Department of General Internal Medicine , The University of Texas MD Anderson Cancer Center , Houston , Texas , USA
| | - Maria E Suarez-Almazor
- a Department of General Internal Medicine , The University of Texas MD Anderson Cancer Center , Houston , Texas , USA
| | - Robert J Volk
- b Department of Health Services Research , The University of Texas, MD Anderson Cancer Center , Houston , Texas , USA
| | - Huifang Lu
- a Department of General Internal Medicine , The University of Texas MD Anderson Cancer Center , Houston , Texas , USA
| | - Beatrice Edwards
- a Department of General Internal Medicine , The University of Texas MD Anderson Cancer Center , Houston , Texas , USA
| | - Maria A Lopez-Olivo
- a Department of General Internal Medicine , The University of Texas MD Anderson Cancer Center , Houston , Texas , USA
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Abstract
Aging poses an unique opportunity to study cancer biology and treatment in older adults. Breast cancer is often studied in young women; however, much investigation remains to be done on breast cancer in our expanding elderly population. Diagnostic and management strategies applicable to younger patients cannot be empirically used to manage older breast cancer patients. Lack of evidence-based data continues to be the major impediment toward delivery of personalized cancer care to elderly breast cancer patients. This article reviews the relevant literature on management of curable breast cancer in the elderly, the role of geriatric assessment, complex treatment decision making within the context of patient's expected life expectancy, comorbidities, physical function, socioeconomic status, barriers to health care delivery, goals of treatment, and therapy-related side effects. Continuing efforts for enrolling elderly breast cancer patients in contemporary clinical trials, and thus improving age-appropriate care, are emphasized.
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The Effect on Bone Outcomes of Adding Exercise to Supplements for Osteopenic Breast Cancer Survivors. Cancer Nurs 2016; 39:144-52. [DOI: 10.1097/ncc.0000000000000245] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Assessing information needs on bone health in cancer survivors. J Cancer Surviv 2015; 10:480-8. [DOI: 10.1007/s11764-015-0491-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 10/10/2015] [Indexed: 12/13/2022]
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Abstract
With earlier cancer diagnosis among older patients with cancer, the possibility of curing cancer increases. However, cancer treatment may have a long-lasting impact on older cancer survivors. It is vital to screen, diagnose, and properly manage the long-term toxicities of cancer treatment in order to maintain the quality of life of older cancer survivors.
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Sudhan DR, Siemann DW. Cathepsin L targeting in cancer treatment. Pharmacol Ther 2015; 155:105-16. [PMID: 26299995 DOI: 10.1016/j.pharmthera.2015.08.007] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 08/17/2015] [Indexed: 12/14/2022]
Abstract
Proteolytic enzymes may serve as promising targets for novel therapeutic treatment strategies seeking to impede cancer progression and metastasis. One such enzyme is cathepsin L (CTSL), a lysosomal cysteine protease. CTSL upregulation, a common occurrence in a variety of human cancers, has been widely correlated with metastatic aggressiveness and poor patient prognosis. In addition, CTSL has been implicated to contribute to cancer-associated osteolysis, a debilitating morbidity affecting both life expectancy and the quality of life. In this review, we highlight the mechanisms by which CTSL contributes to tumor progression and dissemination and discuss the therapeutic utility of CTSL intervention strategies aimed at impeding metastatic progression and bone resorption.
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Affiliation(s)
- Dhivya R Sudhan
- Department of Radiation Oncology, University of Florida Health Cancer Center, Gainesville, FL, USA
| | - Dietmar W Siemann
- Department of Radiation Oncology, University of Florida Health Cancer Center, Gainesville, FL, USA; Department of Pharmacology and Therapeutics, College of Medicine, University of Florida, Gainesville, FL, USA.
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Garg A, Leitzel K, Ali S, Lipton A. Antiresorptive therapy in the management of cancer treatment-induced bone loss. Curr Osteoporos Rep 2015; 13:73-7. [PMID: 25575469 DOI: 10.1007/s11914-014-0252-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Cancer treatment-induced bone loss treatment has an important role to prevent bone loss-related events like fracture, significant morbidity, mortality, disfigurement and loss of self-esteem, and health-care expenditure. Numerous factors, including treatment regimens and bone metastasis, increase the risk of osteoporosis or local bone destruction in most breast and prostate cancer patients. Cytotoxic chemotherapies, radiation, and hormonal therapies can lead to premature menopause and decrease bone mineral density. Over 60 % of breast cancer patients within 1 year of beginning postoperative adjuvant chemotherapy experience ovarian failure. Also, ovarian ablation and aromatase inhibitors used to treat breast cancer and orchiectomy and androgen deprivation therapy (ADT; to treat prostate cancer) cause substantial bone loss. In this article, we will focus mainly on antiresorptive therapy in the management of cancer treatment-induced bone loss (CTIBL). An understanding of CTIBL is critical for determining how to assess the risk and identify which patients may benefit from preventive therapy.
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Affiliation(s)
- Ashwani Garg
- Penn State Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA,
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Winters-Stone KM, Dobek JC, Bennett JA, Maddalozzo GF, Ryan CW, Beer TM. Skeletal response to resistance and impact training in prostate cancer survivors. Med Sci Sports Exerc 2015; 46:1482-8. [PMID: 24500540 DOI: 10.1249/mss.0000000000000265] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Androgen deprivation therapy (ADT) is associated with significant bone loss and an increase in fracture risk among prostate cancer survivors (PCS). We investigated whether impact + resistance training could stop ADT-related declines in bone mineral density (BMD) among PCS on ADT. METHODS We randomized 51 PCS (mean age, 70.2 yr) currently prescribed ADT to participate in 1 yr of impact + resistance training (Prevent Osteoporosis with Impact + Resistance (POWIR)) or in an exercise placebo program of stretching exercise (FLEX). Outcomes were proximal femur (total hip, femoral neck, and greater trochanter) and spine (L1-L4) BMD (g·cm) and bone turnover markers (serum osteocalcin (ng·mL) and urinary deoxypyrodinoline cross-links (nmol·mmol Cr)). RESULTS Retention in the 1-yr study was 84% and median attendance to supervised classes was 84% in POWIR and 74% in FLEX. No study-related injuries were reported. There were no significant differences between groups for average L1-L4 BMD or for BMD at any hip site. When examining individual vertebrae, POWIR has a significant effect on preservation of BMD (-0.4%) at the L4 vertebrae compared with losses (-3.1%) in FLEX (P = 0.03). CONCLUSION Impact + resistance training was a safe and acceptable form of exercise for older PCS on ADT. Among our limited sample, POWIR did not appear to have a clinically meaningful effect on hip or spine BMD, but some evidence of skeletal adaptation to resistance + impact training in an androgen-deprived state was apparent. Future studies need to be conducted on a larger sample of patients and should consider modifications to POWIR that could further enhance loading across the spine and at the hip to preserve BMD at these clinically relevant sites.
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Affiliation(s)
- Kerri M Winters-Stone
- 1School of Nursing, Oregon Health and Science University, Portland, OR; 2School of Medicine, Oregon Health and Science University, Portland, OR; and 3Knight Cancer Institute, Oregon Health and Science University, Portland, OR; 4Department of Exercise and Sport Science, School of Biologic and Population Health, Oregon State University, Corvallis, OR
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Heins M(M, Korevaar J(J, Donker G(G, Rijken P(M, Schellevis F(F. The combined effect of cancer and chronic diseases on general practitioner consultation rates. Cancer Epidemiol 2015; 39:109-14. [DOI: 10.1016/j.canep.2014.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 12/02/2014] [Accepted: 12/07/2014] [Indexed: 10/24/2022]
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Skolarus TA, Wolf AMD, Erb NL, Brooks DD, Rivers BM, Underwood W, Salner AL, Zelefsky MJ, Aragon-Ching JB, Slovin SF, Wittmann DA, Hoyt MA, Sinibaldi VJ, Chodak G, Pratt-Chapman ML, Cowens-Alvarado RL. American Cancer Society prostate cancer survivorship care guidelines. CA Cancer J Clin 2014; 64:225-49. [PMID: 24916760 DOI: 10.3322/caac.21234] [Citation(s) in RCA: 296] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 04/14/2014] [Indexed: 12/15/2022] Open
Abstract
Prostate cancer survivors approach 2.8 million in number and represent 1 in 5 of all cancer survivors in the United States. While guidelines exist for timely treatment and surveillance for recurrent disease, there is limited availability of guidelines that facilitate the provision of posttreatment clinical follow-up care to address the myriad of long-term and late effects that survivors may face. Based on recommendations set forth by a National Cancer Survivorship Resource Center expert panel, the American Cancer Society developed clinical follow-up care guidelines to facilitate the provision of posttreatment care by primary care clinicians. These guidelines were developed using a combined approach of evidence synthesis and expert consensus. Existing guidelines for health promotion, surveillance, and screening for second primary cancers were referenced when available. To promote comprehensive follow-up care and optimal health and quality of life for the posttreatment survivor, the guidelines address health promotion, surveillance for prostate cancer recurrence, screening for second primary cancers, long-term and late effects assessment and management, psychosocial issues, and care coordination among the oncology team, primary care clinicians, and nononcology specialists. A key challenge to the development of these guidelines was the limited availability of published evidence for management of prostate cancer survivors after treatment. Much of the evidence relies on studies with small sample sizes and retrospective analyses of facility-specific and population databases.
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Affiliation(s)
- Ted A Skolarus
- Assistant Professor of Urology, Department of Urology, University of Michigan, Research Investigator, HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
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Choi KH, Park SM, Park JS, Park JH, Kim KH, Kim MJ. Prevalence of and factors associated with osteoporosis among Korean cancer survivors: a cross-sectional analysis of the Fourth and Fifth Korea National Health and Nutrition Examination Surveys. Asian Pac J Cancer Prev 2014; 14:4743-50. [PMID: 24083737 DOI: 10.7314/apjcp.2013.14.8.4743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Identifying and managing osteoporosis among cancer survivors is an important issue, yet little is known about the bone health of cancer survivors in Korea. This study was designed to measure the prevalence of osteoporosis and to assess related factors among Korean cancer survivors. MATERIALS AND METHODS This study was designed as a cross-sectional analysis. Data were obtained from dual energy X-ray absorptiometry measurement of the lumbar vertebrae and femoral neck, and from standardized questionnaires among 556 cancer survivors and 17,623 non-cancer controls who participated in the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (2008-2011). We calculated adjusted proportions of osteoporosis in non-cancer controls vs. cancer survivors, and we performed multivariate logistic regression analysis. RESULTS The prevalence of osteoporosis among cancer survivors was significant higher than that of the non-cancer controls after adjusting for related factors. Furthermore, osteoporosis among cancer survivors was higher in elderly subjects (60-69 years : adjusted odds ratio (aOR) 3.04, 95% CI : 1.16-8.00, ≥70 years : aOR 6.60, 95% CI 2.20-19.79), in female cancer survivors (aOR: 7.03, 95% CI: 1.88-26.28), and in a group with lower monthly income (aOR: 3.38, 95% CI: 1.31-8.71). In male cancer survivors, underweight and lower calcium intake were risk factors. CONCLUSIONS These data suggest that the osteoporosis among cancer survivors varies according to non-oncologic and oncologic factors. Effective screening should be applied, and a sufficient and comprehensive management should be matched to individual cancer survivors early after cancer treatment.
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Affiliation(s)
- Kyung-Hyun Choi
- Department of Family Medicine, Dong-A University College of Medicine, Busan, Korea E-mail : ,
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Poulsen MH, Frost M, Abrahamsen B, Brixen K, Walter S. Osteoporosis and prostate cancer: a cross-sectional study of Danish men with prostate cancer before androgen deprivation therapy. Scand J Urol 2014; 48:350-5. [DOI: 10.3109/21681805.2014.884160] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Tripathy D, Durie BGM, Mautner B, Ferenz KS, Moul JW. Awareness, concern, and communication between physicians and patients on bone health in cancer. Support Care Cancer 2014; 22:1601-10. [PMID: 24477326 DOI: 10.1007/s00520-014-2127-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Accepted: 01/08/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE This study aims to explore physician-patient communications about bone metastases and cancer treatment-induced bone loss (CTIBL). METHODS The study utilizes online survey of patients with breast cancer, prostate cancer, and multiple myeloma, and the physicians who treat them. RESULTS Even though 69 and 48 % of patients with nonmetastatic breast and prostate cancer aware of treatment-induced bone loss, only 39 and 23 %, respectively, were concerned about bone loss. Yet, 62 and 71 % of oncologists treating breast and prostate cancer felt that their patients were concerned. Among patients with metastatic breast and prostate cancer, two thirds had not discussed treatment for bone metastases with their doctor; when discussed, 88 and 91 % of discussions were initiated by the doctor, usually prior to initiating treatment. Most myeloma patients (77 %) had discussed treatment options with their physicians; 99 % of hematologists reported discussing treatment of bone disease with patients. CONCLUSIONS Physicians are primary sources of information to patients regarding bone health. There is a gap between what physicians assume their patients know about bone health and the patients' perceptions, presenting a need for systematic awareness and education.
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Affiliation(s)
- Debu Tripathy
- USC/Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Ave., #3447, Los Angeles, CA, 90033, USA,
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Rizzoli R, Body JJ, Brandi ML, Cannata-Andia J, Chappard D, El Maghraoui A, Glüer CC, Kendler D, Napoli N, Papaioannou A, Pierroz DD, Rahme M, Van Poznak CH, de Villiers TJ, El Hajj Fuleihan G. Cancer-associated bone disease. Osteoporos Int 2013; 24:2929-53. [PMID: 24146095 PMCID: PMC5104551 DOI: 10.1007/s00198-013-2530-3] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 09/25/2013] [Indexed: 12/11/2022]
Abstract
Bone is commonly affected in cancer. Cancer-induced bone disease results from the primary disease, or from therapies against the primary condition, causing bone fragility. Bone-modifying agents, such as bisphosphonates and denosumab, are efficacious in preventing and delaying cancer-related bone disease. With evidence-based care pathways, guidelines assist physicians in clinical decision-making. Of the 57 million deaths in 2008 worldwide, almost two thirds were due to non-communicable diseases, led by cardiovascular diseases and cancers. Bone is a commonly affected organ in cancer, and although the incidence of metastatic bone disease is not well defined, it is estimated that around half of patients who die from cancer in the USA each year have bone involvement. Furthermore, cancer-induced bone disease can result from the primary disease itself, either due to circulating bone resorbing substances or metastatic bone disease, such as commonly occurs with breast, lung and prostate cancer, or from therapies administered to treat the primary condition thus causing bone loss and fractures. Treatment-induced osteoporosis may occur in the setting of glucocorticoid therapy or oestrogen deprivation therapy, chemotherapy-induced ovarian failure and androgen deprivation therapy. Tumour skeletal-related events include pathologic fractures, spinal cord compression, surgery and radiotherapy to bone and may or may not include hypercalcaemia of malignancy while skeletal complication refers to pain and other symptoms. Some evidence demonstrates the efficacy of various interventions including bone-modifying agents, such as bisphosphonates and denosumab, in preventing or delaying cancer-related bone disease. The latter includes treatment of patients with metastatic skeletal lesions in general, adjuvant treatment of breast and prostate cancer in particular, and the prevention of cancer-associated bone disease. This has led to the development of guidelines by several societies and working groups to assist physicians in clinical decision making, providing them with evidence-based care pathways to prevent skeletal-related events and bone loss. The goal of this paper is to put forth an IOF position paper addressing bone diseases and cancer and summarizing the position papers of other organizations.
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Affiliation(s)
- R Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland,
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Oral adjuvant clodronate therapy could improve overall survival in early breast cancer: results from an updated systematic review and meta-analysis. Eur J Cancer 2013; 49:2086-92. [PMID: 23452992 DOI: 10.1016/j.ejca.2013.01.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 01/17/2013] [Accepted: 01/19/2013] [Indexed: 11/21/2022]
Abstract
OBJECT The aim of this study was to evaluate the effectiveness of clodronate in the adjuvant therapy of early breast cancer on patient survival. METHODS We performed a literature search to identify studies that investigated the effects of clodronate treatment on early breast cancer. Random and fixed-effect meta-analytical models were used where indicated and between-study heterogeneity was assessed. The primary study end-points were overall survival. Secondary end-points were bone metastasis-free survival and non-skeletal metastasis (mainly visceral metastases) free survival. RESULTS Four randomised controlled trials met the inclusion criteria. Risk ratio (95% confidence interval (CI)) of overall survival was 0.84 (0.56-1.26); risk ratio (95% CI) of bone metastasis-free survival was 0.77 (0.58-1.02); risk ratio (95% CI) of non-bone metastasis-free survival was 0.89 (0.61-1.30). Outcomes after sensitivity analysis were: risk ratio (95% CI) of overall survival was 0.71 (0.52-0.96); risk ratio (95% CI) of bone metastasis-free survival was 0.70 (0.56-0.86); risk ratio (95% CI) of non-bone metastasis-free survival was 0.76 (0.64-0.92). CONCLUSION Compared with the control arm, adjuvant treatment with clodronate may improve the overall survival, bone metastasis-free survival and non-bone metastasis-free (mainly visceral metastases) survival in patients with early breast cancer. However, further meta-analyses involving all known randomised trials with analysis of sub-groups by age or menopausal status, accessing original trial data, should be performed.
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Nadler M, Alibhai S, Catton P, Catton C, To MJ, Jones JM. Osteoporosis knowledge, health beliefs, and healthy bone behaviours in patients on androgen-deprivation therapy (ADT) for prostate cancer. BJU Int 2013; 111:1301-9. [PMID: 23351062 DOI: 10.1111/j.1464-410x.2012.11777.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To describe in patients with prostate cancer, receiving androgen-deprivation therapy (ADT): (i) knowledge, self-efficacy (SE), and health beliefs about osteoporosis (OP); (ii) current engagement in healthy bone behaviours (HBBs). To explore the relationships between knowledge, SE, and health beliefs, and engagement in HBBs. PATIENTS AND METHODS 175 patients receiving ADT by injection completed questionnaires assessing current HBBs, OP knowledge, SE, and health beliefs (motivation, perceived susceptibility, and seriousness). Descriptive statistics and independent samples t-tests were used to assess relationships between knowledge, SE, health beliefs, and engagement in HBBs. RESULTS Only 38% of patients had undergone a dual X-ray absorptiometry scan in the past 2 years. OP knowledge was low (mean [sd, range] 9.6 [4.4, 0-19]) and perceived SE moderate (84.7 [24.5, 0-120]). Health motivation was fairly high (23.6 [3.1, 6-30]), but perceived susceptibility (16.8 [4.3]) and seriousness (16.8 [4.2]) of OP were low. Few patients met the recommendations for vitamin D intake (42%) and exercise (31%), and 15% were at risk of over-supplementation of calcium. Patients taking calcium supplements (P = 0.04), and meeting guidelines for vitamin D (P = 0.008) and for exercise (P = 0.002) had significantly greater knowledge than those who did not. Patients who were engaging in less than four of five HBBs had lower knowledge (P < 0.001) and health motivation (P = 0.01) than those who were engaging in four or all five HBBs. CONCLUSIONS Most patients who are receiving ADT are not receiving appropriate screening, lack basic information about bone health, and are not engaging in the appropriate HBBs. These findings support the application of the Health Belief Model in this population: interventions that teach patients about the implications of bone loss, encourage proper uptake of HBBs, and promote feelings of SE could increase engagement in HBBs to prevent and manage bone loss.
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Affiliation(s)
- Michelle Nadler
- Cancer Survivorship Program, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
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van Londen G, Beckjord EB, Dew MA, Cuijpers P, Tadic S, Brufsky A. Breast cancer survivorship symptom management: current perspective and future development. BREAST CANCER MANAGEMENT 2013; 2:71-81. [PMID: 23814614 PMCID: PMC3693468 DOI: 10.2217/bmt.12.63] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Increasing numbers and longevity of cancer survivors has furthered our insight into the factors affecting their health outcomes, suggesting that multiple factors play a role (e.g., effects of cancer treatments and health behaviors). Emotional and physical symptoms may not always receive sufficient attention. In this short narrative review highlighting recent literature, we describe the most common physical and emotional symptoms of breast cancer survivors aged 50 years and older and outline a multidisciplinary symptom management approach, regardless of symptom etiology.
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Affiliation(s)
- G van Londen
- University of Pittsburgh, Department of Medicine (Hematology–Oncology, Geriatric Medicine) & Clinical & Translational Science Institute, Pittsburgh, PA, USA
| | - EB Beckjord
- University of Pittsburgh, Department of Psychiatry, Biobehavioral Medicine in Oncology Program, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - MA Dew
- University of Pittsburgh, Departments of Psychiatry, Psychology, Epidemiology & Biostatistics, Pittsburgh, PA, USA
| | - P Cuijpers
- VU University, Department of Clinical Psychology, Amsterdam, The Netherlands
| | - S Tadic
- University of Pittsburgh, Department of Medicine (Geriatric Medicine) & Clinical & Translational Science Institute, Pittsburgh, PA, USA
| | - A Brufsky
- University of Pittsburgh, Department of Medicine (Hematology–Oncology), Pittsburgh, PA, USA
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Rhee Y, Song K, Park S, Park HS, Lim SK, Park BW. Efficacy of a combined alendronate and calcitriol agent (Maxmarvil®) in Korean postmenopausal women with early breast cancer receiving aromatase inhibitor: a double-blind, randomized, placebo-controlled study. Endocr J 2013; 60:167-72. [PMID: 23064476 DOI: 10.1507/endocrj.ej12-0283] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The use of aromatase inhibitor (AI) in postmenopausal women with hormone receptor (HR)-positive early breast cancer (EBC) produces a deleterious effect on bone mass and an increase in fractures. Several studies using intravenous bisphosphonates have shown effective management of AI-induced bone loss. To determine whether a lower dosage in oral form combined with calcitriol can effectively manage AI-induced bone loss, we performed a randomized, double-blind, prospective, placebo-controlled 24-week trial with a combination of alendronate and 0.5-µg of calcitriol daily to HR-positive EBC patients. A total of 98 Korean postmenopausal women with HR-positive EBC who received daily AI, calcium and vitamin D were randomly assigned to 5-mg of alendronate and 0.5-µg of calcitriol (Maxmarvil®) or placebo groups. The bone mineral density (BMD) and turnover markers were measured. At week 24, the difference in lumbar BMD between the groups was 3.0% (p < 0.005). The increase in C-telopeptide after 24 weeks was significantly less in the Maxmarvil group compared to that in the placebo group (35.2 ± 17.5% vs. 109.8 ± 28.6%, p < 0.05). Our study demonstrates that a combination of 5-mg alendronate and 0.5-µg calcitriol is effective to prevent bone loss due to AI in Korean postmenopausal women with EBC.
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Affiliation(s)
- Yumie Rhee
- Department of Internal Medicine, Endocrine Research Institute, and Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, 120-752, Seoul, Korea
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Potential implications of adjuvant endocrine therapy for the oral health of postmenopausal women with breast cancer. Breast Cancer Res Treat 2012; 137:23-32. [PMID: 22986813 DOI: 10.1007/s10549-012-2217-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 08/08/2012] [Indexed: 12/11/2022]
Abstract
Current adjuvant treatment modalities for breast cancer that express the estrogen receptor or progesterone receptor include adjuvant anti-estrogen therapies, and tamoxifen and aromatase inhibitors. Bone, including the jaw, is an endocrine-sensitive organ, as are other oral structures. This review examines the potential links between adjuvant anti-estrogen treatments in postmenopausal women with hormone receptor positive breast cancer and oral health. A search of PubMed, EMBASE, CENTRAL, and the Web of Knowledge was conducted using combinations of key terms "breast," "cancer," "neoplasm," "Tamoxifen," "Aromatase Inhibitor," "chemotherapy," "hormone therapy," "alveolar bone loss," "postmenopausal bone loss," "estrogen," "SERM," "hormone replacement therapy," and "quality of life." We selected articles published in peer-reviewed journals in the English. The authors found no studies reporting on periodontal diseases, alveolar bone loss, oral health, or oral health-related quality of life in association with anti-estrogen breast cancer treatments in postmenopausal women. Periodontal diseases, alveolar bone density, tooth loss, and conditions of the soft tissues of the mouth have all been associated with menopausal status supporting the hypothesis that the soft tissues and bone of the oral cavity could be negatively affected by anti-estrogen therapy. As a conclusion, the impact of adjuvant endocrine breast cancer therapy on the oral health of postmenopausal women is undefined. The structures of the oral cavity are influenced by estrogen; therefore, anti-estrogen therapies may carry the risk of oral toxicities. Oral health care for breast cancer patients is an important but understudied aspect of cancer survivorship.
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Choi DK, Lee IG, Hwang JH. Arterial to end-tidal carbon dioxide pressure gradient increases with age in the steep Trendelenburg position with pneumoperitoneum. Korean J Anesthesiol 2012; 63:209-15. [PMID: 23060976 PMCID: PMC3460148 DOI: 10.4097/kjae.2012.63.3.209] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 03/26/2012] [Accepted: 04/12/2012] [Indexed: 11/10/2022] Open
Abstract
Background Several factors affect the end-tidal carbon dioxide pressure (PETCO2) and increase the arterial to end-tidal carbon dioxide pressure gradient (Pa-ETCO2) during general anesthesia. We evaluated the relationship between age and Pa-ETCO2 during pneumoperitoneum in the steep Trendelenburg position in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). Methods Ninety-two consecutive patients undergoing RALP were divided by age into a middle-aged (45-65 years) and an elderly (> 65 years) group. Anesthesia was standardized. Heart rate, mean arterial pressure, peak inspiratory pressure, lung compliance, minute ventilation, PaO2, PETCO2, PaCO2, and Pa-ETCO2 were measured 10 min after intubation in the supine position without pneumoperitoneum (T0); and 10 (T1), 60 (T2), and 120 (T3) min after pneumoperitoneum in the Trendelenburg position. Results Although PETCO2 did not change significantly during surgery, PaCO2 and Pa-ETCO2 increased gradually with time during pneumoperitoneum in the Trendelenburg position, and both parameters showed greater increases in the elderly than in the middle-aged group. Simple linear regression analyses revealed significant correlations between age and Pa-ETCO2 at T0 (P = 0.018), T1 (P = 0.006), T2 (P < 0.001), and T3 (P = 0.001). Linear mixed model analysis showed that Pa-ETCO2 was associated statistically significantly with age and duration of pneumoperitoneum in the Trendelenburg position, but age and duration of pneumoperitoneum in the Trendelenburg position were not associated (P = 0.090). Conclusions The magnitude of Pa-ETCO2 during pneumoperitoneum in the steep Trendelenburg position increased with age, which could be attributed to age-related respiratory physiological changes.
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Affiliation(s)
- Dae-Kee Choi
- Department of Anesthesiology and Pain Medicine, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea
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Current World Literature. Curr Opin Support Palliat Care 2012; 6:402-16. [DOI: 10.1097/spc.0b013e3283573126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chronic Diseases among Older Cancer Survivors. J Cancer Epidemiol 2012; 2012:206414. [PMID: 22956953 PMCID: PMC3432539 DOI: 10.1155/2012/206414] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 04/30/2012] [Accepted: 05/21/2012] [Indexed: 01/07/2023] Open
Abstract
Objective. To compare the occurrence of pre-existing and subsequent comorbidity among older cancer patients (≥60 years) with older non-cancer patients. Material and Methods. Each cancer patient (n = 3835, mean age 72) was matched with four non-cancer patients in terms of age, sex, and practice. The occurrence of chronic diseases was assessed cross-sectionally (lifetime prevalence at time of diagnosis) and longitudinally (incidence after diagnosis) for all cancer patients and for breast, prostate, and colorectal cancer patients separately. Cancer and non-cancer patients were compared using logistic and Cox regression analysis. Results. The occurrence of the most common pre-existing and incident chronic diseases was largely similar in cancer and non-cancer patients, except for pre-existing COPD (OR 1.21, 95% CI 1.06–1.37) and subsequent venous thrombosis in the first two years after cancer diagnosis (HR 4.20, 95% CI 2.74–6.44), which were significantly more frequent (P < 0.01) among older cancer compared to non-cancer patients. Conclusion. The frequency of multimorbidity in older cancer patients is high. However, apart from COPD and venous thrombosis, the incidence of chronic diseases in older cancer patients is similar compared to non-cancer patients of the same age, sex, and practice.
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Kim SH, Cho YU, Kim SJ, Lee JE, Kim JH. Low bone density in breast cancer survivors in Korea: prevalence, risk factors and associations with health-related quality of life. Eur J Oncol Nurs 2012; 17:196-203. [PMID: 22898655 DOI: 10.1016/j.ejon.2012.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 07/07/2012] [Accepted: 07/11/2012] [Indexed: 11/15/2022]
Abstract
PURPOSE To examine the prevalence and risk factors of low bone density and identify associations with health-related quality of life (HRQOL) in breast cancer survivors in Korea. METHODS This study was a cross-sectional descriptive study design. A total of 136 women with breast cancer who had completed their therapy were recruited at one university-based cancer center in Korea. Bone mineral density (BMD), health behaviors (physical activity, diet/nutrition behaviors, smoking, alcohol consumption, sunlight exposure), and HRQOL were measured. RESULTS Among the 136 breast cancer survivors, 49 women (36.0%) had osteopenia and six women (4.4%) had osteoporosis. Univariate analyses revealed that older age, low education level, low monthly income, tamoxifen therapy, aromatase inhibitor therapy, calcium supplement intake, and past or current smoking were associated with low bone density (BMD T-score < -1.0). In multivariate analyses, low economic status (OR = 2.22, p = 0.050) and past or current smoking (OR = 3.77, p = 0.039) were final risk factors of low bone density. In addition, women who had low bone density reported worse role function (p = 0.022) than women who did not. CONCLUSIONS Women of lower economic status or who are past or current smokers warrant monitoring and treatment strategies to reduce bone loss risk. Nurses may play a crucial role in screening this high-risk group for low bone density and in educating patients on the importance of healthy lifestyle changes.
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Affiliation(s)
- Soo Hyun Kim
- Department of Nursing, Inha University, 253 Yonghyun-dong, Nam-gu, Incheon 410-742, Republic of Korea.
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Ding X, Fan Y, Ma F, Li Q, Wang J, Zhang P, Yuan P, Xu B. Prolonged administration of bisphosphonates is well-tolerated and effective for skeletal-related events in Chinese breast cancer patients with bone metastasis. Breast 2012; 21:544-9. [DOI: 10.1016/j.breast.2012.04.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 03/19/2012] [Accepted: 04/23/2012] [Indexed: 10/28/2022] Open
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Datta M, Schwartz GG. Calcium and vitamin D supplementation during androgen deprivation therapy for prostate cancer: a critical review. Oncologist 2012; 17:1171-9. [PMID: 22836449 PMCID: PMC3448410 DOI: 10.1634/theoncologist.2012-0051] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 07/02/2012] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Loss of bone mineral density is an unintended consequence of androgen deprivation therapy in men with prostate cancer. Supplementation with calcium and/or vitamin D in these men seems logical and is advocated by many lay and professional groups. METHODS We reviewed guidelines for calcium and vitamin D supplementation and the results of clinical trials of calcium and vitamin D supplementation on bone mineral density in men with prostate cancer undergoing androgen deprivation therapy. RESULTS Whether supplementation of men undergoing androgen deprivation therapy with calcium and/or vitamin D results in higher bone mineral density than no supplementation has not been tested. The results of 12 clinical trials show that, at the doses commonly recommended, 500-1,000 mg calcium and 200-500 IU vitamin D per day, men undergoing androgen deprivation lose bone mineral density. CONCLUSION The doses of calcium and vitamin D that have been tested are inadequate to prevent loss of bone mineral density in men undergoing androgen deprivation therapy. In light of evidence that high levels of dietary calcium and calcium supplement use are associated with higher risks for cardiovascular disease and advanced prostate cancer, intervention studies should evaluate the safety as well as the efficacy of calcium and vitamin D supplementation in these men.
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Affiliation(s)
- Mridul Datta
- Wake Forest Baptist Medical Center, Departments of Cancer Biology, Urology, and Epidemiology and Prevention, Winston-Salem, North Carolina, USA
| | - Gary G. Schwartz
- Wake Forest Baptist Medical Center, Departments of Cancer Biology, Urology, and Epidemiology and Prevention, Winston-Salem, North Carolina, USA
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Abstract
Osteoporosis is a highly prevalent chronic disease in the US and worldwide. The most serious consequence of this disorder is fractures, which have a serious negative impact on quality of life and are often the trigger for accelerated deterioration, ultimately ending in death. Despite the availability of effective preventive treatments, osteoporosis is frequently underdiagnosed and/or undertreated, particularly among the elderly, who are also at greatest risk. In addition, the presence of co-morbid medical conditions may be both a barrier to osteoporosis care and a risk factor for falls; thus individuals with multiple co-morbid conditions may be a particularly high-risk group. The management of osteoporosis involves improving bone health via adequate nutrition, calcium and vitamin D supplements, and fall prevention strategies. Although these measures are important in the management of all patients, most elderly patients are likely to need additional pharmacological therapy to adequately reduce their fracture risk. Several pharmacological treatments have been shown to significantly reduce the risk of fracture, including bisphosphonates (e.g. alendronate, risedronate, ibandronate, zoledronic acid), denosumab, raloxifene, calcitonin and teriparatide. Despite recent advances in osteoporosis care, additional action is urgently needed to improve the quality of life of osteoporotic patients in general and of elderly patients in particular, since fracture outcomes are typically poorer in older than in younger patients. This article reviews the current status of osteoporosis management, emphasizing the need to improve osteoporosis care, with a particular focus on the US, by the use of quality-improvement measures and incentives, which might result in an increased awareness and improved treatment for this debilitating disease.
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Affiliation(s)
- Jeffrey R Curtis
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, AL 35294, USA.
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Melton LJ, Hartmann LC, Achenbach SJ, Atkinson EJ, Therneau TM, Khosla S. Fracture risk in women with breast cancer: a population-based study. J Bone Miner Res 2012; 27:1196-205. [PMID: 22258822 PMCID: PMC3361522 DOI: 10.1002/jbmr.1556] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A positive association has been reported between greater bone density and higher breast cancer risk, suggesting that these women could be at reduced risk of fracture. To estimate fracture risk among unselected community women with breast cancer and to systematically assess associations with various risk factors including breast cancer treatments, we conducted a population-based historical cohort study of 608 Olmsted County, MN, USA, women with invasive breast cancer first diagnosed in 1990 to 1999 (mean age 61.6 ± 14.8 years), who were followed for 5776 person-years. Altogether, 568 fractures were observed in 270 women (98 per 1000 person-years). Overall fracture risk was elevated 1.8-fold, but the absolute increase in risk was only 9%, and 56% of the women did not experience a fracture during follow-up. Excluding pathologic fractures (15%) and those found incidentally (24%), to allow for ascertainment bias, the standardized incidence ratio was 1.2 (95% confidence interval [CI] 0.99 to 1.3) for total fracture risk and 0.9 (95% CI 0.7 to 1.2) for osteoporotic fracture risk alone. Various breast cancer treatments were associated with an increased risk of fracture, but those associations were strongest for pathologic fractures, which were relatively more common among the women who were premenopausal when their breast cancer was diagnosed. Moreover, underlying clinical characteristics prompting different treatments may have been partially responsible for the associated fracture outcomes (indication bias). These data thus demonstrate that breast cancer patients in general are not at greatly increased risk of fracture but neither are they protected from fractures despite any determinants that breast cancer and high bone density may have in common.
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Affiliation(s)
- L Joseph Melton
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.
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Cancer in the older person. PSYCHO-ONCOLOGIE 2012. [DOI: 10.1007/s11839-012-0352-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hennequin C, Mongiat-Artus P, Quero L, Pouessel D, Culine S. Les effets secondaires de l’hormonothérapie et leur gestion. ONCOLOGIE 2012. [DOI: 10.1007/s10269-012-2124-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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