Bone Health Issues in the Pediatric Oncology Patient.
Paulette M Kelly, Elaine Pottenger
PMID 35491332WHAT IT FOUND
Pediatric cancer treatment can damage growing bones.
Monitor bone health before, during and after therapy, teach calcium/vitamin D and weight-bearing activity, and refer for a bone density scan or endocrine evaluation when treatment puts children at risk.
Key findings
01The review identifies surgery, radiation, chemotherapy and corticosteroids as direct threats to bone health, and says treatment itself is the main contributor to bone mass impairment.
02The review recommends assessing nutrition, lifestyle and baseline bone health before treatment, and bone density scanning for children with growth hormone deficiency, hypogonadism, delayed puberty, hyperthyroidism, or treatment with methotrexate, corticosteroids or stem cell transplant.
03The review states that bisphosphonates and denosumab are not recommended for general bone building in children outside clinical trials, while weight-bearing physical activity is essential for bone mineral density.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is a narrative review without formal methods, so it cannot establish how strong the evidence is. It reports no original patient outcomes. It notes limited evidence for bone-building drugs in children and no clear practice guidelines for avascular necrosis. It does not specify which patients were assessed or outcomes measured.
Declared interests
No funding or conflict-of-interest declaration appears in the supplied text. The publication types list non-U.S. government research support.
The easy way to misread this
Do not prescribe weight-bearing exercise to every child with a bone tumor. The review says pathologic fracture risk can be high, bracing and non-weight-bearing status may be essential, and activity choices depend on the child's health, age, body weight and treatment history.