People may wonder why physicians and public health officials are so concerned about hip fractures in the elderly and may think "it’s just a broken bone." The explanation is that unlike an uncomplicated arm fracture, hip fractures increase the risk of dying substantially, especially in the year following the fracture. Supplements like vitamin D have demonstrated efficacy in reducing the rate of hip fracture. Now an article published in the Journal of the American Medical Association (2005;294:2587-2593) demonstrates that women undergoing radiation therapy for cancers are at an increased risk of pelvic fractures, like those of the hip. This comes as no surprise as it is common knowledge in the medical community that therapeutic radiation can cause bone damage.
Researchers studied women over 65 years of age who had been diagnosed with anal, cervical or rectal cancer. Of the nearly 6500, 44.4% underwent radiation therapy while 55.6% did not. By comparing the incidence of pelvic fractures in these groups, the association between hip fractures and radiation therapy could be assessed. The results showed that women with anal cancer who underwent radiation therapy were more than 3 times more likely to develop a pelvic fracture (likely due to the location of the radiation as the inguinal lymph nodes are also treated). Women treated for cervical and rectal cancer also experienced a higher incidence of pelvic fracture, however lower than women irradiated for anal cancer.
The authors suggest, "women undergoing irradiation therapy for anal, cervical, or rectal cancer should be counseled with respect to fracture risks from irradiation. Potentially, these women could be targeted for preventive strategies, such as bone mineral densitometry screening, medical regimens aimed at preventing osteoporosis, and fall prevention. Such strategies should be evaluated in prospective studies. In addition, changes in irradiation techniques for high-risk individuals to minimize the irradiation dose received by bone should be investigated." Certainly strategies to prevent and address osteoporosis and hip fracture include supplementation with a quality bone formula and higher dose vitamin D.
Posted by Kristopher Foster on April 17, 2006 07:36 PM
