Osteoporosis, Bone Cancer Treatments Needed

Program is Developing Treatments, Improving Prevention

In the United States, 10 million individuals suffer from various bone diseases, mostly osteoporosis (low bone mass disease) and bone metastasis (spread of cancer to the bone).

Nearly 34 million more people are estimated to have low bone mass, placing them at increased risk for osteoporosis. Some 1.5 million people each year have osteoporosis-related fractures, and women over the age of 50 have more than a 40% chance of suffering a fracture at some subsequent time.

Bone metastasis is the primary cause of death in prostate cancer patients. It's also one of the most frequent causes of pain in breast, lung, kidney and thyroid cancers.

To date, these bone diseases have no effective treatment. And while the unique characteristics of bone make it difficult to study, the new Bone Disease Program of Texas hopes to make advances in the treatment of bone disease.

The program mission is to:

• Develop bone-forming treatment for all degenerative bone diseases
• Improve prevention and treatment for bone cancer metastasis
• Foster existing collaborations between M. D. Anderson and Baylor College of Medicine in Houston, the two institutions involved in this research and clinical program

Why are cancer patients at risk for osteoporosis?

Many cancer therapies, including chemotherapy and corticosteroids, have direct negative effects on bone, according to Robert Gagel, M.D., head of the Division of Internal Medicine at M. D. Anderson and clinical director of the Bone Disease Program of Texas. "In addition, certain cancers such as prostate or breast cancer are treated by hormone removal, a condition that causes bone loss. As a result, osteoporosis in cancer patients is a serious problem for both men and women," he says.

Many drugs are available to stop the destruction of bone, Gagel says, but none help form new bone. "It is critical to develop bone-forming drugs in order to effectively treat osteoporosis," he says.

Why does cancer spread to bone?

A great deal has been learned about the interaction between cancer and bone cells. Cancer cells "hijack" normal regulatory mechanisms involved in bone remodeling. Substances produced by cancer cells activate bone breakdown, leading to thinning and destruction of bone and subsequent fracture. Recent discoveries of the signaling molecules involved in this process hold promise for therapeutic advances over the next five years.

"We have learned that there are specific interactions between proteins produced by cancer cells and those produced by bone cells, which create a friendly environment for the cancer cells. These interactions hold the promise for future drug development, which can target these processes," Gagel says.

Gerard Karsenty, M.D., Ph.D., professor of molecular and human genetics and medicine at Baylor College of Medicine, serves as co-director and scientific director of the Bone Disease Program of Texas.

For more information, please contact the M. D. Anderson Information Line at 1-800-392-1611, option 3.