Osteoporosis is a disease that causes gradual loss of bone mass, which predisposes an osteoporosis sufferer to painful fractures. Some of these fractures, particularly ones involving the hip, can be fatal.
To combat this problem, some women take medications called oral bisphosphonates. Although this group of medications helps to reduce bone loss, a recent study came to a disturbing conclusion. Taking bisphosphonates may increase the risk of esophageal cancer, a serious malignancy with a poor prognosis.
What are Oral Bisphosphonates?
Oral bisphosphonates are medications that help to reduce bone loss and the risk of fractures. They work by reducing the action of osteoclasts, a special type of cell that breaks down bone. These cells normally act in conjunction with other cells called osteoblasts that have the opposite effect – they build bone. Normally, there’s a balance between these cells, but when osteoclast activity overrides the actions of the osteoblasts, bones start to lose their mass.
Does Taking Bisphosphonates Increase the Risk of Esophageal Cancer?
A recent study showed that people who filled ten or more prescriptions for oral bisphosphonates had a greater risk of esophageal cancer than those who filled nine or fewer prescriptions. This contradicts a recent British study that showed no increased risk of esophageal cancer among people using oral bisphosphonates for osteoporosis.
Why the conflicting results? The first study that found no increased risk was only 4.5 years long, while the most recent research showing an increased risk was almost eight years in duration – which means there was more time for esophageal cancers to show up. Experts believe the latest study is the more statistically sound of the two.
Is It Safe to Take Oral Bisphosphonates for Osteoporosis?
The absolute risk of getting esophageal cancer from taking oral bisphosphonates is small, according to this study. Only about one or two out of a thousand bisphosphonate users would be expected to get esophageal cancer over five years on the medication. This is not a large number, unless you happen to be one of those affected. Esophageal cancer is usually not curable. On a positive note, taking bisphosphonates short-term (a year or less) is not associated with an increased risk of esophageal cancer. Longer term use carries the greatest risk.
Taking Bisphosphonates for Osteoporosis: The Bottom Line?
For some women, the very small risk of esophageal cancer may be outweighed by the benefits of oral bisphosphonates, but it’s a good idea to talk to your doctor about other alternatives for treating osteoporosis. There are osteoporosis medications that don’t carry the risk of esophageal cancer. Women or men who have a family history of esophageal cancer, a history of esophageal inflammation, or who have esophageal reflux disease should definitely look into other alternatives for treating osteoporosis – and avoid taking bisphosphonates.
Medscape.com. “About Face: Oral Bisphosphonates Linked to Esophageal Cancer”