September 3rd, 2010
04:37 PM ET

Osteoporosis drugs may boost cancer risk

People who take bisphosphonates, or bone-strengthening drugs for osteoporosis, may have a slightly higher risk of developing esophageal cancer, especially if they take them for several years, a study out this week in the British Journal of Medicine finds.

Researchers tracked almost 3,000 people with cancer of the esophagus or throat for eight years and compared them with a group of 15,000 people who did not have the disease. All were over age 40. The scientists found that 90 of the cancer patients had been prescribed the bone-building drugs, while 345 people in the larger group were taking the medication.

By figuring the odds, scientists estimated the risk of esophageal cancer increased with 10 or more prescriptions for oral bisphosphonates or with prescriptions over a five-year period. According to the study, in Europe and North America, the incidence of esophageal cancer in people ages 60-79 is typically one per every 1,000 over five years. This study estimated an increase of two per 1,000 in this age group, if the drugs were used for five years or more.

The researchers also looked at about 10,000 people with bowel cancer and 2,000 others with stomach cancer and found no increased risk with the use of these drugs.

Experts aren't sure why the drugs might lead to throat cancer. They do know however, that bisphosphonates can cause inflammation in the esophagus, which could cause cancer to develop more easily.

soundoff (127 Responses)
  1. musings

    While I agree that many old people go on a rapidly downward course after a major bone fracture, it seems excessive to offer them the choice of that or esophageal cancer (the current disease of hard-drinking sixty-something Christopher Hitchens). Esophageal cancer kills almost everyone diagnosed with it, in a short time. The fractures of old age can mean disability and death over more variable periods, but at greater cost to society perhaps. But perhaps the problem is that staving off the harm is possible by other means – supplements and exercise, and things like prevention of falls. My mother fell two months ago on a scatter rug in her home which we warned her to get rid of. She's doing well though after her upper femur was replaced. She isn't spiraling down into dementia, but that is due to intensive care by many caretakers and an exercise therapist. At 87, she is coming around. This would not be the case had she been diagnosed with esophageal cancer after taking these drugs. Nor is it certain that the break would not have happened. Are the bisphosponates 100% effective? If they were, perhaps you might take the risk if you were also at high risk for osteoporosis. But the way pills are dispensed, you get the feeling that they are given to everyone across the board. This may also be only one of the side effects. Someone on this board mentioned colitis. There may be more side effects down the line, as well as drug interactions. So many old people are loaded up with pills.

    September 5, 2010 at 09:42 | Report abuse | Reply
  2. mary

    This may have a little to do with the article, but it made me wonder:
    when someone takes PPI (Prilosec Prevacid, Nexium, etc.) one is told that the medication may potentially harm one's bones;
    when one takes bisphosphonates one may end up with serious esophageal problems.
    It appears to me that there is some correlation with stomach acid (or the suppression of it) and the health of the bones, and viceversa.

    On a different note, I think no adult should ever drink milk.

    September 5, 2010 at 09:49 | Report abuse | Reply
    • JC

      The concern with PPI's is that it can effect absorption. Many of these medications are purposely formulated to 24h dosages for patient convenience but the obvious issue is there is no "optimal" time to take your vitamin D or calcium.

      Interestingly enough, 15 mins of direct sunlight in summer months will give you a boatload of vitamin D, however in northern states you the sun does not provide direct enough sunlight to make vitamin D, leaving everyone at risk for mid winter deficiency. This is especially true for those with dark skin. Is this an issue? Many people think so, at this point we dont know for sure, but its worth more research.

      September 5, 2010 at 20:29 | Report abuse |
  3. Rob

    An interesting article: this demonstrates the classic problem of potential observer bias. A retrospective study aiming to make a link of an exposure, in this case a bisphosphonate, to a disease, esophageal cancer, is just that: a potential link. While it's a good starting point, one would need to prospectively compare two identical groups of patients and expose just one group to the drug. Why? What if people who are more prone to get osteoporosis (and hence, this drug group) have another unidentified reason to be prone to cancer?

    September 5, 2010 at 10:09 | Report abuse | Reply
    • cindy kosta

      My mother-in-law used osteoporosis drugs for 15+ years. She was just diagnosed with throat cancer. She had all the side effects but her Dr only prescribed more medications for GERD and sore throat and muscle tightness. And she was referred to other "specialists" with more drugs prescribed. NO ONE ever thought this might be a side effect? Drug companies are killing us....not helping us!

      July 3, 2012 at 13:31 | Report abuse |
  4. Mona Steel

    I am 64 and have had numerous bad falls, when I say bad is bad but never a broken bone and I was diagnosed with oesteo pina and oesto prosis in its early stages, I have taken fosamax for a couple of years but then an angel doctor and my persistence told me to take Evista and I did but then finding it expensive I asked my brother in law who worked for a pharmaceutical what is a equivalent and now I take something called Ralista which is quarter the price and has helped me tremendously. OF COURSE its not available in the USA. Just eat well and take calcium, Vit D and lots of yogurt.

    September 5, 2010 at 10:13 | Report abuse | Reply
  5. wvgirl

    Evista is extremely expensive and every year the price goes up about $8 per month (yes, that is what I meant to say). In the US it is the only drug in the category of Selective Estrogen Receptor Modulator. This is a case of the drug company making big bucks on a needed (?) drug because no one else makes it.

    September 5, 2010 at 10:43 | Report abuse | Reply
  6. Fosomaxnomore

    In response to RS1201: What non-prescribed drug are you smoking? I have a similar story to AnitaRN. I, too, am a nurse. After just three weekly doses of Fosomax, I will be taking Protonix for the rest of my life, elevating the head of my bed on blocks and having routine Esophagoscopies to evaluate the status of my GERD which I did not have prior to taking the Fosomax. With new research showing that the acid inhibiting drugs, e.g. Protonix, may cause bone loss due to non-absorption of clacium, I am stuck in a catch 22.

    September 5, 2010 at 11:14 | Report abuse | Reply
  7. Cindy

    There is a new twice-a-year injection, Prolia, that is now available for those of us that choose not to take Reclast. Prolia is in a completely different family of drug used to treat osteoporosis. I chose Prolia after two years on Actonel (which failed), and two more years on Forteo (which can only be prescribed once in a lifetime because of cancer risk and must be stopped after two years). I realize that I am lucky because insurance is covering most of the cost of Prolia. Somehow, we women must demand better choices to treat our osteoporosis–I am only 57 and have had it for years, and my doctor tells me that I've done everything RIGHT with good eating habits, lots of exercise, yoga, walking, etc.

    September 5, 2010 at 12:23 | Report abuse | Reply
  8. Joann

    I was disagnosed with osteoporosis and have been on Actonel for almost 5 years. I have had no side effects. Sionce I've been on the drug, I have had two serious falls. Neither of which resulted in a fracture. My latest bone scan shows that I am now at pre-osteoporosis. Also, I have a friend who is almost 83 years old and she has been on Foxomax for at least 8 years and she has never had a side effect. Just thought I'd throw my story into the mis.

    September 5, 2010 at 12:30 | Report abuse | Reply
  9. conch

    12 years on this drug – never had a problem, bone pain reduced by oh.... 75 – 80%
    no GERD, no acid ...
    what am I doing wrong?

    September 6, 2010 at 01:15 | Report abuse | Reply
  10. Ellen

    My 86-year old mother has been taking Actonel for several years now. This summer she developed problems swallowing. An endoscopic exam was done and found a "mass" in her stomach as well as a large hiatial hernia, that is compressing her esophagus, making it difficult for her to swallow. After reading this and other articles about the link between osteoporosis medications and esophageal cancer, I am beginning to believe that the Actonel is what did this to my mom.

    September 6, 2010 at 13:52 | Report abuse | Reply
  11. deb

    If you don't think these drugs are poison, just go on askapatient.com and read the thousands of horror stories. I refuse to take them. My mom had a broken femur and was on Fosamax for years.............the info about it causing hard brittle bones is TRUE.

    September 8, 2010 at 23:17 | Report abuse | Reply
  12. deb

    Want to add, my mom's femur broke while she was doing absolutely nothing...............got up from a chair, took a few steps, fractured, splintered femur. Nice!

    September 8, 2010 at 23:19 | Report abuse | Reply
  13. No trials for me

    I no longer trust some doctors, many?, and I just can't become a part of another trial. A diabetes trial I was in apparently was not concerned about honest data. The nurse advised me to "put down anything" for my blood sugars which I had become very weary of recording. I said I wanted out of the study. They were not happy and decided to use my flawed data anyway.

    September 9, 2010 at 03:12 | Report abuse | Reply
  14. Rabbi Morey Huckleman//Great Neck New York

    Percy Uris the greatest Builder ever fought this disease.

    September 19, 2010 at 16:26 | Report abuse | Reply
  15. Alden Pulver

    Donald Pulver is the greatest developer of his generation.

    September 19, 2010 at 16:27 | Report abuse | Reply
  16. Alden Continoo

    Let us stay on point!

    September 19, 2010 at 16:28 | Report abuse | Reply
  17. David & Myrna Band/Sarasota Florida (Siesta Key)

    We need to find new answers to Old problems. Could the Wellington Think Tank in New York help us?

    September 19, 2010 at 16:29 | Report abuse | Reply
  18. Milton Slosburg

    We will find the cure without the people at Wellington!

    September 19, 2010 at 16:31 | Report abuse | Reply
  19. Carlos Ripps Dimimentto

    We will find the cure.

    September 19, 2010 at 16:31 | Report abuse | Reply
  20. Shortie Stotman

    I have been short my whole life, why the dialogue now?

    September 19, 2010 at 16:32 | Report abuse | Reply
  21. Alden Pulver

    The new family facility developed built and managed by Donald Pulver will solve these issues.

    September 19, 2010 at 16:34 | Report abuse | Reply
  22. Donald Pulver Developer

    By shear volume i am the biggest developer ever in the Delaware Valley.

    Thank you for your gnerous words.

    September 19, 2010 at 16:35 | Report abuse | Reply
  23. Rance Clauss/ Clauss Building Corporation

    Donald Pulver is the best and biggest developer in the Delaware Valley.

    September 19, 2010 at 16:36 | Report abuse | Reply
  24. Philip Miller/Miller Plumbing

    Donald Pulver is a great developer who does a great job.

    September 19, 2010 at 16:37 | Report abuse | Reply
  25. Sallie Contino //Utah

    I agree with Rabbi Huckleman, the Wellington Think Tank could help with this mattter.

    September 26, 2010 at 09:16 | Report abuse | Reply
  26. Karen Fishel

    I do not think you have yet to report on the relationship between these drugs and sudden femur breaks and hairline fractures. The FDA is looking into it...Wall Street Journal had a report on Sept. 14, 2010 and ABC News did a report in March. Where are you CNN? This is a problem...we are seeing the tip of the iceberg and I am writing this because I have femur fractures in both legs, just had surgery and possibly face surgery on my other leg. Many doctors do not know about this...Please do some investigations and report to the public. Thank you.

    September 30, 2010 at 14:16 | Report abuse | Reply
  27. LuvToBike

    Osteoporosis and animal protein intake (especially dairy) are highly correlated. Countries that eat animal proteins and dairy the highest also have the highest rates of Osteoporosis. This documented in several studies. Read the book 'China Study' by T. Colin Campbell. Until we realize that going to mostly plant based foods is the answer to the diseases that plague the western nations, we will not handle this by pharmaceutical means.

    October 14, 2010 at 16:07 | Report abuse | Reply
  28. Robert Rainer, MD

    Osteoporosis drugs promote cancer. Read my article, "Alcohol, Aging, and Curing Cancer" by Robert Rainer, MD

    October 23, 2010 at 11:07 | Report abuse | Reply
  29. Robert E. Rainer, MD

    Life expectancy variation amongst different ethnicities is purely a function of bone density. People of Asian descent have the lowest bone density and likewise have the greatest life expectancy. Those of African descent have the highest bone density and accordingly, have the least life expectancy. Additionally, women's lower bone density explains why they tend to outlive men. Drugs given to treat osteoporosis by increasing bone density, will invariably shorten life span and cause cancer. Read my article, "Alcohol, Aging, and Curing Cancer" by Robert E. Rainer, MD

    July 28, 2011 at 03:07 | Report abuse | Reply
  30. Melody Cittadino

    Currently, about 12 million Americans have been diagnosed with osteoporosis at age 50, which is almost four percent of the country's population. With the mass of Christmas cookies and heavy dinners we all encountered over the holidays, these findings give us some food for thought..

    Take a look at all of the most recently released piece of writing at our new blog site

    March 24, 2013 at 04:18 | Report abuse | Reply
  31. Matt Kerbel

    The form of osteoporosis most common in women after menopause is referred to as primary type 1 or postmenopausal osteoporosis. Primary type 2 osteoporosis or senile osteoporosis occurs after age 75 and is seen in both females and males at a ratio of 2:1. Secondary osteoporosis may arise at any age and affect men and women equally. ^'-"

    Current short article from our web-site

    June 30, 2013 at 11:34 | Report abuse | Reply
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