Bisphosphonate-related osteonecrosis of the jaw in cancer patients: Implications for nurses

PurposeThis paper reports a review of the literature with a specific focus on osteonecrosis of the jaw. Bisphosphonate drugs are commonly used in the treatment of bone disease secondary to myeloma and solid tumours, such as breast and prostate cancer. In the past few years, an uncommon but distressing condition known as osteonecrosis of the jaw (ONJ) has been detected in patients who are having bisphosphonate treatment, particularly the intravenous (IV) preparations. Osteonecrosis of the jaw results from bone exposure in the oral cavity with subsequent death of bone tissue (necrosis).MethodThe review searched key databases including Medline, British Nursing Index, Cochrane, and meeting abstracts to ascertain the extent of literature in this field.ResultsFourty-two articles were reviewed which described the clinical manifestations of ONJ, the reported incidence and clinical cases.ConclusionThe results indicate there is an emerging body of evidence in this field and nurses delivering bisphosphonates need to familiarise themselves with the current guidance to ensure risks are minimised for patients.