Bone health in patients with brain tumors

BackgroundSeveral factors, including the use of antiepileptic drugs, glucocorticoids, anticoagulants, chemotherapy, radiation therapy, and hemiplegia-associated osteopenia, render patients with brain tumor susceptible to bone disease.MethodsThe authors review the pathophysiology of these factors and their impact upon bone integrity.ResultsSteps that can be taken to minimize or eliminate bone morbidity including measurement of bone mineral density at treatment onset, adequate calcium intake, vitamins D and K supplementation, adequate sunlight exposure, weight-bearing exercises, fall prevention, avoidance of antiepileptic drugs linked to osteopenia, and judicious use and choice of glucocorticoids and anticoagulants are suggested.ConclusionsMedical management of osteoporosis related to brain tumor treatment with bisphosphonates, teriparitide, and calcitonin is beneficial, as is kyphoplasty for symptomatic vertebral compression fractures.