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Skeletal health in patients with differentiated thyroid carcinoma
- Publication Year :
- 2020
- Publisher :
- Springer, 2020.
-
Abstract
- Osteoporosis and fractures are important comorbidities in patients with differentiated thyroid cancer (DTC), with potential negative impact on quality of life and survival. The main determinant of skeletal fragility in DTC is the thyrotropin (TSH)-suppressive therapy, which is commonly recommended to prevent disease's recurrence, especially in patients with structural incomplete response after thyroid surgery and radio-iodine therapy. TSH-suppressive therapy can stimulate bone resorption with consequent bone loss, deterioration of bone microstructure and high risk of fragility fractures. The skeletal effects of TSH-suppressive therapy may be amplified when thyroid cancer cells localize to the skeleton inducing alterations in bone remodelling, impairment of bone structure and further increase in risk of fractures. The management of skeletal fragility in DTC may be challenging, since prediction of fractures is a matter of uncertainty and data on effectiveness and safety of bone-active agents in this clinical setting are still scanty. This review deals with pathophysiological, clinical and therapeutic aspects of skeletal fragility of patients with DTC.
- Subjects :
- Oncology
endocrine system
medicine.medical_specialty
TSH suppression
Endocrinology, Diabetes and Metabolism
Osteoporosis
Levothyroxine
030209 endocrinology & metabolism
Disease
Adenocarcinoma
Bone resorption
Bone remodeling
Thyroid carcinoma
03 medical and health sciences
0302 clinical medicine
Endocrinology
Internal medicine
medicine
Bone mineral density
Humans
Thyroid Neoplasms
Bone metastases
Differentiated thyroid carcinoma
Fractures
Thyroid cancer
business.industry
Thyroid
Cell Differentiation
Prognosis
medicine.disease
medicine.anatomical_structure
030220 oncology & carcinogenesis
Bone Diseases
business
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....9bc8fabaa6a695e4d9dd32a24c0c65e2