ESPE Yearbook of Paediatric Endocrinology

To read the full abstract: Int J Cancer. 2020 Mar 13. doi: 10.1002/ijc.32963. Epub ahead of print. susi.kriemlerwiget@uzh.ch

Childhood cancer survivors (CCS) can experience impaired bone health as a consequence of the disease itself, the specific treatments and/or associated chronic conditions. This cross-sectional study analyses baseline data from the single-centre randomized-control SURfit trial – which is testing a physical activity (PA) intervention in adult and adolescent survivors of childhood cancer that is ongoing in Switzerland. The purpose of this analysis was to define the prevalence of BMD Z -score < -1 SDS (reduced bone health) in 161 young adult childhood cancer survivors (CCS) and to analyse the relationship between mechanical impact loading induced by PA and bone health. Mechanical loading of bone results from bending or torsional forces through muscles, or from bone compression through impact forces (running, jumping).

An elevated frequency of reduced bone health in CCS was confirmed by both DXA and pQCT, and was associated with increased risks of fracture and osteoporosis. As in the general population, bone health was better in physically active patients. CCSs exercising with high duration and frequency impact loadings showed healthier bone characteristics (higher trabecular bone density and conserved cortical geometry) compared to their sedentary counterparts.

The authors propose a relatively simple solution to the problem of bone impairment, because they demonstrate that just few minutes of feasible impact loading of the lower body are associated with better microstructural and densitometric bone characteristics and reduced risk of bone pathologies. The better results might be obtained with fast running or jumping, which have a high impact on bone. These results should be confirmed in younger and still growing CCS, in order to define whether regular PA is able to restore a normal BMD and promote the achievement of an appropriate bone mass peak.