Prevention, diagnosis and treatment of osteoporosis following menopause induced due to oncological disease.

Owing to the improved effectiveness of the treatment protocols for oncological disease, in the last few years we have seen an increase in the number of women in iatrogenic menopause secondary to integrated oncological treatments or surgical, pharmacological or radiological therapies. Particularly if it is premature, menopause in these subjects, who are already strongly debilitated by the primary pathology, may have heavy physical and psychic repercussions on the quality of life.Particular attention must be paid to the prevention and treatment of osteoporosis, which is linked both to premature cessation of the reproductive capacity and to the treatments for the oncological disease, which may represent an additional risk for the development of premature, severe osteoporosis. Some oncological diseases involve therapies which affect bone metabolism. At the sametime, for example in breast cancer, some bone protective drugs like hormone replacement therapy are controindicated. The introduction for breast cancer of a new category of drugs, aromatase inhibitors, seems to be linked to an increase in bone fractures. Correct treatment of these subjects involves a multidisciplinary specialist approach which we believe can be created through a targeted menopause surgery, which would thus become the ideal place for the evaluation of problems linked to the treatment of cancer and the consequent early menopause.A targeted surgery like this allows us to create individual treatment paths with differentiated timing, and to address questions which are still unanswered, such as the risk of osteoporosis deriving from the effects of aromatase inhibitors on the bones, and the preventive effectiveness of the combination with bisphosphonates.