The long-term use of oral bisphosphonate drugs for osteoporosis such as Actonel, Boniva, and Fosamax may be associated with a doubling in esophageal cancer risk according to a recent study from Oxford University.  Patients taking these drugs over  a five year period were twice and likely to develop esophageal cancer. The risk for developing esophageal cancer is 1/1000 for the general public and 2/1000 for patients taking these medications.  Two in every thousand doesn’t sound too bad, but 2000/100,000 vs 1000/100,000 does.  Researchers from this study still maintain that the benefits outweigh the risks, but I’m not convinced.

If the use of these medications to develop bone mass was our only option then I might be able to appreciate the risk/benefit argument, but there are other alternatives to these medications that should be explored before taking a medication that doubles the risk of cancer.

What is the cause of osteoporosis?

There are a number of factors that are thought to be associated with osteoporosis, but the most common is genetic.  This model is advantageous to the companies who manufacture these drugs because it promotes the notion that osteoporosis is out of your control and the only way to prevent your skeleton from disintegration is to take one of these medications.  SNL did a great parody of drug commercials for osteoporosis that you can see at by clicking here.

Genetics do play a role in our bone structure, but there are other factors that we can control which will prevent bone loss, namely inflammation.  When we think of inflammation we typically think of acute inflammation that we experience following an injury or a trauma.   Acute inflammation is one type of inflammation, but we can also experience chronic systemic inflammation (CSI).  CSI occurs throughout the body at a much lower level than acute inflammation and often goes unnoticed because it is not painful.

inflammation_cellsHow does inflammation related to osteoporosis?

Bone is a very valuable resource to the body.  One of its functions is to decrease the acidity of the internal environment of the body.  When the body becomes inflamed, the acidity increases or lowers the pH.  The body wants to do everything it can to keep the the pH at neutral, so it pulls calcium from the bones to “cool” the systemic inflammation.

How do we prevent chronic systemic inflammation?

This is a big topic and will be discussed in the second part of this series.