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Bone Drugs, Throat Cancer Linked: Are Patients Trapped?

Do popular bone-strengthening pills raise the risk for throat cancer? (iStockPhoto) iStockPhoto

(CBS/AP) It's the kind of news that sticks in your throat: popular bone-strengthening drugs like Boniva and Fosamax raise the risk for cancer of the esophagus, according to a new study.

The finding contradicts another recent study that used the same database of 80,000 patients. It found no link between drugs to prevent or treat osteoporosis and esophageal cancer.

That study was published last month in the Journal of the American Medical Association.

In the new study, British researchers looked at nearly 3,000 people with esophageal cancer and matched each one to five similar people who didn't have the disease. Ninety of the cancer patients and 345 people in the comparison group had been taking bisphosphonate drugs such as Fosamax, Boniva, Actonel and other brands.

Normally, the risk of developing throat cancer in people 60 to 79 years old is 1 in 1,000. Researchers say after using the drugs for about five years, the risk is 2 in 1,000.

The study, published in the medical journal BMJ, was only observational and is not the kind of evidence that can show whether such drugs cause cancer.

"Esophageal cancer is an uncommon cancer," said Jane Green, a clinical epidemiologist at the University of Oxford, one of the paper's authors. "Even a doubled risk is still a very small risk."

The chances of developing esophageal cancer after taking bisphosphonates are much smaller than from known causes like being obese, smoking or drinking.

But the disease is often caught late, as it was in actor Michael Douglas, which lowers the survival rate.

Green said the findings shouldn't affect patients taking osteoporosis drugs, but added the medicines should be watched closely.

"People are increasingly being prescribed bisphosphonates and we just don't know enough about their use over the long term," she said. The pills have other side effects including throat ulcers, abdominal pain and an irregular heartbeat.

Experts aren't sure why the drugs might lead to throat cancer, but the pills can cause inflammation in the esophagus, which could make cancer more likely.

Diane K. Wysowski, an epidemiologist at the FDA, wrote recently that patients should take the drugs carefully, like with a full glass of water before eating and not reclining for at least 30 minutes afterward.

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