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Many therapeutic regimens used for the treatment of breast and prostate cancer survivors are associated with bone loss and adverse skeletal events. The purpose of this review is to identify mechanisms of treatment-induced bone loss and adverse skeletal events in this population. Furthermore, this review emphasizes the importance of screening for baseline risk factors for adverse skeletal events. Once these risk factors are identified, early evaluation and treatment of bone health is warranted. This article reviews an approach to the management of bone health in breast and prostate cancer survivors, including a discussion regarding lifestyle interventions, calcium and vitamin D supplementation, as well as the indications for initiation of bisphosphonate therapy. This article also reviews potential new agents, such as cathepsin K inhibitors and RANKL inhibitors, for the reduction of bone loss in high-risk populations.