Recover Overcoming Treatment Osteoporosis
One of the potential side effects of chemotherapy doesn’t necessarily reveal itself right away, but it could lead to serious problems down the road. It is osteoporosis, which happens naturally over time as women age. But if you have had breast cancer treatment, and particularly chemotherapy, you could be at greater risk.
Osteoporosis occurs "silently" and progressively. Most often, there are no symptoms until a fracture occurs. The term literally means "porous bone," and it happens when the bone density and quality of your bones are reduced. When your bones become more porous and fragile, they are more likely to break, therefore your risk of fracture increases.
With chemotherapy treatment, and sometimes surgery, many breast cancer survivors experience a loss of ovarian function, which reduces estrogen levels. Estrogen protects the bones, and when it is suppressed by chemotherapy treatment, it creates an estrogen deficiency that triggers bone loss and becomes a risk factor for osteoporosis. If a woman already has low bone mass (osteopenia) before her breast cancer is diagnosed, she is at even greater risk.
Aside from chemotherapy treatment, there are other links between breast cancer and osteoporosis. They are:
- Breast cancer itself. This disease can increase the bone-dissolving process of cells known as osteoclasts. As a result, the bones weaken.
- Early menopause. Some types of chemotherapy (cyclophosphamide, methotrexate and fluorouracil) might stop the ovaries from producing estrogen, which in turn brings on menopause. Without estrogen’s bone-protecting effects, bone loss may occur.
- Steroids. These often help women cope with the side effects of chemotherapy. But bone loss is a potential side effect of their continuous use.
- Surgically induced menopause from removal of the ovaries (oophorectomy) or radiation-induced menopause resulting from irradiation to the ovaries. While these procedures are done to slow breast cancer growth (some breast cancers are stimulated by estrogen), they can also lead to a sudden lowering of estrogen levels, as well as a rapid loss of bone mass.
- Hormonal therapies using aromatase inhibitors (letrozole, anastrozole, others). These are newer types of treatment used for postmenopausal women with breast cancer. Early research suggests these have the potential to lead to a loss of bone density, but further studies are going on. Other hormonal treatments such as leuprolide and goserelin can shut down the ovaries in premenopausal women, leading to a lack of estrogen production and, consequently, bone loss.
So, how do you manage and treat osteoporosis?
Even though bone loss cannot be totally reversed, you can take action to prevent osteoporosis and treat your condition even after the onset. First, you must realize that nutrition and exercise are crucial to good bone health. But before you take any action, consult your doctor to discuss adequate screening and bone-density testing, as well as any proper interventions, if necessary.
You can easily make some lifestyle adjustments, if you haven’t already, such as:
There are medications available to treat and manage osteoporosis, such as bisphosphonates and raloxifene, that are useful, especially with breast cancer survivors. Bisphosphonate drugs, such as Fosamax, Boniva and Zometa, are some of the most popular drugs for women that work to prevent bone loss.
- Taking calcium on a daily basis. Daily calcium intake should be 1,000 milligrams for women ages 19 to 50 and 1,200 milligrams for women older than 50. Your Vitamin D intake should be between 400-800 international units.
- Exercising regularly by engaging in cardio activities such as dancing, climbing stairs, walking and weight and strength training.
- Refraining from smoking, it weakens the bones.
- Decreasing alcohol intake.
- Maintaining good posture. Yoga, Pilates and tai chi may also help you maintain good posture and overall body health and flexibility.
Here are some resources that might help you better understand how to treat and manage osteoporosis:
Harvard Medical School PriMed Patient Education Center’s brochure on The “Thin Bone” Disease
The Brittle Bone Disease brochure
The National Institutes of Health Osteoporosis and Related Bone Diseases Resource Center’s article on What Breast Cancer Survivors Need to Know About Osteoporosis
The National Osteoporosis Foundation article on Can it Happen to You?
For more information on osteoporosis, go to Breast Cancer Partner’s Resources. You can also share your knowledge and success with other survivors in our Partner Forum or at Survivor Tips.