Author: Virginia Leach
Several things can impact how our bone health may deteriorate over time. First, you might be taking steps to be proactive about your bone health, including taking vitamin C and D supplements, stretching daily, and incorporating non-traditional wellness habits such as red-light therapy. All of these activities can support healthy bones. Still, other things outside of our control may impact and contribute to bone loss.
What You Should Know About Bone Health When It Comes to Breast Cancer
When young women are diagnosed with breast cancer, they can experience early menopause, osteoporosis, and loss of estrogen due to treatment.
Many factors need to be managed while undergoing breast cancer treatment. Even though certain items may be obvious, others may not be as straightforward. Bone health is an element that should be top-of-mind when undergoing your breast cancer treatment journey.
Chemotherapy is a standard treatment for breast cancer. While many women succeed with this treatment, they may find a lower bone mineral density (BMD) once treatment is complete. This is likely due to chemotherapy’s effects on the ovaries and organs that produce estrogen. Chemotherapy is associated with ovarian dysfunction. Thus, the onset of menopause can begin and arrive earlier in premenopausal women who received chemotherapy treatments. Earlier menopause means estrogen levels are reduced, which leads to an increase in bone breakdown that results in the loss of bone density.
Ovarian suppression, also known as Ovarian Ablation, is a controversial therapy for breast cancer treatment. It has been used for many years and involves removing or temporarily stopping the ovaries from working. When ovaries are not working efficiently, estrogen is not being secreted. Thus, with reduced estrogen, bones may break down faster resulting in a higher risk of bone loss or fracture.
Radiation therapy is a cancer treatment that utilizes high doses of radiation directly onto the tumor. Undergoing radiation therapy can take a toll on bone health by damaging soft-tissue components of the bone, including blood vessels. As a result, radiation may lead to bone loss in the area where radiation therapy was given, as well as an increased risk of fracture over time.
A study conducted by Dr. Cody Ramin and colleagues (2018) found that osteoporosis can occur in women under 50 years old at a higher risk than those of the same age who do not have cancer. From their research, breast cancer survivors had a 68% higher risk of developing osteopenia and osteoporosis than cancer-free women. The reason for developing osteoporosis earlier stems from undergoing cancer treatment. Bone health should be monitored during and after the cancer treatment process.
Bone Loss Prevention Therapies
Bone loss prevention therapies have proven almost universally effective for limiting bone loss in cancer patients. Some examples of bone loss prevention therapies are as follows:
- Resistance and weight-bearing exercises are popular bone loss treatments. Bone is a living tissue that becomes stronger with exercise. Participating in resistance exercises like weight-lifting or weight-bearing exercises like walking can be an excellent part of bone loss prevention therapy.
- Immunotherapy helps the immune system identify and more effectively eliminate cancer cells.
- Denosumab (Prolia/Xgeva) is a group of drugs used to prevent or treat bone problems. It has been shown to increase bone mass in some instances.
- Bisphosphonates are drugs that prevent the loss of bone density. They are the most prescribed drugs used to treat osteoporosis. Zoledronic acid (Reclast/Zometa) is a bisphosphonate that reduces the amount of calcium released from bones into the bloodstream. It also works by slowing the breakdown of your bones by cancer to prevent bone fractures.
Note that specific side effects may occur, such as osteonecrosis of the jaw (when the jaw bone is exposed and begins to starve from a lack of blood) and hypocalcemia (low blood calcium levels). Therefore, always consult a medical provider before starting any therapies mentioned above.
Bone health can, unfortunately, be compromised when treating breast cancer, depending on the plan of care. Supporting bone health before, during, and after treatment is a wise step to reduce your risk of struggling with bone health issues later in life, like fractures or an osteoporosis diagnosis. Simple steps can have a large impact when it comes to bone health.
Johns Hopkins Medicine. “Bone Densitometry.” Johns Hopkins Medicine, n.d. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/bone-densitometry.
Johns Hopkins Bloomberg School of Public Health. “Osteoporosis Risk Rises Sharply Even For Younger Breast Cancer Survivors.” Johns Hopkins Bloomberg School of Public Health, 28 November 2018. https://publichealth.jhu.edu/2018/osteoporosis-risk-rises-sharply-even-for-younger-breast-cancer-survivors#:~:text=Study%20results%20suggest%20that%20common,who%20do%20not%20have%20cancer.
Tigerlily Foundation. “My Life Glossary.” Tigerlily Foundation, n.d. https://www.tigerlilyfoundation.org/breast-cancer-toolkit/my-life-glossary/.
Tigerlily Foundation. “Treatments.” Tigerlily Foundation, n.d. https://www.tigerlilyfoundation.org/breast-cancer-toolkit/treatments/.