Author: Virginia Leach
To conclude the Amgen Bone Health Series, the Tigerlily Foundation has connected with one of our ANGEL Advocates to learn about the effects of breast cancer on bones.
Unfortunately, being diagnosed with breast cancer can lead to a ripple effect of health issues that patients are not always aware of. Although the primary concern is reducing and removing cancer from the body, patients put their bodies through extreme processes when exposed to chemotherapy, radiation, and intensive drug medications. Exposure to harsh treatments forces the body to change rapidly. One of the potential changes is the drastic loss of bone mass in the body, leading to osteoporosis.
The story of Kiana Wooten demonstrates just one example of breast cancer treatment leading to unintended health consequences needing to be addressed.
Kiana Wooten’s Story
Kiana Wooten was very young when she was diagnosed with breast cancer. At 34 years old, she was informed that she had Stage 2A Invasive Ductal Carcinoma (IDC).
This type of cancer is labeled as one of the most common types of breast cancer due to its prevalence in diagnosis. Almost 80% of all breast cancer diagnoses are labeled as IDC. What does this type of breast cancer mean exactly: “Invasive” means that cancer has spread or invaded throughout the surrounding breast tissues; “Ductal” means that cancer has started in the milk ducts, which are tubes that carry milk to the nipple; and “Carcinoma” is cancer that begins in the skin or any tissue that cover internal organs. Therefore, this type of cancer has moved from the wall of the milk duct to move throughout the breast; from there, it can spread to the lymph nodes then to the rest of the body. Over 180,000 women are diagnosed with this cancer yearly.
Just three years after Kiana’s breast cancer diagnosis and completing several cycles of chemotherapy, she was told that she had full-blown osteoporosis after completing a bone density scan. She has lost almost 15% of bone mass due to the side effects of chemotherapy on her bones. You might be thinking 15% loss of bone mass does not sound like a lot, but in just one year, that is a significant amount of bone loss.
To address osteoporosis in Kiana’s bones, she recently started receiving Zoledronic acid infusions to strengthen her bones at her local cancer institute twice a year. These infusions take several hours to complete, in addition to getting blood drawn. Depending on time and point in the osteoporosis treatment cycle, Kiana may have to get two infusions of Zoledronic acid in one day, which takes a lot of energy to complete.
In her own words, this is what Kiana had to say about dealing with the side effects of chemotherapy: “People look at me, and they say I look great and that I don’t look sick. I’m not sick, technically, but having to do injections monthly and taking oral chemo and now having other ailments from chemotherapy really stresses me. It would stress anybody in that situation. I’m sure other cancer patients could attest and agree with what I’m saying. This is what we go through. This is the aftermath. This is my aftermath of chemotherapy.”
Breast Cancer, Bone Health, and Patient Self-Advocacy
Conversations around breast cancer and bone health are rarely discussed with patients until the issue has grown severe, like in Kiana’s case. There is an urgent need for primary care physicians and oncologists to speak with their patients about bone health before starting cancer treatment. Everyone recognizes the seriousness of detecting breast cancer early and beginning a holistic treatment plan right away. However, bone health should not be left off the table for discussion.
Research from one study demonstrated that, “Overall, breast cancer survivors had a 68% higher risk of osteopenia and osteoporosis than [individuals without cancer].” The study also showed, “The risk for women receiving chemotherapy plus hormone therapy was 2.7 times higher than [individuals without cancer]. The risk was greatest for women receiving chemotherapy plus aromatase inhibitors—3.83 times higher.”
Breast cancer patients and survivors should be well-informed of the short and long-term effects of cancer treatment. When patients are armed with this knowledge, they can bring it to the attention of their medical providers and prepare a proactive plan to protect and love their bones.
Kiana said it best: “The frustration I feel when it comes to the aftermath of cancer. We, breast cancer patients and survivors, honestly, just exchange one ailment for another! If people only knew…”
Amgen. “Know Your Bones.” Amgen, 8 October 2018. https://www.amgen.com/stories/2018/10/know-your-bones.
Bath, Charlotte. “Increased Risk of Bone Loss Extends to Younger Women Treated for Breast Cancer.” The ASCO Post, 25 February 2019. https://ascopost.com/issues/february-25-2019/increased-risk-of-bone-loss-extends-to-younger-women-treated-for-breast-cancer/.
Tigerlily Foundation. “My Life Glossary.” Tigerlily Foundation, n.d. https://www.tigerlilyfoundation.org/breast-cancer-toolkit/my-life-glossary/