What You Should Know About Osteoporosis After Breast Cancer
Osteoporosis is a condition in which the bones become less dense and more likely to fracture. It is known as a silent disease because, if undetected, bone loss can progress for many years without symptoms until a fracture occurs. Osteoporosis has been called a childhood disease with old age consequences because building healthy bones in youth helps prevent osteoporosis and fractures later in life. However, it is never too late to adopt new habits for healthy bones.
The Link Between Breast Cancer
Women who have had breast cancer treatment may be at increased risk for osteoporosis and fracture for several reasons. First, estrogen has a protective effect on bone, and reduced levels of the hormone trigger bone loss. Because of chemotherapy or surgery, many breast cancer survivors experience a loss of ovarian function and, consequently, a drop in estrogen levels. Women who were premenopausal before their cancer treatment tend to go through menopause earlier than those who have not had breast cancer.
Studies suggest that chemotherapy also may have a direct negative effect on bone. In addition, the breast cancer itself may stimulate the production of osteoclasts, the cells that break down bone.
Like muscle, bone is living tissue that responds to exercise by becoming stronger.
Osteoporosis Management Strategies
Several strategies can reduce your risk for osteoporosis or lessen the effects of the disease if you have already been diagnosed.
As far as bone health is concerned, a well-balanced diet rich in calcium and vitamin D is important. Good sources of calcium include lowfat dairy products; dark green, leafy vegetables; and calcium-fortified foods and beverages. Supplements can help ensure that the calcium requirement is met each day, especially in people with a proven milk allergy. The Institute of Medicine recommends a daily calcium intake of 1,000 mg for men and women up to age 50. Women over age 50 and men over age 70 should increase their intake to 1,200 mg daily.
Vitamin D plays an important role in calcium absorption and bone health. Food sources of vitamin D include egg yolks, saltwater fish, and liver. Many people, especially those who are older or housebound, may need vitamin D supplements to achieve the recommended intake of 600 to 800 IU each day.
Risk Factors for Developing Osteoporosis
• Thinness or small frame
• Family history of the disease
• Being postmenopausal, particularly having had early menopause
• Abnormal absence of menstrual periods
• Prolonged use of certain medications, such as those used to treat lupus, asthma, thyroid deficiencies, and seizures
• Low calcium intake
• Lack of physical activity
• Excessive alcohol intake
Like muscle, bone is living tissue that responds to exercise by becoming stronger. The best activity for your bones is weight-bearing exercise that forces you to work against gravity. Some examples include walking, climbing stairs, weight training, and dancing. Regular exercise may help prevent bone loss and will provide many other health benefits.
Smoking is bad for bones, as well as the heart and lungs. Women who smoke tend to go through menopause earlier, resulting in earlier reduction in levels of the bone-preserving hormone estrogen and triggering earlier bone loss. In addition, smokers may absorb less calcium from their diets. Evidence also suggests that alcohol can have a negative effect on bone health. Those who drink heavily are more prone to bone loss and fracture.
Bone density test
A bone mineral density test measures bone density in various parts of the body. This safe and painless test can detect osteoporosis before a fracture occurs and can predict your chances of fracturing in the future. The bone mineral density test can help determine whether medication should be considered. A woman recovering from breast cancer should ask her doctor whether she might be a candidate for a bone density test.
There is no cure for osteoporosis. However, medications are available to prevent and treat this disease.
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For more information on osteoporosis, visit the National Institutes of Health Osteoporosis and Related Bone Diseases – National Resource Center website at niams.nih.gov/bone or call (800) 624-2663.
Source: National Institutes of Health
This article was originally published in Coping® with Cancer magazine, July/August 2011.