Cancer treatment and osteoporosis

Having cancer is bad enough. It is very distressing when other medical issues arise that may be related to the cancer treatment we are receiving. I am thinking of things like lymphedema, weight gain, chemobrain, and osteoporosis. In a way, these are collateral damage wrought by the surgery or radiation or drugs that we have endured. If the world were fair, none of these would happen; getting through cancer would be more than enough. Unfortunately, we all know that fairness is never a promise.

Osteopenia and osteoporosis refer to the loss of bone density/mass that occurs naturally as we age. Osteopenia is when bones are weaker than normal, but not yet at risk of fracture. Osteoporosis means that bones are even weaker and can break easily. Our bones are strongest when we are about 30, and naturally begin to thin after about 50. For women, this is usually around the time of menopause when estrogen is reduced, and most women are aware of the issue.

There are other things that can accelerate this process, and, unfortunately, cancer treatment is one of them. Cancer that has spread to the bone or bone cancers that originate there clearly can cause great damage. Those are different and more difficult issues than osteoporosis.

Since some chemotherapy drugs can cause bone loss, this is an issue of importance for many of us. Women are more susceptible than men in general, and the hormonal therapies commonly used to treat ER-positive breast cancers can cause this problem. Women taking any of the AIs are usually aware of this, and are generally followed by periodic bone density scans. Also called a dual energy x-ray absorptiometry (DEXA) scan, these are actually an easy, non-invasive and quick procedure. The scan measures the density and strength of bones by determining the amount of calcium that is contained. Usually measurements are taken at the hip and lower spine. Read about bones density tests at BIDMC's Osteoporosis Prevention and Treatment Center.

What is the bottom line here? Simply, this is just one more thing that we should know about. Ask your doctor if your treatment or other issues have put you at greater risk for bone loss. If so, there are a number of drugs, both oral and IV, that can be used to treat the problem.