29 Aug Breast Cancer & Bone Health
The bone health of a breast cancer patient/ survivor gets affected during the course of their treatment and if proper care is not taken, it can lead to more problems (increased risk of fractures) for them apart from their cancer.
The usual reasons why bone health is adversely affected in these patients are:
1. Post-menopausal status – usually Breast Cancer is diagnosed in the 5 th decade of life and majority of the
patients are post-menopausal at the time of diagnosis.
The protective effect of estrogen on the bones is lost after menopause and the bones start becoming weak
2. Chemotherapy – has a direct effect on the bone mineral density and can also induce ovarian failure in pre-menopausal patients, thereby leading to decreased bone mineral density
3. Hormonal therapy – Drugs like aromatase inhibitors (anastrozole, letrozole) lead to progressive loss of bone
mineral density and considering the duration these drugs are given for, they have a significant impact on the bone
health of the lady.
4. Oophrectomy – is indicated in select young, hormone receptor positive patients and as a part of risk reduction in
patients with BRCA mutations. Oophrectomy (ovarian removal) induces a post-menopausal state and adversely
affects the bone health. If bone health is not paid attention to during the course of treatment, it can increase the risk of pathological fractures.
A DEXA scan (Bone mineral density test) should be contemplated in patients who are at a risk of developing
reduced bone health during their treatment. A bone mineral density (BMD) test measures bone density in various parts of the body. It is a painless test which can detect osteoporosis before a fracture occurs.
If osteoporosis is detected, the following interventions can be done to improve the bone health of a Breast Cancer patient:
1. Nutrition: A well balanced diet rich in calcium and vitamin D is important for a breast cancer patient. Good sources of calcium include low-fat dairy products; dark green, leafy vegetables; and calcium-fortified foods and beverages.
2. Healthy lifestyle: Smoking and alcohol consumption adversely affect bone health and they should be avoided
by breast cancer patients. In addition to this, regular exercise, especially weight bearing exercises help in keeping the bones stronger.
3. Medication: There is no cure for osteoporosis. However, calcium tablets, Vitamin D3 sachets and bisphosphonates, a class of osteoporosis treatment medications, have demonstrated some success in their ability to treat breast cancers that have spread to bone.
If you are suffering from breast cancer, discuss about your bone health with your Breast Cancer Oncologist.
Consultant, Breast Onco-Surgeon
W Pratiksha Hospital