Submitted by Elizabeth Madlem, APN, The Bone Health Clinic at Millennium Pain Center
Other than skin cancer, breast cancer is the most common cancer in women. The risk of developing breast cancer increases with age, particularly in women age 60 and older. Because of their age, these women are already at increased risk for osteoporosis. Given the rising incidence of breast cancer and the improvement of long-term survival rates, bone health and fracture prevention have become important health issues among breast cancer survivors.
Osteoporosis is a disease that thins and weakens the bones to the point that they become fragile and break easily. There are no symptoms of osteoporosis until a fracture occurs. Osteoporosis is considered to be a global public health problem and is estimated to affect half of all Americans over age 50.
Risk factors for developing osteoporosis include the following:
- Thinness or small frame
- Family history of the disease
- Being postmenopausal and particularly having had early menopause
- Abnormal absence of menstrual periods (amenorrhea)
- Prolonged use of certain medications, such as those used to treat lupus, asthma, thyroid deficiencies, and seizures
- Low calcium intake
- Lack of physical activity
- Smoking
- Excessive alcohol intake.
The link between breast cancer and osteoporosis
Women who have had breast cancer treatment may be at increased risk for osteoporosis and fracture. Estrogen has a protective effect on bone, and reduced levels of the hormone trigger bone loss. Because of treatment medications 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 may go through menopause earlier than those who have not had breast cancer. Results from the NIH-supported Women’s Health Initiative Observational Study (WHI-OS) found an increase in fracture risk among breast cancer survivors.
Osteoporosis management strategies
Several strategies can reduce one’s risk for osteoporosis or lessen the effects of the disease in women who have already been diagnosed.
Nutrition: Some studies have found a link between diet and breast cancer. However, it is not yet clear which foods or supplements may play a role in reducing breast cancer risk. As far as bone health is concerned, a well-balanced diet rich in calcium and vitamin D is vital. Calcium and Vitamin D go hand-in-hand. If you have trouble getting enough calcium and/or Vitamin D, you may need to take a calcium supplement. Always work with your doctor or health care professional to determine if a calcium supplement is needed as too much calcium can cause other health problems.
Exercise: 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, such as walking, may help prevent bone loss and will provide many other health benefits. Research also suggests that exercise may reduce breast cancer risk.
Healthy lifestyle: 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. Some studies have found a slightly higher risk of breast cancer in women who drink alcohol, and evidence suggests that alcohol can have a negative effect on bone health. Those who drink heavily are more prone to bone loss and fracture, because of both poor nutrition and an increased risk of falling.
Medication: There is no cure for osteoporosis, but it can be treated. Several medications are available to prevent and treat this disease. Bisphosphonates, a class of osteoporosis treatment medications, have demonstrated some success in their ability to treat breast cancers that have spread to bone. Another osteoporosis treatment medication, raloxifene, is a selective estrogen receptor modulator (SERM) that has been shown to reduce the risk of breast cancer in women with osteoporosis. The National Institutes of Health’s Study of Tamoxifen and Raloxifene (STAR) found that raloxifene was as effective as tamoxifen in reducing the risk of postmenopausal breast cancer in high-risk women.
It’s important for everyone to take control of their health — and this includes bone health. Preventing osteoporosis is a lifelong endeavor. In fact, it 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.
For more information on osteoporosis, you may contact The Bone Health Clinic at Millennium Pain Center, 309-662-4321. They are located at 1015 Mercer Ave. in Bloomington. Elizabeth Madlem is a certified bone health consultant. The clinic provides screening, diagnosis, and a comprehensive treatment plan for people who have or are at risk of developing osteoporosis.