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What is the Connection Between Breast Cancer and Bone Health

Submitted by Porselvi Chockalingam, MD

So many great strides have been made in breast cancer research in the past few decades that there are more than 3 million breast cancer survivors in the United States today. Although the tragedy of experiencing breast cancer cannot be diminished, the fact is that more than ever before, breast cancer survivors are living long and fulfilling lives. With more survivors than any other cancer group, we are learning more everyday about the long term effects of breast cancer and cancer treatments. With bone health becoming an increasing concern in breast cancer survivors, it is important to educate yourself to know your risks and take the necessary steps to stay healthy.

Osteoporosis
It is known as a silent disease. You many never show any signs or symptoms, but then it happens—a broken bone.  Osteoporosis is a condition in which bones lose mass and density, becoming brittle and more likely to fracture, and fractured bones can cause intense pain and lead to long term disabilities.

Risk factors for osteoporosis and bone loss include:  Family history of osteoporosis, small frame, being postmenopausal/early menopause, low calcium intake, lack of physical activity, smoking, excessive consumption of alcohol, prolonged use of certain medications.

What Does Osteoporosis Have to Do With Breast Cancer?
Anyone can have osteoporosis, but it is more common in older women due to menopause. The hormone estrogen has a way of protecting your bones; therefore, a change in hormone levels during menopause can generate bone loss. Women going through breast cancer treatment are very likely to go through early menopause.  Due to surgery and chemotherapy, women often lose ovarian function causing a change in estrogen levels and initiating menopause. 

Beyond hormone changes, the cancer treatments themselves can also have a directly negative effect on the bone. Radiation therapy can break down the bone building cells, while certain chemotherapy medications can cause bone loss or suppress bone growth.

How to Manage Osteoporosis
Although osteoporosis is a preventable disease, by the time symptoms show you may think it is too late. It is never too late for healthy lifestyle changes to strengthen your bones and lower your risk of breast cancer.

Nutrition is a key factor in any healthy lifestyle. To specifically fight the effects of osteoporosis, you want to make sure your diet is full of calcium and vitamin D. A few good sources of calcium are dairy products such as low-fat milk, yogurt, and cheese; calcium-fortified orange juice; dark green leafy vegetables such as broccoli, spinach, collard greens, and bok choy;  tofu;  almonds and vitamin-fortified cereal.  You may also want to consider taking a calcium supplement. The dose can vary based on gender and age, so be sure to talk to your doctor before beginning a supplement regimen.

Vitamin D assists with calcium absorption, so it is just as important. Your body absorbs Vitamin D through sunlight; so if you are not outside much, be sure to incorporate vitamin D-fortified milk, egg yolks,  herring, salmon, and tuna into your diet. You may also want to consider a Vitamin D supplement.

Weight-bearing exercise makes your bones stronger because you are forced to work against gravity. It is as easy as going for a walking or taking the stairs. If you are looking for something a bit more challenging, try playing tennis, taking a dance class, or lifting weights. You may even reduce your risk for breast cancer, according to recent research.

Healthy lifestyle choices are key to an overall better quality life. We all know that smoking can damage our lungs and is a risk factor for breast cancer, but it can also cause women to go into early menopause which can leave your bones less protected and more susceptible to bone loss. Smoking can also block calcium absorption, so important to keeping bones strong. Be mindful of alcohol intake and nutrition, and be sure to get your cancer screenings.

If you think you are at risk for osteoporosis, especially if you have had breast cancer, talk to your doctor about a bone density test. It is an easy and painless test that can measure bone density throughout the body and predict the likelihood of a fracture, and if medication could be a necessary treatment option.

Resources:
http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/Conditions_Behaviors/osteoporosis_breast_cancer.asp#a

Porselvi Chockalingam, MD, known to her patients as Dr. Selvi, is Board Certified in Internal Medicine, Oncology and Hematology. She is Fellowship Trained in Oncology and Hematology. She sees patients at Tunnell Cancer Center at the Beebe Health Campus in Rehoboth Beach. Find out more about Tunnell Cancer Center at www.beebehealthcare.org/tunnell-cancer-center
 

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