Due to the number of different breast cancer treatments available, side effects can vary from patient to patient. Though not all patients will experience it, some may notice a change in their bone health after certain treatments.
Bone health may also be at risk before treatment begins. Due to the close proximity of the breast tissue to the skeletal structure, there is the risk that the bone is the first location the cancer spreads. When it metastasizes, cancer often spreads first to adjacent tissue. This is why doctors often check beneath the armpits for enlarged lymph nodes in case the cancer has spread there.
Estrogen suppression during treatment
There are many components that make up bone health, such as nutrition and exercise. Hormone levels also affect bone health; for example, estrogen has a protective effect on bone density. This is why postmenopausal women are at an increased risk of bone fractures.
Because some forms of breast cancer are directly associated with estrogen, some cancer treatments aim to lower estrogen levels. These include treatments such as aromatase inhibitors, which block estrogen and are used in women with hormone receptor-positive breast cancer and are postmenopausal. Other therapies, such as gonadotropin-releasing hormone (GnRH) analogs and the surgical removal of the ovaries, result in ovarian suppression, which lowers estrogen since the ovaries produce estrogen. Chemotherapy can also contribute to ovarian suppression, which is why it can induce early menopause.
While these treatments are often prescribed out of necessity, the side effects of less estrogen production is that its protective effect on bone health is lost.
Read more about breast cancer testing and diagnosis
Monitoring and prevention
Because of the negative effects of these therapies on bones, doctors often monitor bone health using the DEXA scan, which analyzes bone density. This is sometimes administered on a yearly basis. The DEXA scan is a sophisticated device that can give a precise score that indicates whether the threshold for osteoporosis is met. In cases of which bone density falls to the level meriting a diagnosis of osteoporosis, doctors can prescribe treatments such as biphosphonates.
To prevent bone health from deteriorating, there are a number of lifestyle changes that are recommended. It is highly advisable to ensure that your calcium and vitamin D intake is sufficient and consistent. This can be helped with supplements.
Getting enough sunlight can help the body naturally produce vitamin D. In addition, it is important to continue to physically exercise. This is also protective against obesity, which can have a negative effect on bone health. Other healthy lifestyle habits, such as quitting smoking and limiting alcohol intake, can indirectly benefit your bone health.
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