why do I keep fracturing bones?

purell

why do I keep fracturing bones?

purell

I don't know where to ask this question.  I hope this is OK.  Here is the chronolgy.

A few months prior to DX of invasive ductal breast cancer in 2003 I woke up one morning with a fractured pelvis (stress fractures on left and right side-hurt like the dickens).  Only treatment was "take it easy".

After the CA dx I had every scan imaginable to see if there was mets to the pelvis or back.  None.  My bone density tests said my bones were strong as steel.

After chemo my spinal facet joints were dried out and severely degenerative which has resulted in a lot of pain for me.  Bone density tests now show osteopenia, the beginnings of osteoporosis.

Now, after weeks of leg pain I found out I have a stress fracture of my femur.

Husband feels it is all related somehow to the breast cancer.  Tests do not show any met to the bones yet I have all these problems.  Coincidence? Anyone have any ideas?

Missjaq

Maybe you should be checked by an Orthopedic Oncologist. They will hopefully give you a reason for these fractures. Please take care. I am sure it is perplexing and painful.

Member_of_the_Club

Or just an orthopedist. I wouldn't jump to a cancer-related conclusion. I wonder if there is an autoimmune disorder that would cause this sort of thing, because it does sound systemic.



My radiation oncologist told me she had only one patient who suffered a broken rib from radiation and this same patient broke bones very, very easily, like just walking down the street. She didn't know why, but she thought the patient had something entirely unrelated to cancer and cancer treatment.

Anonymous

Question for the poster:



1) Have you ever been prescribed P450 aromatase enzyme inhibitors? These include the reversible inhibitors Armidex (Anastrozole), Femara (Letrozole), and the irreversible suicidal inhibitors such as Aromasin (Exemestane), and Formestane (4-hydroxyandrostenediol).



WHY: Cytochrome P450 aromatase enzyme inhibitors work by inhibiting the aromatase enzyme which is responsible for converting androgens into estrogens and more. When you inhibit the aromatase enzyme, a common practice for preventing the proliferation of estrogen-dependant breast cancer cells, you are essentially lowering estrogen levels. Lowering estrogen levels can, overtime, especially at the large dosages of these inhibitors given for breast cancer therapy, result in osteoporosis, sometimes VERY severe.



This has been reported many times during breast cancer treatments with this category of compounds.





2) Have you ever been prescribed Selective Estrogen Receptor Modulators (SERMs) such as Nolvadex (Tamoxifen)??



WHY?: Tamoxifen is a SERM, or, Selective Estrogen Receptor Modulator. Its an exogenous synthetic estrogen also used for treating and in serious cases of risk, preventing breast cancer. Its often given at large dosages over prolonged periods of time. Tamoxifen works by binding to estrogen receptors with different pharmacokinetics in different tissues. For example in breast tissue Tamoxifen is an antagonist at the estrogen receptor alpha, whereas in uterus tissue Tamoxifen is an estrogen receptor agonist and has been linked to increased risk for developing uterine cancer, one of the reasons why Tamoxifen is soon to be replaced by newer SERMs with more ideal pharmacokinetic profiles such as Raloxifene. Another biological effect of Tamoxifen is its effect as an estrogen receptor alpha antagonist in skeletal tissues. This has an end result similar to aromatase inhibitors, in that it will weaken the skeletal structure and can even in extreme cases, cause osteoporosis. In any case, it does, like aromatase inhibitors, cause a statistically significant drop in bone mineral density which can result in significantly increased potential for fractures.







While there are countless other possible explanations to your interesting condition, these two above therapies commonplace in breast cancer treatment regimens, can, and have been well documented to, cause significant losses in bone mineral density, in some cases to the degree of being diagnosed as suffering osteoporosis. Even if not to that degree, there is still a significant loss in BMD, and this can account for frequent fractures and brittle bones.







Regardless of what your cause is, this may sound contradictory, but physical weight bearing exercise such as resistance training, has been clinically proven to dramatically reduce the risk for skeletal fractures. At first, you must engage in the exercise in a slow, low weight manner and almost always under medical supervision. However, very rapidly, bone mineral density will increase when acquiring proper nutrition.





Something to consider. I would contact your health care practitioner to discuss options for physiotherapy under supervision to engage in weight bearing exercise to increase bone mineral density. Dense bones dont simply fracture. So whatever the cause of your fractures are, the end result has certainly been a loss in bone mineral density, and the way to counteract that has been well established to be weight bearing exercise.



Epimedium Brevicornums active ingredient Icariin has also been shown to have extremely effective benefits for improving bone mineral density, with significantly greater benefits when combined with weight bearing exercise verse. either of the two elements on their own alone. Icariin has been shown to have no estrogenic effects, and therefore is likely to have no interaction with breast cancer (although dont mark my words on that!).







Hope this helps! That sounds really terrible, you must have extremely brittle bones, almost certainly the result of your treatments, whatever they may be.





Im sure chemotherapy does a number on bone mineral density.





Look into Epimedium Brevicornum (Icariin), and weight bearing exercise such as resistance training. Start light, under supervision of a physiotherapist that specializes in osteoporosis exercise therapies preferably, and you'll be surprised how fast you can recover lost bone density.





Good luck

MUSEGAL295

 Since I had my cancer in 2002, (chemo and total r mastectomy)  I have had shoulder replacement, knee replacement, neck surgery, and cannot walk a block without stopping due to pain.  I cannot do the pulling needed for nursing and cannot find a nursing job that I can do.  My orthopedist says I have bad DNA.  My oncologist says the chemo is not the cause.  My bone density tests are okay. This is very frustrating.