Breast Cancer and Osteoporosis

Brenda_R

I wish I had paid more attention to possible bone loss due to chemo and BC.

I just had my first bone density screening and it was very bad. I did some research and found an article from the National Institutes on Health about BC and Osteoporosis. This is not just for those that took AI's either. I was not hormone positive. It can be a result of taking certain chemo drugs or from the BC itself, according to this article. I'll try to post a link. 

I just want others to be aware!

thepinkbirdie

Me too.

I wish one of my doctors would have ordered a bone density scan before I began the Tamoxifen, etc.  It would have been nice to have something to have compared it to... for all I know, I may have had osteoporosis before treatment.

Brenda_R

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

Brenda_R

Not a single one of my doctors over the last 5 years said one word about the bone density screening.  Including 2 Oncologists, 1 Orthopediac Surgeon, my Oncology Radiologist, or 2 Family Practice docs.  I'm celebrating being 5 yrs out from DX and NED, and worked hard to lose weight and get healthy over the last 2 yrs, and I get hit with this. Don't get me wrong, I am greatful to be NED.  This is just another health problem, but it possibly could have been avoided if I'd had the proper advice.

sam52

Make sure you also ask for parathyroid hormone testing - a lot us of seem to have elevated levels and this can cause osteoporosis too. It is underdiagnosed and appears to have some correlation with a BC dx

tenaj

I was dx with hyperparathyroidism 3 months after my BC dx. My onc found my calcium levels elevated & did further tests & confirmed by an endocrinologist. Surgery done 11/11 for a benign adenoma. Things normal in that department now.

Anonymous

This whole thing seems so ironic.  I nearly fell over when my BS told me I would be on an AI for at least 5 years (I'm surgically post-menopausal and my BC can't get much more homone receptive than it is) and then discovered that one of its side effects is bone density loss.  That was just a couple of days after my PCP put me on Fosamax because my osteopenia is just this side of full on osteoporosis. 

Uhm...uhm...what's a girl to do??

Fearless_One

Yes, my onc told me the chemo itself could cause osteoporosis.   Combine that with menopause and Arimidex, and I guess I am pretty high risk.  

For what it's worth, my friend broke her hip and was back to work in a WEEK.   I feel a little better knowing they can patch you up so quickly these days if something does happen (which it may not).

ICanDoThis

Ysa - my bones were just the other side of osteoporotic, and I was on Fosamax when I was diagnosed the same grade and stage as you.

While NCCN guidelines prescribe AIs for post-menopausal, hormone-positive women, many docs are open to keeping low-grade women on tamox, which is actually so good for one's bones that my onc took me off Fosamax. The difference at our stage between the 2 treatments is about 1%, which to me wasn't worth destroying my bones.

What I did was refuse the AI, take tamoxifen and do an aggressive program of bone improvement - had Vitamin D tested, and take vitamins that contains all the micronutrients one needs for bone health - a little vitamin K, a little magnesium, made sure I got enough calcium in my diet (breaskfast yogurt takes care of that). And do weight-bearing exercise (that is, walking)
My bones are rebuilding, to the point where I am on the good size of osteopenia/ostroporosis. 

purple32

Fearless

I have known people who have broken a hip and ended up in a nursing home.  That had to be a "minor" clean break your friend had.

 I am on the edge of osteoporosis anmd  have broken 3 bones  BEFORE this dx ( I am 54 btw) and it is bad.  I will not take  a biosphosphate <can make bones more brittle> or armidex which greatly accelerates bone loss.

What's a girl to do (?) is right !  I feel that the disabling risks of osteoporosis may potentially be worse than my BC dx.  It's a crap shoot for me and quite discouraging.

peggy_j

ICanDoThis wrote:

My bones are rebuilding, to the point where I am on the good size of osteopenia/ostroporosis.

Wow, that's terrific. I didn't know it was possible to reverse bone loss, just to stop it or slow it down. Congrats on the excellent results.  Yeah, I'm revisiting my dairy intake from food (I'm lactose intolerant so it's a bit more work). But now I'm inspired. Thanks for posting.

Mopsy

I heard from Gyn that testosterone gel from a compounding pharmacy does way more to prevent bone loss than any of the standard treatments.  He gave me the perccentages and they were astounding.  Does anyone use this gel?

dogsandjogs

Depends on the break. I had a very wide fracture of the femoral neck. They doc put in 3 pins the size of knitting needles. I was able to walk (toe touch only) the next day and could drive the next week. On the other hand, my 3 vertebrae fractures were much more painful and look 3 months to heal.

LtotheK

I'm reading around in this section, as I'm in the same boat.  With my family risk, I'm a little appalled my onc didn't get a baseline and put me on Zometa during treatment to deal with bone loss from chemopause and treatment.  Not sure why that's not SOP, since they invariably foist the Fosamax later.  Waiting for my second DEXA results after a year on Fosamax, two years on Tamoxifen, 3x a week weightlifting, and calcium supplementation, as well as D management (though I still run quite low).  A girl can only do so much before throwing the old hands up.

My issue is, I'm firmly convinced Fosamax is bunk.  I'm using it so they don't push Prolia in a year or two if things progress. 

Tamoxifen is a very tricky drug.  For pre-menopausal women, it can actually have the same effect on bones as AIs.  That is why regardless of treatment protocol, I think it's so important for women to be vigilant with diagnosis and self-care so they don't end up with more damage than necessary. 

These conditions can be reversed.  It is not easy to do, but it does happen.  Of course it varies person to person, and I think the accuracy of the DEXA given a lot of factors must be weighed.  Reminds me a bit of lymphedema:  a real lack of study and a double edged sword of treatment! 

Joan1112

I was diagnosed with breast cancer and osteoporosis this last june. It was a double blow. The osteoporosis treatment is actually the hardest decision. I had lumpectomy in july, low oncotype recurrence score, no chemo, but 4 weeks of radiation. After that he recommends arimidex as hormone therapy and zometa IV every 6 months for the osteoporosis. Has anyone used this combination? Good results? Side effects? I hate taking all these drugs.....but want to do what's best...

NSJ2

So what about all the Zometa/Boniva side effects I read about?  How common or what are the % risks of contracting these?

-Femur Fractures

-Esophageal Cancer

-Osteonecrosis of the Jaw/Dead Jaw Syndrome

-Atrial Fibrillation

-Severe Musculoskelatal Pain

Source: http://www.yourlawyer.com/topics/overview/zometa

NSJ2