Ensuring Bone Integrity throughout Breast Cancer Therapy
Breast cancer treatments can have an impact on bone health, and it's essential to understand how lifestyle choices and medications can help maintain bone strength.
Some breast cancers are estrogen receptor-positive, meaning that estrogen fuels their growth. This key role of estrogen in breast cancer also extends to bone health, as a reduction in estrogen levels can lead to a higher rate of bone cell turnover, resulting in bone loss over time. Endocrine therapy for breast cancer, which suppresses or blocks estrogen, can affect bone density.
Chemotherapy, a common breast cancer treatment, can cause a complication called chemotherapy-induced ovarian failure (CIOF), which can raise the risk of weakened bones. Radiation therapy also increases the risk of bone loss and fractures. Certain therapies such as aromatase inhibitors and some targeted agents may lead to bone loss or osteonecrosis, as seen in some patients treated with Aybintio.
Lifestyle practices can play a crucial role in promoting bone strength. Performing weight-bearing exercises, such as walking, stair climbing, dancing, and weightlifting, for 30 minutes per day, as recommended by the National Breast Cancer Foundation, can help increase bone strength. A balanced diet is also beneficial during cancer treatment, with a focus on protein, calcium, magnesium, and vitamin D for bone strength.
Sources of protein include lean meats, beans, nuts, tofu, and dairy products. Calcium can be obtained from dairy products, fortified foods, almonds, and dark green leafy vegetables. For extra vitamin D, people can eat oily fish, fortified foods, eggs, and mushrooms. When possible, people should aim for twice-weekly sunlight exposure on the skin, or take a vitamin D supplement if necessary. Sources of magnesium include spinach, avocados, bananas, dark chocolate, certain nuts and seeds.
Quitting smoking may reduce the impact of cancer treatment on bone health, as smoking limits calcium absorption, slows the formation of bone-forming cells, decreases the protective effect of estrogen, and reduces blood supply to the bones. Limiting alcohol intake to less than 3 ounces (85 milliliters) per day may help reduce bone loss.
Doctors use drugs called bisphosphonates or RANKL inhibitors to manage bone loss in breast cancer. Continuing these lifestyle practices and possibly osteoporosis medications after breast cancer treatment can reduce the risk of fractures throughout life.
Examples of endocrine therapy include aromatase inhibitors, tamoxifen, and estrogen suppression of the ovaries. Examples of weight-bearing exercises include walking, stair climbing, dancing, and weightlifting.
In conclusion, understanding the impact of breast cancer treatments on bone health and adopting lifestyle practices that promote bone strength can help reduce the risk of fractures throughout life. It's important to discuss any concerns with a healthcare provider and to work together to create a personalised plan for maintaining bone health during and after breast cancer treatment.
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