Bone Health for Cancer Patients
Please click on the link to the video: Bone Health for Cancer Patients which will discuss bone health, bone loss, risk factors for cancer patients, osteoporosis, treatment and prevention strategies for bone loss.
If you do not wish to view the video in its entirety:
What is Osteoporosis
Osteoporosis is a condition in which a person's bone mass is lost faster than it can be replaced. This results in bones that are weak, less dense and more likely to break.
Osteoporosis is the most common degenerative disease in developed countries because of extended lifespan. It is characterized by loss of bone and increased skeletal fragility, leading to an increased number of fractures.
Causes of Osteoporosis
Risk factors for bone loss include:
- First degree relative with osteoporosis or history of fracture
- Gender - women are four times more likely to be affected than men
- Lack of exercise; sedentary lifestyle
- Use of tobacco products
- Consuming more than two alcoholic drinks per day for men and more than one alcoholic drink per day for women
- Many drugs, including steroids, hormonal agents, blood thinners, anticonvulsants and certain chemotherapy drugs
- Menopause, the stopping of menstrual periods in women, whether natural, surgical or drug-induced. Early menopause is one of the strongest predictors of the development of osteoporosis in women.
- Low testosterone production in men known as hypogonadism
- Calcium or vitamin D deficiency
- Other diseases, such as hyperparathyroidism, hyperthyroidism, multiple myeloma and Cushing's syndrome
Most of the time, a person doesn't know he or she has osteoporosis until a bone breaks. The bones of the hips, spine and wrists have the greatest risk of fracture.
The diagnostic test used for measuring bone mass is an X-ray called a bone densitometry, also called a bone mineral density test. The first test, sometimes performed when a woman reaches menopause, serves as a baseline to compare and track any bone loss over time. Men are not screened routinely, but a doctor may order the test if other risk factors are present or if the patient experiences a fracture.
Bone mineral density often is measured before or during cancer treatment.
Eating a well-balanced diet that includes plenty of calcium and vitamin D can help build strong bones. You can help maintain bone health by exercising regularly (especially by doing weight-bearing exercises), avoiding tobacco products and avoiding excessive alcohol use - defined as more than two drinks per day for men and more than one drink per day for women.
Two types of exercise are important for building and maintaining bone mass and density: weight-bearing and resistance exercises. Weight-bearing exercises cause your bones and muscles to work against gravity. Walking, dancing, playing tennis and climbing stairs are examples of weight-bearing exercises with different degrees of impact. Swimming and bicycling are not weight-bearing exercises.
A second type of activity to improve bone strength is resistance exercise. Resistance exercises use muscular strength to improve muscle mass and strengthen bone. These activities include weight lifting, such as using free weights and weight machines found in gyms and health clubs. The optimal goal for exercise is 30 minutes to an hour at least four times a week. It is important to check with your doctor before you begin a regular exercise program.
Are There Medicines That Help?
Prescription medicines may stop or slow bone loss and reduce the risk of bone fractures.
Alendronate (Fosamax®) is approved for both the prevention (5 mg per day or 35 mg once a week) and treatment (10 mg per day or 70 mg once a week) of postmenopausal osteoporosis. Alendronate reduces bone loss, increases bone density and reduces the risk of spine, wrist and hip fractures.
Risedronate (Actonel®) is approved for the prevention and treatment of postmenopausal osteoporosis. Taken daily (5 mg dose) or weekly (35 mg dose) risedronate slows bone loss, increases bone density and reduces the risk of spine and non-spine fractures.
Raloxifene (Evista®) is approved for the prevention and treatment of postmenopausal osteoporosis. Raloxifene increases bone mass and reduces the risk of spine fractures. Data is not yet available to demonstrate that raloxifene can reduce the risk of hip and other non-spine fractures. Ibandronate (Boniva®) is approved for the treatment of postmenopausal osteoporosis and is the first once-a-month (150 mg) medicine. Parathyroid hormone 1-34 (PTH1-34) or teriparatide (Forteo®) is approved for the treatment of osteoporosis in postmenopausal women, and men who are at high risk for a fracture. PTH1-34 promotes new bone growth and greatly increases bone mineral density. Research studies have shown a decrease in fractures of the spine and other sites in postmenopausal women. Teriparatide also is approved for treatment of osteoporosis in men. It is self-administered as a daily injection for up to 24 months.
Calcium Content in Milligrams (mg)
|Cereal, calcium fortified||1 cup||250-1,000|
|Cheese, American||1 slice||100|
|Cheese, cottage||1/2 cup||250|
|Cheese, Swiss||1 ounce||250|
|Ice Cream||1/2 cup||60-150|
|Juice, calcium fortified||1 cup||350|
|Lactaid® milk||1 cup||300-500|
|Salmon, canned with bones||2 ounces||100|
|Soy milk, calcium fortified||1 cup||200-300|
|Yogurt, frozen||1/2 cup||100-300|
About Bone Metastases:
Did You Know That:
- Bone metastases occur when cancer cells break off from a primary tumor site, enter the bloodstream and grow in bones.
- Bone metastasis is the primary cause of death in prostate cancer, which is the most common cancer in American males. It also is a common problem in breast cancer, myeloma, leukemia and other forms of cancer.
- Bone metastasis is one of the most frequent causes of pain in cancer patients. It not only causes fractures, but also increases blood calcium concentration that can greatly reduce an individual’s quality of life, and even threaten life.
Our understanding of the process of metastasis to the bone is still limited, and this hinders our ability to design effective methods to prevent or control the process. However, recent discoveries about the interactions between cancer cells and normal bone cells hold promise that additional research will translate into new drugs in the near future.