Breast cancer and osteoporosis are common age-related diseases for women. The good news is that we, as a medical community, have gotten better at treating both. Most women diagnosed with breast cancer today will be long term survivors. It is therefore important to consider osteoporosis and its effect of fracture risk during the diagnosis, treatment, and survivorship of those with breast cancer. We build our bone mass through age 30 and then slowly lose that bone mass over time. Normal bone loss is 1-2% per year for healthy postmenopausal women. Breast cancer treatment can increase bone loss anywhere from 2-11% per year. Due to the risk of increased bone loss during cancer treatment, osteoporosis is both a long term and late effect of breast cancer treatment. Meaning that osteoporosis can occur during treatment and extend afterwards as well as occur after treatment for breast cancer has ended. The first line approach to bone loss is lifestyle modifications. These include quitting smoking, decreasing alcohol consumption (2-3 drinks per day increases one’s risk), and increasing physical activity. Women should also know that there are medications effective at preventing and treating osteoporosis without increasing the risk of breast cancer recurrence. The first symptom of osteoporosis is often a fracture—which means that women and their care team need to prioritize screening, prevention and treatment of osteoporosis. It is very important for women to identify a health care provider who will take responsibility for their bone health. Depending on areas of expertise, this may be your primary care, oncologist, obstetrics and gynecology, endocrinologist or rheumatologist physician.
Osteoporosis is one of those diseases that many areas of medicine can be involved in. Your physician team is the best team to refer to for screening (such as a Dexa scan) as well as medication management. Nutritionists can help you to incorporate a bone healthy diet, rich in calcium, vitamin C and D as well as magnesium, into your daily lifestyle. Physical therapists are your movement experts. They can help you to regain your balance and prevent falls, improve your posture, instruct you in a bone building gym routine, and teach you safe movements. It is important to find a physical therapist knowledgeable in osteoporosis management. For example, did you know that flexion movements (reaching towards your toes and crunches) can increase the risk of compression fractures in the spine of people with osteoporosis? At Apex Physical Therapy and Wellness, we have a specialized osteoporosis program that will educate you on how to care for yourself and prevent fractures. It is appropriate for patients who have osteopenia or osteoporosis. It is one on one therapy with a physical therapist and covered by insurance. In this program, you will be empowered with the knowledge you need to take care of yourself, manage your osteoporosis, and prevent the downhill spiral that can occur with fractures. The program is tailored to every individual’s needs and includes education on what movements tend to increase your risk of spinal fractures, safe exercises to improve bone health, balance, and reduce your risk of falls. We will educate you what weight bearing exercises tend to be the best for building and maintaining bone density. Most program participants see an improvement in posture and feel much more knowledgeable and safer with their daily routines once they have completed the program. If you believe you could benefit from this type of program, give us a call.