Your responses to cancer: Do cancer patients need an osteoporosis test? | Health, medicine and fitness
Question: Do cancer patients need an osteoporosis test?
Osteoporosis is a disease in which your bones lose their strength and density. This makes the bones brittle and more likely to break (fracture). There are many causes that can lead to this condition. One is that of breast cancer survivors taking anti-estrogen therapy (aromatase inhibitors).
Blocking estrogen is one way to reduce this risk of recurrence in women with hormone receptor positive breast cancer. However, estrogen is beneficial for strengthening bones. For this reason, it is important to have an accurate bone measurement when starting these therapies as well as every few years after starting.
The bone mineral density (BMD) test, also known as dual energy x-ray absorptiometry (DEXA), is the most useful and reliable bone density test. It is a special type of x-ray that emits very little radiation. DEXA gives reliable measurements of bone density in different parts of the body, such as the spine, hip and wrist.
DEXA is the best test for diagnosing osteoporosis, predicting the risk of fractures and checking the effectiveness of treatment. During the DEXA scan, you lie down on a table. Then an x-ray machine scans one of your bones. The test doesn’t hurt or make you uncomfortable. The whole process usually takes less than 15 minutes. At Mission Hope, we have a newly installed system, the Hologic Horizon-W.
It offers excellent image quality and scans efficiently in 10 seconds or less. Along with the ability to measure bone health, we can now measure body composition and assess cardiovascular risk. Examinations can be performed at Mission Hope Breast Center and Matthew Will Imaging, the systems are identical, allowing changes in density to be measured consistently over a period of time.
Based on the results, various measures can be taken to protect the bones. Eating a healthy, balanced diet of fruits and vegetables can reduce bone loss. Plus, regular weight-bearing exercises can build and strengthen bones. Finally, drugs designed to strengthen bones can be used. Osteoporosis in people who have had breast cancer is most often treated with a group of medicines called bisphosphonates.
This includes zoledronic acid, risedronate, ibandronate, or alendronate. Bisphosphonates help strengthen your bones and lower your risk of fractures. Bisphosphonates may also be prescribed to protect your bones if you are taking an aromatase inhibitor (such as exemestane, letrozole, or anastrozole).
Denosumab is a medicine that may be recommended to reduce the risk of fractures. It is given as an injection twice a year and slows down bone loss in osteoporosis. It is a treatment for postmenopausal women who cannot take certain bisphosphonates and who have particular risk factors for fractures.
If you are a breast cancer survivor, Dr. Stevenson will be the guest speaker for the next breast cancer support group on Tuesday, July 20 at 4:00 p.m. Space is limited, so please RVSP at 805-219-HOPE (4673).
Dr. Dustin Stevenson is board certified in internal medicine, medical oncology and hematology. He treats people with cancer and blood disorders and is oncology staff at Marian Regional Medical Center and Arroyo Grande Community Hospital. He can be reached at 805-349-9393.
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