It was round this time two years in the past when Katie Finley was recognized with breast most cancers and had a bilateral mastectomy. Before the surgical procedure, docs advised her they didn’t suppose it was severe, and that they didn’t suppose she’d want chemotherapy or radiation.
However, throughout the surgical procedure, Finley’s healthcare staff eliminated just a few of her lymph nodes (the primary place breast most cancers sometimes spreads) and located extra cancerous cells than anticipated. A follow-up scan confirmed the worst: The breast most cancers had metastasized, or unfold, to her bones. “I had numerous lesions on my sacrum, hip and a certain number of vertebrae,” Finley mentioned. “Looking back, I don’t think I had any symptoms that the breast cancer had spread — no pain or weakness — but I could have brushed it off as just getting older.”
For many ladies with breast most cancers, consideration to bone well being is necessary for quite a lot of causes. Maintaining wholesome bone density might be tough for girls with breast most cancers — together with survivors — who take sure medicines that may pace up and improve bone loss. For instance, ladies with hormone-receptor-positive breast most cancers are sometimes on hormone suppression remedy, that means their our bodies are producing little to no estrogen. Without estrogen, which is the hormone that protects bones from harm, bones grow to be skinny and weak. This can result in osteoporosis and an elevated threat for fracture, damaged bones and bone ache.
Women with breast most cancers cells which have unfold to the bone, also called stage 4 breast most cancers, might have lesions that may trigger bones to fracture and break simply. In some circumstances, most cancers rising within the bones can press on the spinal twine, which might result in a lack of mobility and even paralysis. In reality, analysis exhibits that 70% of girls with bone metastasis will endure a skeleton-related occasion (damaged bones, spinal twine compression, continual ache) inside two years of analysis.
Dr. Brian Wojciechowski, medical advisor for breastcancer.org, mentioned ladies with metastasis to the bone ought to discuss to their healthcare staff about osteoclast inhibitors — pharmaceuticals that may delay bone well being and cut back the frequency of bone loss. And for all ladies with breast most cancers which can be at excessive threat for osteoporosis, a mixture of remedy and way of life selections might help preserve bones as robust as attainable. According to the National Cancer Institute, resistance and weight-bearing workout routines assist strengthen bones, and analysis exhibits that bisphosphonates, a category of osteoporosis remedy, can enhance bone density in some ladies with breast most cancers.
The advantages of weight-reduction plan and train
A weight-reduction plan wealthy in calcium and vitamin D can even assist in stopping or slowing bone loss in ladies with breast most cancers. Good sources of calcium embody dairy merchandise and leafy greens, however insufficient quantities of the mineral from meals might require that ladies take a calcium and/or vitamin D complement.
Finley’s therapy plan features a calcium complement taken twice a day. Still, the continuing bone ache and stiffness from each the most cancers and the therapies might be very uncomfortable. Finley mentioned it’s tough to sit down down for a standard tv present or sleep in the identical place for too lengthy. “You feel like a rusty skeleton,” she mentioned.
In the previous, some docs had been extra hesitant to advocate train for bone metastasis due to weakened bones. But a 2021 research confirmed that train in a supervised setting is protected for girls with metastatic breast most cancers, and common train helps enhance bodily operate.
Wojciechowski recommends any form of weight-bearing exercise, together with operating, strolling or weightlifting for all ladies with breast most cancers. “The key is to put a little bit of stress on the bones, which will stimulate them to produce more bone cells,” he mentioned. “Anyone starting an exercise program, especially with breast cancer that has metastasized to the bone, should consult with their physician before doing so.”
Understanding your fracture threat
Women with each early and superior phases of breast most cancers have an elevated threat for bone fractures, which might have a severe impression on mobility and way of life sooner or later. (Assess your 10-year fracture threat.) Eating a nutritious diet and getting loads of train are necessary steps to stop fractures. Screening for bone well being in ladies with breast most cancers can be a excessive precedence. The finest technique to gauge bone well being is by having a bone density (DEXA) check, a easy scan that measures bone power and helps element the danger for future breaks and osteoporosis.
Important questions on bone well being
For ladies residing with breast most cancers and survivors of the illness, it's equally necessary to seek the advice of a healthcare supplier about the right way to make bone well being and way of life selections that will cut back the danger for severe skeletal problems. Just a few necessary inquiries to ask your doctor embody:
- How can I shield my bones from fractures?
- What modifications can I make to my weight-reduction plan to assist shield my bones?
- Should I've a DEXA check?
- What therapies am I on that will negatively have an effect on bone well being?
- What pharmaceuticals will assist enhance bone density?
For Finley, modifications in her weight-reduction plan, like getting extra calcium from cheese, and doing yoga have had a constructive impact on her “rusty skeleton.” And extra excellent news: Her most up-to-date scans present enchancment in her illness and that her bones are responding effectively to therapy. “Metastatic breast cancer pushes you closer to the finish line than you ever thought you would be, but you need to think about being an older person,” Finley mentioned. “Your bones are older. You have to treat them with care.”
American Bone Health Fracture Risk Calculator
Susan G. Komen Guide to Questions to Ask Your Doctor About MBC and Bone Cancer
This useful resource was created with help from Amgen.