Treatments and Your Bone Health

Updated 
May 15, 2017

Breast cancer treatments affect your body’s ability to make or use estrogeninfo-icon to stop cancer cells from growing and multiplying. But lowering the amount of your hormones or stopping their creation altogether may also cause your bones to lose density faster and put you at higher risk for osteoporosisinfo-icon. For this reason, it is especially important to watch your bone health during and after treatment.

There are ways you can help improve your bone health if you know it may be affected by treatments. Speak to your healthcare providerinfo-icon about what you can do to lessen the risk of bone loss on your own or, if necessary, through medicineinfo-icon.

Chemotherapy

If you are still having regular periods, which means you are premenopausalinfo-icon, or are still having periods but they are only occasional, called perimenopausalinfo-icon, then chemotherapyinfo-icon may contribute to bone loss. Cellinfo-icon damage to your ovaries may interrupt your menstrual cycleinfo-icon and your body’s ability to make estrogeninfo-icon. Because estrogen has a role in rebuilding bones this could lead to lower bone densityinfo-icon.

Women who were younger when treated may have a regular period again when chemotherapy treatment ends. If you are one of these women your bone density may recover too, with the help of some healthy lifestyle choices or medicines.

Chemotherapy will stop periods in some women permanently. In this case your body is not likely to recover the same ability to rebuild bone. But you can still maintain good bone health through diet and exercise. You can also work with your doctor to monitor your bone density and get medicineinfo-icon, if needed. Check out our page on improving your bone health to learn more.

Hormonal Therapy

If tests show the breast cancer is estrogen receptor-positiveinfo-icon, you will likely take hormonal therapyinfo-icon to lower the risk of the cancer returning. Hormonal therapy will weaken your body’s ability to make or use estrogeninfo-icon and this will affect your bone health. Some common hormonal therapies are:

  • Tamoxifeninfo-icon, a daily pill given to block cancer cells from taking in estrogen. Premenopausalinfo-icon women have experienced bone loss on tamoxifen. But, because it can sometimes act like estrogen, tamoxifen has been found to protect bones in women who are postmenopausalinfo-icon.
  • Aromatase inhibitors (AI), a type of hormonal therapy that interrupts the body’s ability to convert other hormones into estrogen for postmenopausal women. Letrozoleinfo-icon (Femrara), anastrozoleinfo-icon (Arimidex) and exemestaneinfo-icon (Aromasininfo-icon) are the three most commons AIs and each has been associated with bone loss.
  • Raloxifeneinfo-icon (Evistainfo-icon) was developed as a treatment for bone health in women with osteoporosisinfo-icon, but it recently has been approved as a medicineinfo-icon to reduce the risk of invasive breast cancerinfo-icon for postmenopausal women considered “high-risk” but who have not been diagnosed. 

Surgery and Ovarian Suppression

Another treatment option for women with breast cancer that grows in response to estrogeninfo-icon is to stop the function of the ovaries. You may get surgeryinfo-icon to have them removed (oophorectomyinfo-icon) or medicineinfo-icon to stop them from making estrogen, called ovarian suppressioninfo-icon.

Like hormonal therapies, oophorectomy and ovarian suppression will lower your risk of recurrenceinfo-icon but may also contribute to significant bone loss. The drop in estrogen levels experienced with the stopping or removal of your ovaries will cause you to experience menopauseinfo-icon-like symptoms and the possible bone loss that comes with them. Speak with your doctors about the side effects of any treatment they recommend and how to best watch for or prevent them.

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Article May 15, 2017
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