Lani
09-20-2007, 04:32 PM
Bone Health of Breast Cancer Patients Compromised by Long-Term Chemotherapy
By Martha Kerr
HONOLULU (Reuters Health) Sept 19 - The bones of breast cancer patients tend to age prematurely as a result of chemotherapy and aromatase inhibitor therapy, and the bone health of these patients should be evaluated as if this were a much older population of women, investigators advised attendees of the annual meeting here of the American Society for Bone and Mineral Research.
Dr. Pauline M. Camacho and colleagues at Loyola University in Chicago conducted a retrospective chart review of 238 postmenopausal women referred to their institution between 2000-2005 for the management of osteoporosis or osteopenia.
Patients were divided into those with a history of breast cancer (64 patients) and a control group without breast cancer (174 patients). The breast cancer group had early-stage disease and the women were in the midst of, or considering, adjuvant hormonal therapy with aromatase inhibitors.
The mean age of those with breast cancer was 59.5 years, while it was 64.2 years in women without breast cancer. Vitamin D levels were slightly lower in the control group than in the cancer group.
The presence of at least one secondary cause of osteoporosis was found in roughly three-quarters of both groups. Vitamin D deficiency was the most common for both groups. The investigators found that 37.5% of the breast cancer group and 51.1% of the non-breast cancer group were vitamin D-deficient.
"There is a high prevalence of secondary causes of osteoporosis among breast cancer patients undergoing or considering undergoing adjuvant hormonal therapy with aromatase inhibitors," Dr. Camacho told meeting attendees. "This prevalence was similar to the non-breast cancer group despite a difference in age."
"It is prudent to obtain a baseline dual-energy X-ray absorptiometry evaluation and to screen patients with breast cancer for secondary causes of bone loss," Dr. Camacho added.
"These women should be evaluated as if they were much older," she commented in an interview with Reuters Health. "It may be wise to keep them on tamoxifen, which is bone-sparing, and avoid the aromatase inhibitors, which cause bone loss."
Again, this is a general paper as if bc were one entity. Her2+ BC is a different beast and behaves differently resulting in a need to treat it differently.
But the principal is, be careful not to ignore possible skeletal side effects --guidelines seem to suggest this can be done by getting regular DEXA scans, doing what you can to correct Calcium, vit D deficiencies (including getting sun exposure), and participating in regular exercise, if possible.
By Martha Kerr
HONOLULU (Reuters Health) Sept 19 - The bones of breast cancer patients tend to age prematurely as a result of chemotherapy and aromatase inhibitor therapy, and the bone health of these patients should be evaluated as if this were a much older population of women, investigators advised attendees of the annual meeting here of the American Society for Bone and Mineral Research.
Dr. Pauline M. Camacho and colleagues at Loyola University in Chicago conducted a retrospective chart review of 238 postmenopausal women referred to their institution between 2000-2005 for the management of osteoporosis or osteopenia.
Patients were divided into those with a history of breast cancer (64 patients) and a control group without breast cancer (174 patients). The breast cancer group had early-stage disease and the women were in the midst of, or considering, adjuvant hormonal therapy with aromatase inhibitors.
The mean age of those with breast cancer was 59.5 years, while it was 64.2 years in women without breast cancer. Vitamin D levels were slightly lower in the control group than in the cancer group.
The presence of at least one secondary cause of osteoporosis was found in roughly three-quarters of both groups. Vitamin D deficiency was the most common for both groups. The investigators found that 37.5% of the breast cancer group and 51.1% of the non-breast cancer group were vitamin D-deficient.
"There is a high prevalence of secondary causes of osteoporosis among breast cancer patients undergoing or considering undergoing adjuvant hormonal therapy with aromatase inhibitors," Dr. Camacho told meeting attendees. "This prevalence was similar to the non-breast cancer group despite a difference in age."
"It is prudent to obtain a baseline dual-energy X-ray absorptiometry evaluation and to screen patients with breast cancer for secondary causes of bone loss," Dr. Camacho added.
"These women should be evaluated as if they were much older," she commented in an interview with Reuters Health. "It may be wise to keep them on tamoxifen, which is bone-sparing, and avoid the aromatase inhibitors, which cause bone loss."
Again, this is a general paper as if bc were one entity. Her2+ BC is a different beast and behaves differently resulting in a need to treat it differently.
But the principal is, be careful not to ignore possible skeletal side effects --guidelines seem to suggest this can be done by getting regular DEXA scans, doing what you can to correct Calcium, vit D deficiencies (including getting sun exposure), and participating in regular exercise, if possible.