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Old 02-02-2007, 11:26 AM   #1
Linda2
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Osteopenia?

I had a bone density scan last week and the onc called today to tell me I have osteopenia. I was told to start Caltrate and Fosamax. Is this possibly caused from being on Femara or from the chemotherapy?

I have no one in my family that had or has this.

Did this happen to any of you from the chemo or Femara?
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Linda2

DX 6/2005
Stage IIA, Grade I
ER/PR +, HER2 +++
Lumpectomy on Left breast 7/2005
No lymph nodes involved
4 cycles of A/C
12 weekly doses Taxol and Herceptin
33 Rads
Herceptin for one year ended 12/2006
Femara for 5 years
NED as of now
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Old 02-02-2007, 01:48 PM   #2
rosamarie
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osteoporosis and arimidex

Hi
I was on Arimidex for 6 months and then had a dxa scan, it revealed severe osteoporosis in spine and hip which was quite a shock. I was then taken off Arimidex as I am only weakly pr+ and er-. The thinking seems to be that I may have had some osteoporosis to start with and it was accelerated by chemo, steroids and arimidex. Guess I'll never know! I am currently taking Protolos (strontium ranelate) and calcichew.
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Old 02-02-2007, 02:25 PM   #3
Lolly
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I was diagnosed with Osteopenia after finishing treatment for primary disease in 2000, but as I had gone through menopause somewhat early (periods ended in early '97, when I was 43 yrs. old), the jury's out on whether chemo accelerated the process or not. Anyway, I excersise and take calcium supplements, and so far it hasn't progressed to Osteoporosis. I was on Fosamax for less than a month as I couldn't tolerate it, but will probably try again if/when I HAVE to take something.

VERY IMPORTANT to do weight-bearing excersise for at least 30 minutes daily, and do take those calcium supplements, it helps!

<3 Lolly
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Sept.'99 - Dx.Stage IIIB, IDC ER/PR-, HER2+++ by IHC, confirmed '04 by FISH. Left MRM, AC x's 4, Taxol x's 4, 33 Rads, finishing Tx May 2000. Jan.'01 - local/regional recurrence, Stage IV. Herceptin/Navelbine weekly till NED August 2001, then maintenance Herceptin. Right Mast. April 2002. Local/Regional recurrence April '04, Herceptin plus/minus chemo until May '07. Gemzar added from Feb.'07-April '07; Tykerb/Abraxane until August '07, back on Herceptin plus Taxotere and Xeloda Sept. '07. Stopped T/X Nov. '07, stopped Herceptin Dec. '07, started Avastin/Taxol/Carboplatin Dec. '07. Progression in chest skin, stopped TAC March '03, started radiation.

Herceptin has served as the "Backbone" of my treatment strategy for over 6 years, giving me great quality of life. In 2005, I was privileged to participate in the University of Washington/Seattle HER2 Vaccine Trial.
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Old 02-02-2007, 04:17 PM   #4
tricia keegan
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Question?

Can I ask any of you ladies if you had any symptoms or pain before your scan with this?
I had a bone scan today but results will take a week along with a dexa scan last week for back pain.
I'm of course scared the cancer has spread but just wondering if it has'nt may be this could be the culprit?
I've been taking Arimidex since Sept last year.
Thanks
Tricia
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Tricia
Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
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Old 02-02-2007, 04:51 PM   #5
R.B.
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You might like to search on omega three DHA EPA and bone density on this site and NCBI. On NCBI the last two lines or so of the summary are a good place to start.

I have posted some links on this site to trials that suggest higher omega three consumption may help with bone density issues.

Omega six is the other half of the omega three issue. Posts can be found by clicking on search above and entering your search terms.

Complex as usual, and cannot be taken out of the context of wider diet etc.

Also see posts on magnesium and calcium re calcium.

Please talk to your advisors about dietary changes.

Please come back if you do not find what you want.

RB
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Old 02-02-2007, 10:52 PM   #6
Lolly
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RB has good suggestions as usual I do take a balanced Omega 3-6-9 supplement, along with extra Magnesium plus extra Vit. D, in addition to the calcium.

I had pain in my left hip and lower back for several years before the diagnosis of cancer, and then the subsequent diagnosis of Osteopenia(which was in hip and several lower vertebrae).
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Sept.'99 - Dx.Stage IIIB, IDC ER/PR-, HER2+++ by IHC, confirmed '04 by FISH. Left MRM, AC x's 4, Taxol x's 4, 33 Rads, finishing Tx May 2000. Jan.'01 - local/regional recurrence, Stage IV. Herceptin/Navelbine weekly till NED August 2001, then maintenance Herceptin. Right Mast. April 2002. Local/Regional recurrence April '04, Herceptin plus/minus chemo until May '07. Gemzar added from Feb.'07-April '07; Tykerb/Abraxane until August '07, back on Herceptin plus Taxotere and Xeloda Sept. '07. Stopped T/X Nov. '07, stopped Herceptin Dec. '07, started Avastin/Taxol/Carboplatin Dec. '07. Progression in chest skin, stopped TAC March '03, started radiation.

Herceptin has served as the "Backbone" of my treatment strategy for over 6 years, giving me great quality of life. In 2005, I was privileged to participate in the University of Washington/Seattle HER2 Vaccine Trial.
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Old 02-02-2007, 11:03 PM   #7
rinaina
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can chemo cause osteopenia and/or osteoarthritis? great, another thing to worry about and deal with.
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~Rina~
Dx:3/06 had a lumpectomy April 19, 2006
Her2+ er/pr- Stage I Grade 3 tumor size 1.4 cm, node negative
AC 4 dense doses
34 radiation treatments including booster doses
receiving herceptin every 3 weeks since late August 2006 for 12 months
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Old 02-03-2007, 01:14 AM   #8
Chelee
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This is something I have been concerned about. I requested that I have a dexa scan and it turns out I was DX with osteopenia. My onc said nothing about it and I've been on femara and it worries me. I finally asked her if I should be on something? She said I can have Fosomax or Zometa. She asked which one I want? (I don't know? I thought she would tell me.)

I wondered like Linda if this is caused by the chemo? Or at least added to the problem...then add any "AI" to it. Since I started Femara, I blamed it on that alone. I've been misrable since starting it.

Chelee
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DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
Rt. MRM on 1-3-06 -- No Rads due to compromised lungs.
Chemo started 2-7-06 -- TCH - - Finished 6-12-06
Finished yr of wkly herceptin 3-19-07
3-15-07 Lt side prophylactic simple mastectomy. -- Ooph 4-05-07
9-21-09 PET/CT "Recurrence" to Rt. axllia, Rt. femur, ilium. Possible Sacrum & liver? Now stage IV.
9-28-09 Loading dose of Herceptin & started Zometa
9-29-09 Power Port Placement
10-24-09 Mass 6.4 x 4.7 cm on Rt. femur head.
11-19-09 RT. Femur surgery - Rod placed
12-7-09 Navelbine added to Herceptin/Zometa.
3-23-10 Ten days of rads to RT femur. Completed.
4-05-10 Quit Navelbine--Herceptin/Zometa alone.
5-4-10 Appt. with Dr. Slamon to see what is next? Waiting on FISH results from femur biopsy.
Results to FISH was unsuccessful--this happens less then 2% of the time.
7-7-10 Recurrence to RT axilla again. Back to UCLA for options.
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Old 02-03-2007, 06:11 AM   #9
sarah
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Since I started Femara my bone scans have been worse each year except for this year when they improved! why? because my onc here in france put me on Clastoban. I also take calcium with D3 and Magne B6 (magnesium with B6 which is taken several times a day and not near the calcium). so there's hope.
all the best
sarah
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Old 02-03-2007, 07:13 AM   #10
rosamarie
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I dont get pain from my osteoporosis but I think Arimidex can cause back pain.

I dont think chemo can cause osteoarthritis, but it can help to cause osteopenia and osteoporosis.
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Old 02-03-2007, 07:22 AM   #11
tricia keegan
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Thanks RB for your suggestions which I'll check out and I'll be taking a closer look at my diet too.

Tricia
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Tricia
Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
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Old 02-03-2007, 08:18 AM   #12
Hopeful
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If I am not mistaken, I believe I read recently that SSRI's (i.e., Paxil) also contribute to bone loss. Something else to consider.

Hopeful
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Old 02-03-2007, 01:41 PM   #13
R.B.
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Lolly - thanks for the smiley wherever that came from - complicated but in balancing the threes and sixes you might want to look at long chain omega three sources too.

If the 3,6,9 product is vegetable oil based you will not get the long chain 3s EPA and DHA. The body can convert the mother omega three to long chain but the process is sensitive. IF blocked to whatever degree then the only way to get it is by eating foods that contain it.

Sources of long chain omega threes in the diet are limited. Small amounts are found in meat offal eggs etc, but animals that are grain reared are likley to have a 3,6 imbalance too - regretably that leaves fish oil or DAH and EPA from algae.

It is more complicated but dependent on other dietary intake general health, sugar and alcohol intake, mineral status, and drug intake that may impact on the conversion pathways supplementation of long chain omega threes is worth reading up on and considering.

RB
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Old 02-03-2007, 08:37 PM   #14
romo9
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My 73 year old mother has better bones than me(I'm 49)!! She and I had DEXA scans around the same time she is fine I have osteopenia. I use a cross trainer 5 times a week,walk once a week and do pilates twice a week, she walks about three times a week. My oncologist suggests the steroids and chemically induced menopause are the culprits. Calcitrate makes me throw up so Im left with higher impact exercise. Oh my poor bones!!
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Old 02-04-2007, 08:09 PM   #15
AlaskaAngel
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Linda2

Bone density scans are done to keep an eye on loss of bone strength due to the loss that occurs naturally with menopause, unnaturally with chemopause, and also through the use of aromatase inhibitors. If there is enough loss of bone density (bone strength) then usually a bisphosponate like Fosamax is added. One reason aromatase inhibitors are generally given for a limited time of 5 years is to limit the amount of loss of bone strength.

Take the calcium and get as much natural sunshine as possible, or else addsupplemental vitamin D (or both). Some take a magnesium and vitamin C as well to help with absorption. Some weightbearing exercise can help too.
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Old 02-04-2007, 08:27 PM   #16
Linda2
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Thank you AlaskaAngel. You answered several questions that I was going to ask my onc. I was wondering why I only took the Femara for 5 years. Now I know. Thanks everyone for your input.
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Linda2

DX 6/2005
Stage IIA, Grade I
ER/PR +, HER2 +++
Lumpectomy on Left breast 7/2005
No lymph nodes involved
4 cycles of A/C
12 weekly doses Taxol and Herceptin
33 Rads
Herceptin for one year ended 12/2006
Femara for 5 years
NED as of now
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