Do Cancer Patients Need Osteoporosis Testing?

Dustin Stevenson, DO

Osteoporosis is a condition where your bones lose their strength and density. This leads to bones becoming fragile and more likely to break (fracture).  There are many causes that can lead to this condition.  One is breast cancer survivors who are on anti-estrogen therapies (Aromatase Inhibitors).  Blocking estrogen is a way to reduce this risk of recurrence in women with hormone receptor positive breast cancer.  However, estrogen is beneficial in strengthening bones.  Because of this, it is important to have an accurate measurement of the bones when starting these therapies as well as every few years after starting.

Bone Mineral Density (BMD) testing otherwise known as Dual-energy X-ray absorptiometry (DEXA) is the most useful and reliable bone density test. It is a special kind of X-ray that gives off very little radiation. DEXA gives reliable measures of bone density in different parts of the body, such as the spine, hip, and wrist. DEXA is the best test to diagnose osteoporosis, predict the chances that you will break a bone, and check how well treatment is working. During the DEXA scan, you lie 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 is typically less than 15 minutes.  Here at Mission Hope, we have a newly installed system the Hologic Horizon-W. It provides great image quality and efficiently scans in 10 seconds or less. Along with the ability to measure bone health we now can measure body composition and assess cardiovascular risk. The exams can be performed at Mission Hope Breast Center and Matthew Will Imaging, the systems are identical aiding the ability to consistently measure changes in density over a period of time.

Based on the results, various measures can be taken to protect the bones.  A healthy well balanced diet in fruits and vegetables can reduce bone loss.  In addition, regular weight bearing exercises can build and strengthen bones.  Finally, medications designed to strengthen bones can be used.  Osteoporosis in people who have had breast cancer is most commonly treated with a group of drugs called bisphosphonates. This includes zoledronic acid, risedronate, ibandronate or alendronate. Bisphosphonates help strengthen your bones and reduce your risk of fractures. Bisphosphonates may also be prescribed to protect your bones if you’re taking an aromatase inhibitor (such as exemestane, letrozole or anastrozole). Denosumab is a drug 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’s a treatment for postmenopausal women who are unable to take certain bisphosphonates and who have particular fracture risk factors.

If you are a breast cancer survivor Dr. Stevenson will be the guest speaker upcoming breast cancer support group on Tuesday, July 20th at 4:00pm. Space is limited so please RVSP to 805.219.HOPE (4673).

Dr. Dustin Stevenson is Board Certified in Internal Medicine, Medical Oncology and Hematology. He treats people with cancer and hematology disorders and serves as a member of the Marian Regional Medical Center’s and Arroyo Grande Community Hospital’s specialized oncology staff. He can be reached at 805.349-9393.

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