You’re feeling fit, healthy, enjoying life. Sure, you’re not 20 years old anymore; maybe you can’t pedal uphill as fast, run as far, or dance all night. But for your age, you’re doing just fine.
Scenario A: As part of your regular physical, the doctor suggests a DEXA scan . “Just precautionary,” he says. “Just a baseline. Everyone gets one at your age.”
But then the results come back, and your doctor calls to tell you the bad news: you have osteoporosis. And your life changes forever.
Scenario B: As part of your regular physical your doctor schedules a mammogram (or a PSA test). “You’re over 50; you should have one every year,” she says. “Just precautionary.”
But then the results come back, and your doctor calls to tell you the bad news: you have cancer. And your life changes forever.
Which of these two kick-in-the-gut phone calls have you received?
You have osteoporosis? You have cancer?
How about both?
Osteoporosis and cancer often go hand in hand – for both women AND men. Treatment for both breast cancer and prostate cancer often involves shutting off the essential sex hormones: estrogen for women, testosterone for men. These hormones can feed cancer; to help prevent recurrence, hormone production is shut down, either via surgery, or drugs.
But estrogen and testosterone play a vital part in our lives; their loss is devastating. Remember hormone replacement therapy (HRT)? Thirty years ago, it was the Fountain of Youth for middle-aged women, who popped Prempro along with their daily multivitamin.
Maintaining estrogen/progesterone levels beyond menopause was said to reduce a woman’s risk of heart attacks; keep skin and hair young and vibrant; allay the hot flashes and mood swings brought on by “the change,” AND prevent bone loss: osteoporosis.
And HRT did work. In fact, it worked very well. But within the past decade, studies have shown that not only did HRT make us feel better; it gave some of us breast cancer, others cardiovascular problems. It was no longer a win/win; it was a win/BIG potential loss.
End of HRT . Enter our recognition of the evil alliance between cancer and osteoporosis.
Women with hormone-dependent breast cancer often undergo years of post-treatment estrogen suppression, via hormone therapy drugs like tamoxifen and the family of aromatase inhibitors : Aromasin, Femara, and Arimidex. Women on these drugs experience abnormally low levels of circulating estrogen: good for cancer prevention, bad for bones.
In addition, some chemotherapy drugs promote loss of bone density. And research indicates that breast cancer itself can increase a woman’s level of osteoclasts, the cells that break down bone.
In recent years, men with prostate cancer have increasingly been treated with anti-testosterone medications, such as Lupron and Zoladex. These medications do exactly what women’s hormone therapy drugs do: they suppress a man’s chief sex hormone, testosterone. Again, good for cancer prevention, terrible for bones.
