Osteoporosis and breast cancer

We get a number of calls on the helpline from people taking aromatase inhibitors (AIs) such as letrozole, arimidex or exemestane as part of their treatment for breast cancer who are worried about their risk of osteoporosis asking what they can do about it.

Osteoporosis means ‘porous bones’ when the usually strong structure of the bones becomes thin and weakened. Natural bone loss tends to happen as we get older anyway, but during our lives the hormone oestrogen has a protective effect on bones helping them to stay strong. Taking an AI, which reduces the amount of oestrogen circulating in the body, therefore reduces this protective effect and in turn may lead to an increased possibility of the bones becoming so fragile that they may break. The risk does depend on how healthy the bones were before having breast cancer, so those with good bone density levels before starting an AI are far less likely to develop osteoporosis whilst they are on it.

Guidance recommends that women taking an AI for the treatment of primary breast cancer should have their bone density checked around the time they start taking it as well as possibly having additional scans during treatment. This tells the specialist whether any other treatment may be needed to help keep the bones strong.

But when you want the benefit of the treatment being offered for your breast cancer yet are worried about the risk of osteoporosis, what can you do to look after your bones? And what do we talk through with our callers if they ask about this subject? Well, making some simple lifestyle choices can help keep your bones strong and healthy.  Eating a healthy balanced diet will give you the vitamins and minerals important for strong healthy bones. If you eat little or no dairy produce though, ensuring you get enough calcium, which is vital for strengthening bones, is particularly important. Vitamin D is also important so that your body can absorb the calcium. The best source of vitamin D is sunlight, so spending even a short period of time each day outside during the summer months whether you are walking, gardening etc, should provide you with enough of this vitamin which is stored by the body to be used throughout the year. Our Breast cancer treatment and the risk of osteoporosis factsheet tells you much more about the risk of osteoporosis and has information on typical foods that are good sources of calcium and vitamin D. 

Besides other health benefits to the body, regularly doing some weight bearing exercise like skipping, aerobics, tennis, dancing or even a brisk walk have also been shown to increase bone strength in those who are at risk of osteoporosis due to treatment for breast cancer. Our DVD Getting fitter, feeling stronger includes an exercise class suitable for people of all levels of fitness that may also be useful as well as helping to improve your overall health and wellbeing of course!