Bone Health
 Strong bones are an important part of overall health and well-being and are especially important for people with cancer. Maintaining healthy bones can help avoid loss of bone mass, which is common as people age. The loss of bone mass can also be triggered by cancer and its treatment.
The loss of bone mass is known as osteoporosis. This condition occurs when the bone cells that help rebuild bone (osteoblasts) don't get replaced at the same rate as bones that naturally break down bone (osteoclasts). Bones become thin and porous (full of tiny holes) and are more likely to fracture (break) or cause pain and disability.
Among the many cancer-related causes of bone loss are the following:
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Spread (metastasis) of cancer to the bone (occurs most frequently with breast, prostate, and lung cancer and multiple myeloma)
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Some chemotherapy drugs (they decrease the level of calcium in the body)
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Radiation therapy to the pelvic region (especially for women over the age of 65)
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Hormone therapy (treatments that reduce levels of either estrogen in women or testosterone in men)
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Other medications, such as corticosteroids (prednisone) and synthetic thyroid hormone agents
Working together, you and your doctor can help minimize the risk of bone loss and bone pain.
What Your Doctor Can Do
It’s important to take action before bone damage even starts. If your treatment plan calls for hormone therapy or another therapy that increases the risk for bone loss, your doctor may order a bone density test to see if there are early signs of bone loss. If there are, your doctor may prescribe a bisphosphonate. Bisphosphonates are drugs that help to decrease the risk of bone loss and fractures and to reduce pain related to bone metastasis.
Your doctor may also prescribe external-beam radiation therapy to relieve bone symptoms related to advanced (metastatic) cancer. Radiation can also be delivered internally with use of drugs known as radiopharmaceuticals. Radiopharmaceuticals are used when there is widespread bone pain caused by multiple sites of metastasis.
What You Can Do
The most important things that you can do to help keep your bones healthy and strong are to make sure to get enough calcium and vitamin D. Be sure to eat plenty of dairy foods (such as milk or cheese); dark, leafy greens; and beans to help maintain a healthy level of calcium in your bloodstream. Vitamin D is important because it helps the body absorb calcium properly. Look for vitamin D-fortified milk and cereal and fatty fish, such as salmon, tuna, sardines, and swordfish, to help increase your intake of vitamin D. Your doctor may also suggest that you take calcium and vitamin D supplements to ensure that you get enough of these two essential elements.
You can help your body make vitamin D by spending time in the sun; just 5-10 minutes in sunlight 2 or 3 days a week is all you need. Remember to apply sunscreen if you will be exposed to the sun for a longer period of time.
Exercise is another important way to strengthen bones. Make light exercise part of your daily routine as much as you can. Weight-bearing activities, such as walking, dancing, and climbing stairs, are best because they help stimulate the production of bone-forming cells. Light weightlifting is also helpful.
Maintaining a healthy weight is another factor in keeping bones healthy. If you are underweight, you are more likely to have bone loss and fractures.
Because weak bones fracture more easily, you should take extra care to prevent falls.
The bone pain that can be caused by advanced cancer can be severe, yet many people with cancer do not tell their doctor about such pain. No one should have to suffer from bone pain. Treatments are available to help alleviate your pain; talk to your doctor or other member of your health care team.
Additional Resources
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