During October the world focuses on Breast Cancer Awareness Month and on the 20th of October we celebrate World Osteoporosis Day.

Osteoporosis in tandem with any other disease is distressing enough, but when combined with breast cancer, conditions present a unique set of challenges and considerations. While osteoporosis can be thwarted or warded off through various preventative measures, breast cancer may be more difficult to discover, keep at bay, or support with simple lifestyle changes. The screening, prevention and treatment of osteoporosis are similar in women with or without breast cancer.

Breast cancer is characterised by the abnormal growth of cells in the breast tissue, while osteoporosis is a condition marked by decreased bone density and increased fragility. Both diseases are more commonly associated with postmenopausal women but can affect individuals of all genders and ages.

Effects of simultaneous Breast Cancer and Osteoporosis

  • One of the primary effects of concurrent breast cancer and osteoporosis is the increased risk of bone health complications. Many breast cancer treatments, such as aromatase inhibitors, chemotherapy-induced ovarian failure and gonadotrophin-releasing hormone antagonists all decrease oestrogen levels which in turn causes increased bone resorption and bone loss. This exacerbates osteoporosis and increases the likelihood of fractures and skeletal issues.
  • Osteoporotic fractures, particularly in the spine and hip, can cause excruciating pain and discomfort. For breast cancer patients, these fractures can be especially problematic as they may limit mobility during and after cancer treatments, affecting the overall quality of life. This rather frustrating situation often leads to a limited pool of treatment options, making it challenging for healthcare providers to manage both conditions effectively at the same time.
  • The result of this difficulty, a multidisciplinary approach is called for. Patients benefit from a team of healthcare professionals, including oncologists, endocrinologists, orthopaedic specialists, and physical therapists, who work together to develop a comprehensive care plan.
  • With regard to tracking the development of osteoporosis, regular bone density tests, such as Dual-Energy X-ray Absorptiometry (DXA) scans, are essential to assess the extent of bone loss and to guide decisions regarding treatment. These tests should be performed before, during, and after breast cancer treatment to track changes in bone health.
  • Medication plays a major role in both conditions. When breast cancer patients have osteoporosis, treatment plans may involve modifying or discontinuing certain medications in order to reduce the impact on bone density while still managing the cancer effectively. When clinically indicated, women should receive anti-osteoporosis drugs such as zoledronic acid, denosumab or oral bisphosphonates.
  • Lifestyle is always important in any health situation. A healthy lifestyle remains important for individuals facing both breast cancer and osteoporosis. Weight-bearing exercises, a balanced diet rich in calcium and vitamin D, and reducing and stopping smoking can help preserve bone health and improve overall wellbeing in general.
  • Osteoporosis increases the risk of fractures, so fall prevention strategies are vital. At home it’s a good idea to remove all hazards that might lead to tripping, such as scatter rugs, and adding in some helpful modifications such as handrails, improved lighting, hand-holds in the shower, etc. It is vital to reduce the risk of falls and fractures.

Coping Strategies

Engaging with supportive therapies such as physical therapy and occupational therapy can play pivotal roles in managing pain, improving mobility, and enhancing the quality of life for individuals with both conditions.

Keeping yourself well-informed about both breast cancer and osteoporosis, helps you to gain confidence to advocate for yourself, and actively participate in the advice and practical applications of the required care. This includes understanding treatment options, potential side effects, and lifestyle modifications.

This is crucial to coping with the emotional fallout of discovering you are suffering from both conditions. Seeking emotional support from friends, family, support groups, or mental health professionals, can certainly help to provide the strengths and more positive philosophies that can help one to cope with the stress and anxiety associated with these conditions. In addition, a personalised nutrition plan that supports bone health and overall recovery must be included in all treatments.

The simultaneous diagnosis of breast cancer and osteoporosis presents a complex medical challenge, but not without measures to effectively manage both conditions. Breast cancer and osteoporosis are not insurmountable obstacles, and with the right approach, support, and informed decisions, individuals can maintain their physical and emotional wellbeing while working to find balance and promote better health.

Love your bones! Remember that any illness can adversely affect them. Keep healthy, and remain aware.

NOFSA (National Osteoporosis Foundation South Africa)

NOFSA is the only non-profit, voluntary health organisation dedicated to promoting lifelong bone health. We focus on reducing the widespread prevalence of osteoporosis while working to find a cure for the disease, and by supporting research and developing programmes of education and advocacy.

Find out more about our work at: www.osteoporosis.org.za