Hello Again! In this post, there’s info about Bone Health, Breast Cancer and a video on the whole body effects of breast cancer treatment
When we think about bone health (which is probably not as often as we should…) generally our thoughts turn to spinal fractures… but did you know that In 2005, approximately 2 million fractures in the United States were attributed to osteoporosis; the direct cost of these fractures in 2005 was $17 billion and that 94% of that amount was spent on nonvertebral sites such as the hip, pelvis, and wrist? (deRuig & Watson 2020)
Did you know ?
That approximately 1 in 5 individuals dies within a year of sustaining an osteoporosis-related hip fracture?
That of those who survive, nearly one-third require long-term nursing care, and only 40% regain their pre-fracture level of independence?
The majority of low-force (fragility) fractures occur in postmenopausal women with osteopenia, so early recognition of clinical risk factors for fracture is essential. Clinical risk factors are physiological attributes of an individual that predispose them to a particular condition or disease…but what are the risk factors for loss of bone quality and strength?
Some obvious ones may spring to mind, such as age and sex – these are commonly recognised as the most noncontrollable risk factors for osteoporosis.
Ethnicity has historically been recognized as another risk factor, with Caucasian and Asian women demonstrating the highest risk of developing osteoporosis
Menopause – oestrogen is bone protective and declining levels at menopause do leave bones vulnerable, especially if there has been premature ovarian failure
History of steroid use
History of RED-S – Relative Energy Deficiency in Sport – what we used to call the Female Athlete Triad of low energy availability/ anorexia, menstrual irregularity/ amenorrhea and osteopenia/ osteoporotic changes (more on The Female Athlete in upcoming blogposts!)
But also – and perhaps under the radar – using the oral contraceptive pill: Scholes et al’s paper from 2010 concluded that ‘…Prolonged use of today’s OCs, particularly <30 mcg EE, may adversely impact young adult women’s bone density while ingesting these agents.’ The authors state that: ‘…OC use is highest in women under age 30 years, a critical time for bone mass accrual. OCs’ effects on bone remain unclear, with increasing evidence suggesting current OC formulations may act differently in women who have not yet achieved peak bone mass as compared to skeletally mature women… Studies in adolescent and young adult women report mixed results, with some bone density studies reporting an OC benefit or no difference from nonusers, but others noting that OCs may inhibit bone mass accrual…’ So, if a young woman is using OC’s …AND has other risk factors like heavy alcohol use, especially before she reaches peak bone mas…. (laBrie et al 2018)…there may be trouble ahead.
So what can we do?
The mainstays of optimal bone health are eating well and exercise prescription – it’s a HUGE focus of the online global menopause certification that I’ve developed with Jenny Burrell, the 3rdAge Course
We can’t forget to think about bone health in women after breast cancer treatment – it is a threat to bone health on a number of levels – from restricted use of the upper limb after surgery or radiotherapy, chemotherapy or endocrine therapy induced rotator cuff issues or even misconceptions about exercise and lymphedema…But the good news is that exercise strategies that promote bone health – strength training, stress management and breath work, and refuelling with bone friendly foods (see last weeks blog for ideas about prunes and butternut squash!) will also be beneficial for lymphatic health – as long as a few caveats and precautions are followed (I go into this in detail in the course, of course!)
I’ve often said that breast cancer treatment really is like menopause with the volume turned up (as well as the surgical after effects) and I’ve made this short video to talk about how breast cancer treatment affects more than just the breasts… If you’d like to expand your Breast Cancer Rehab toolbox, I’d love to invite you to join me in the online Breast Cancer Rehab Coach course – it is a deep and wide programme that focuses on helping women live well during and after breast cancer treatment – you can find out more here!
Until next time
Onwards & Upwards