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UA, Tucson Women Have Role in Cancer/Bone Study

Posted on: Saturday, 7 May 2005, 09:00 CDT

As if battling breast cancer isn't bad enough, older women who survive it face a significantly higher risk of bone fractures, according to the results of a national study that included Tucson women.

"Women in this age group already face a pretty high risk of fractures, because they are losing bone density," said Zhao Chen, a public health researcher at the University of Arizona. "But after breast cancer, that risk jumps even higher - by about 30 percent."

Scientists are not sure why this happens. Some smaller studies have shown cancer chemotherapy drugs have toxic effects on cells involved in bone formation. Those drugs also lower estrogen levels, which leads to loss of bone density.

"Or it may also be the pathological effect the cancer itself has on bone," said Chen, who directed the Arizona arm of the national study.

The risk was confirmed by comparing some 5,300 postmenopausal women with a history of breast cancer to more than 80,000 postmenopausal women without cancer.

All of these women, including about 4,000 from Tucson and Phoenix, are enrolled in the giant, federally funded Women's Health Initiative, a study that has probed women's health trends for more than a decade.

Over a five-year period, the women reported annually on fractures they sustained in the hip, spine, wrist and forearm, and other clinical fractures.

"An increased risk in total fractures was observed in all ages of breast cancer survivors, regardless of the time of the breast cancer diagnosis," the study concluded in a report published last month in the journal Archives of Internal Medicine.

As women age and pass through menopause, they stop producing estrogen, causing bones to thin. At that point, about four of every 10 women face a risk of fractures. But if a woman has endured breast cancer, that risk jumps yet another 15 percent to 30 percent, the study found.

In raw numbers, that means there will be around 13,000 more fractures among the 2 million postmenopausal breast cancer survivors in the United States than among other women of the same age.

Although doctors have not yet worked out exactly how to help these vulnerable women, for now they should take steps advised for all older women with a family history of osteoporosis - the age- related loss of bone density.

"The first thing to do is see your doctor and have a bone density test, to see how much has been lost," Chen said. "There are medications available that can increase it."

Precautions to follow breast cancer

* To avoid bone fractures, breast cancer survivors should:

*Schedule a bone-density test through your physician.

*Consider medication to increase bone density, if there is loss, or drugs that prevent loss.

*Make sure your calcium intake is adequate, through diet or supplements if necessary.

*Do weight-bearing exercises on a regular basis.

*Correct physical risks in the home that might cause falls.

Source: UA College of Public Health)

* Contact reporter Carla McClain at 806-7754 or at cmcclain@azstarnet.com.

Source: Arizona Daily Star

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