Taking care of bone health in cancer patients

The article was written by Doctor Nong Ngoc Son - Oncology Center - Vinmec Central Park International General Hospital

Bones act as a framework to help anchor muscles, support and protect internal organs in the body. For cancer patients, the impact of disease treatment can affect bones and joints, so taking care of bone health in cancer patients is something to be concerned about.

As we age, our bone density decreases. The activity of bone-forming cells is out of proportion to the rate of bone resorption and causes bones to become increasingly thin and filled with tiny holes, which can lead to fractures and limited range of motion. This condition is called osteoporosis - the most common of all bone diseases. Estrogen is an important hormone that helps regulate bone density. More than 80% of people with osteoporosis are postmenopausal women, which occurs due to a lack of this hormone in the body. Bone loss can occur in both men and women if there is malnutrition, inadequate calcium and vitamin D supplementation, as well as in seriously ill people who have to stay in place for a long time.
Besides, cancer and cancer treatment can also cause bone loss. Causes of cancer-related bone loss include:
Chemotherapy drugs (such as methotrexate, ifosfamide,...) that can lower calcium levels in the body or drugs that cause early menopause and accelerate bone loss. Hormone therapy such as sex hormone inhibitors (goserelin) or aromatase inhibitors (anastrozole, exemestane, letrozole, etc.) that inhibit estrogen can also lead to bone loss. Ovarian suppression therapy using drugs, radiation therapy or surgery to the ovaries also induces menopause; thus leading to bone loss. High-dose steroid therapy or steroid use for more than 3 months can cause bone loss and increase the risk of fracture. Targeted therapies such as imatinib, nilotinib, and dasatinib can affect blood calcium levels. If blood calcium levels drop low for a long time, it can cause bone loss. Radiation therapy to the pelvis (eg in gynecological, anal, rectal cancers, etc.), especially in women 65 years of age and older can cause bone loss and fractures. This fracture usually occurs within the first two years of pelvic radiation therapy. Cancer invades or metastasizes to bone.

If you find yourself suffering from one of the above causes, pay attention to your bone health. Here are ways to help reduce the risk of bone loss and strengthen bones during cancer treatment:
Early detection: Measurement of bone mineralization can help identify bone loss before, during, and after cancer treatment.
Maintain a healthy weight: A balanced and varied diet is a key factor in keeping bones healthy. Underweight people are more prone to bone loss and fractures.
Provide adequate calcium: Calcium is a mineral that helps keep bones strong. Therefore, we need to supplement calcium with adequate food and supplements. Foods rich in calcium include milk, cheese, yogurt, soy milk, broccoli, orange juice, etc. Should limit coffee, carbonated drinks such as cola, red meat,... because it can reduce calcium balance in the body.

Vitamin D: Vitamin D helps the body absorb and retain calcium in the body. The body can synthesize vitamin D in the skin when the skin is exposed to enough energy from the sun. Vitamin D can also be supplemented with milk, animal liver and eggs,...
Hormone replacement therapy : There are many types of hormone replacement therapy, applicable to both men and women. This therapy can be effective in improving bone loss but also carries a high risk of potential side effects.
Exercise: Activities and exercises like walking, dancing, climbing stairs and jumping rope can promote the production of bone-forming cells as well as help build the muscle mass that helps the body to stay strong. more sturdy. You should do exercises that increase your heart rate for 30 minutes, 5 times per week. This 30-minute exercise should be divided into 3 sets of 10 minutes each. Besides, you should do exercises that help increase muscle strength (such as using dumbbells, exercise machines,...) twice a week and exercises to improve balance and coordination (yoga). , tai chi,...) at least 2 times per week. When exercising, do not exercise too hard.

Avoid falls Try to reduce potential falls from your surroundings by removing items that can cause slips on the floor,...
Bisphosphonates This is a speed reducer. degree of bone loss and may promote bone growth by reducing the activity of osteoclasts (cells that cause bone destruction). Bisphosphonates cannot help replace lost bone cells, but they can slow bone loss and promote stronger bone health. Therefore, this drug is used to reduce the risk of fractures in patients with osteoporosis, to prevent bone loss caused by hormone therapy, and other cancer treatments. In addition, bisphosphonates also help prevent and treat bone metastases.
Denosumab and raloxifene also work to reduce bone loss, and are often used in women who cannot take bisphosphonates. The above are knowledge of bone health care for cancer patients to keep bones and joints healthy. In case the patient detects abnormal signs in the bones, quickly go to medical facilities for timely examination and treatment.