Women and their Post-Menopausal, Post-Cancer Bones

One of the silent side effects of breast cancer treatment is something that is not typically seen by the patient—bone density loss (or osteoporosis). Causing the bones to become fragile and thin, bone density loss can lead to bone breaks, loss of height, severe back pain, permanent disability and even serious spinal or vertebral fractures.

Yesterday I had my first bone density scan.  It’s one of the easier scans I’ve had, as it’s painless, non-invasive, requires no preparation or drugs or radioactive fluids to drink, and you don’t even have to undress.  You simply lay on a very comfortable cushioned table for about 20 minutes, and the scan passes over your body, taking several x-ray readings, in critical areas like the spine and hip joints, to measure the amount of calcium in the bones, to determine if your bones have thinned.  This is what they call your actual bone mass. 

Keep in mind – estrogen in women protects the bones.  So, if you're post-menopausal or you no longer take estrogen, bone density in women is always a healthcare issue.  The test I had yesterday is the common procedure used to determine if someone has developed osteoporosis, a disease most common in post-menopausal women.  I’ve been in this PM category since I was 40 after having a hysterectomy, but for ten years I took estrogen replacement therapy to prevent bone thinning like this.  Because I no longer take estrogen replacement, bone thinning is now my new health care issue. 

There are two other causes for bone density loss in breast cancer patients: 

1. The effect of chemotherapy on bone marrow blood cells. As chemotherapy targets rapidly dividing cancer cells, it also damages blood cells in bone marrow tissues and prevents new ones from forming.
2. Taking aromatase inhibitors, such as Arimidex, the pill I’ll be taking for the next five years.  Now I know why the nice technician at the bone density lab said, “see you again soon.”  This will obviously be a regular test for me. 

My good news yesterday is that all my blood levels are in normal range for all the key components they test– all of them, 100%!!  My bad news – I have experienced bone thinning in my lower spine, and one other area too.  After a closer look at my Vitamin D levels, Dr. Makhoul will determine the next course of treatment.  In the meantime, I’m doing my research on a drug called Reclast that the good doctor seems to think will serve me well.  And while it is a once-a-year injection that helps treat bone loss, it has its own set of side effects, so I’ll continue my research.  

As I left UAMS last night, it really hit home:  For those who survive cancer, life is never the same again.  It’s a whole new ballgame with new health issues and concerns, new problems and things to watch out for.  And while we could lament for the rest of our days about cancer and chemotherapy’s more permanent side effects, I'm just not up for that.  Surely it will be a much more joyful life to remain grateful each morning that for now, we have won the cancer battle. 

As for me, I remain in the very best hands with my outstanding medical team, and my circle of love continues to surround me.  I fully intend to wake up these tired bones each day and do what I need to get done, and also squeeze in some great fun!  Without a doubt, there is still much to be thankful for.