A few months ago my oncologist, Dr. Stewart, scheduled me for a bone density scan to check me for osteoporosis, a potential side effect of hormone therapy. The procedure was non-invasive, painless, and produced so little radiation that the technicians administering the scan were able to sit in the same room with me. It was a novelty for me given the precautions taken for CT and MRI scans and radiation therapy. It took about ten minutes to scan my hips, upper legs, and lower back…
“Can I talk?”, I asked the technician seated across from me.
“Sure, just don’t move too much.”, the technician replied.
“Hey … so you’re not just scanning my butt to fax to your co-workers, are you?…”
“…because this thing you have me laying on really doesn’t look much different than a larger version of the copy machine at my office.”, I joked.
“No ( laugh ), of course not!”, the tech replied.
“I’m not sure I believe you…..”, I laughed, trying not to move.
A few days later I got the initial report : I had mild osteoporosis. The results warranted a visit with Dr. Hofflich, an orthopedic doctor, to go over the results in more detail and discuss potential treatments. It was a very educational meeting.
Hormone therapy weakens bones
Leuprolide ( or, “Lupron” ) and other types of hormone therapy can weaken bones over time. In addition some steroids can also weaken bones, particularly Prednisone, a steroid which is prescribed along with Abiraterone Acetate ( also known by the brand name “Zytiga” ). Dr. Hofflich told me that given my test results she would have, in retrospect, started me on a medication to strengthen my bones at the outset of my hormone therapy. However, as my therapy would be paused ( hopefully indefinitely) towards the end of the year, it wouldn’t make sense to do so so late in the game. I got the impression that, for older patients, a preliminary bone density scan would have been standard procedure prior to starting treatment for cancer. However, for a 43 year old in otherwise good shape I don’t think it ever crossed anyone’s minds – including mine.
The good news is that bones can recover
It’s a slow process that can take years, but bones can recover on their own. Dr. Hofflich emphasized doing “impact” exercises. These are exercises that stress the bones and force them to become tougher and stronger. Running, jogging, hiking … even walking helps. Weight training, too. In general alI exercise is good, however I was a little surprised to hear that Dr. Hofflich wasn’t a big fan of bicycling or swimming…
“Swimming and bicycling are great for building muscle and losing weight, but not so much for building bone.”, she told me. “These exercises don’t stress the bones enough.”
I mentioned to her that I was on a Whole Food Plant Based (WFPB) Diet and she wasn’t perturbed. She told me that as long as I take calcium and magnesium supplements along with my normal diet, I would be getting more than enough calcium. She did, however, emphasize that I shouldn’t take all of the supplements at the same time and that, instead, I should stagger the dosage throughout the day to improve absorption.
As part of my monthly blood panel, Dr. Hofflich ran some additional tests to see if there are any other explanations for my osteoporosis. The tests all came back negative. In a year she plans on running another bone density scan to reevaluate my bone density. In the meantime it’s more walking, more impact, and … bubble wrap.
Take care. Stay healthy. Live life.
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