Adjuvant hormonal treatments, effective against breast cancer, have effects on bone tissue. Healthy living, nutrition and preventive therapy protect us from bone fragility
Thanks to the increasingly precise and effective therapies, it is easier to control breast cancer over time. But in some cases, the treatments to defeat the enemy can lead to side effects that must be adequately controlled, such as excessive fragility of the bones which can increase the risk of fractures. For this it is necessary to know this theme. This is remembered by the “Ora pOSSO” awareness campaign promoted by Amgen, Europa Donna Italia and F.I.R.M.O. in collaboration with SIOMMMS, and with the patronage of CONI, SIE, the AIOM Foundation and W4O.
Because the bone is at risk
Although breast cancer is the most common among the female population (30% of all cancer cases), thanks to early diagnosis and the effectiveness of therapies, it is the cancer with the highest number of patients alive five years after diagnosis. The treatments, of course, differ according to the characteristics of the cells but on average in almost 70-75% of cases the tumor is positive for estrogen and / or progesterone receptors. This involves the need for adjuvant hormone therapy, which is essential for controlling the picture but which can have as a side effect the alteration of bone tissue. This is why it is important to defend the bones. In scientific terms, the fragility of the skeleton and the increased risk of fractures are caused by excessive resorption of bone tissue linked to adjuvant hormone therapy. Unfortunately, correct habits alone are not enough against this type of frailty: targeted pharmacological therapy is also needed. "Women on adjuvant hormone therapy can suffer a fracture even in the presence of unchanged bone mineral density values: treatments to reduce bone resorption can halve the risk" explains Maria Luisa Brandi, President F.I.R.M.O. Onlus – Italian Foundation for Research on Bone Diseases, specialist in Endocrinology. “Chemically synthesized anti-resorptive drugs to be taken orally, weekly or monthly, and other biologics can be prescribed. It is also important to remember that regular physical activity contributes to making the bone qualitatively better, as well as improving coordination and balance, thus reducing the risk of falls ". Finally, a curiosity. Women already in menopause add the risk of drug-induced bone fragility to that of a possible pre-existing osteoporosis. But those who fall ill in childbearing age have a greater risk of fractures, because the higher the level of estrogen in the body, the greater the impact of adjuvant hormone therapies. "It is clear that bone fragility is not determined only by quantitative factors, but above all qualitative factors starting from an alteration of the architecture of the bone tissue" concludes Francesco Bertoldo, Professor of Internal Medicine, University of Verona, SIOMMMS delegate, specialist in Endocrinology and Medicine internal. "Regardless of the patient's age and the bone mass detected by Bone Densitometry (or MOC, Computerized Bone Mineralometry), all women with breast cancer on adjuvant hormone therapy need preventive therapy".
What the campaign proposes
The “Ora pOSSO” campaign has tennis player Francesca Schiavone as testimonial. Now in its third edition, it is enriched with initiatives designed on the basis of the needs expressed by patients. The EuropaDonnaItalia Facebook page will host a program to support patients to face the interview with the oncologist in a pragmatic and effective way. A monthly calendar of live broadcasts will be available to investigate issues related to bone fragility and its impact on quality of life with specialists. Space will be given to physical exercise, with the new Training Ora pOSSO program, created by Progress Lab: a path of physical activity with trainers specialized in specific physical exercise for women with breast cancer and dedicated to the "Ora pOSSO" community. All the new content will be available on the official website of the ossefragili.it/oraposso campaign. "According to a sample survey conducted in 2019, 62% of women on adjuvant hormone therapy for breast cancer stated that they had not received adequate information on the problem of bone fragility induced by the treatments and among these one in three admitted to having stopped taking the prescribed drugs for that very reason ”reports Rosanna D'Antona, President of Europa Donna Italia“ This is why Ora pOSSO's goal is to multiply the channels every year to raise awareness and inform women. The dedicated site and all the initiatives promoted on the Europa Donna Italia Facebook page have an added value in this period, in which the Covid-19 emergency makes the relationship with the doctor complicated ".
With the contribution of Amgen