Posts Tagged ‘Bone Loss’
The American Society of Clinical Oncology received bad news about Breast Cancer Patients this week.¬† A study of women with breast cancer, being treated with Aromatase Inhibitors (AI), was presented at the 2014 Breast Cancer Symposium.¬† AI is a great treatment for breast cancer, however…
AI is known to decrease bone strength and to increase Fracture Risk.¬† How many of these patients¬† were evaluated for their bone health?¬† Only 54%.¬† How many got a repeat evaluation to check to¬†be sure that¬†their bone health was not deteriorating?¬†¬†Only 46%.
Of those tested, 43% had a DXA T-score in the “osteopenia” range.¬† In this situation, FRAX is needed to calculate Fracture Risk.¬† 41% of this group met guidelines for treatment with medication to prevent bone¬†loss and Fractures.¬† Of those who should have been treated, only 23% were.
Modern Hormone Replacement Therapy (HRT) is safe in most women through their 60’s. ¬†20 years ago, when Progesterone was included in the formulation, HRT was associated with heart problems. ¬†Estrogen alone in modern HRT avoids this issue, at least until age 70. ¬†Recent studies have shown that modern HRT actually decreases heart disease deaths in women in their 50’s.
Modern HRT is most commonly used to treat menopausal symptoms. ¬†However, human estrogen is what naturally preserves bone in a pre-menopausal woman. ¬†Restoring human estrogen will also preserve bone in a post-menopausal women. ¬†You can postpone Osteoclasts Gone Wild eating away your bones!
Several patients in the last month have decided not to take the “unnatural” risk of taking medication for their Postmenopausal Osteoporosis.¬† They have been scared by the media emphasis on rare possible risks and side effects of taking osteoporosis medication.¬† They are not aware of the much greater Natural Fracture Risk of being a Post-menopausal Woman.
One patient specifically cited the risk of OsteoNecrosis of the Jaw (ONJ) as her reason.¬† Her risk of ONJ if she takes an Antiresorptive is less than 1 /10,000 per year.¬†¬† Her FRAX calculation shows a total fracture risk of 1/10 per year and hip fracture of 1/35 per year if she does not take medication.¬†¬† She is 1000 times more likely to fracture without medication as she is to have ONJ with medication.¬† Natural Risk¬†can be a Bummer!
Fracture Risk is much more than Bone Mineral Density (BMD)¬†or t-score. ¬†Many medical conditions cause bone loss, osteoporosis and fractures. ¬†Blood tests can detect medical problems.