- Researchers report that people who have survived cancer, especially those treated with chemotherapy, are at increased risk of bone fracture.
- They say the increased risk may be due to osteoporosis, low muscle mass, and even balance problems.
- They point out that bone fractures can lead to other long-term health problems.
Those potential side effects include hearing loss from high-dose chemotherapy, increased risk of stroke from high-dose radiation to the brain, dental problems, early menopause, and infertility.
The researchers used data from 92,431 older adults in the US Cancer Prevention Study II nutrition cohort linked to Medicare claims from 1999 to 2017.
Data was analyzed from July 15, 2021 to May 3, 2022.
The researchers investigated associations between cancer diagnoses, including time since and stage at diagnosis, and risk of pelvic, radial, and vertebral fractures (separately and combined) compared with adults with no history of cancer .
They also examined differences in fracture risk stratified by modifiable behaviors, treatment, and cancer type.
The results showed betweenOf the 92,431 participants included in the study, 12,943 experienced a fragility-related bone fracture.
Compared with participants with no history of cancer, cancer survivors who were most recently diagnosed within five years with advanced-stage cancer had the highest risk of fracture.
The researchers reported that the increased fracture risk in cancer survivors was largely due to vertebral and pelvic fracture sites.
“We found that older cancer survivors, especially survivors who received a more recent diagnosis (less than 5 years from diagnosis) or who had a history of chemotherapy, were at higher risk of pelvic and vertebral fractures than older adults with no history of cancer. cancer”.
Rees-Punia noted that smoking was also associated with increased risk, and there was some suggestion that physical activity might be associated with a lower risk of fractures in cancer survivors.
“Although we did not study why cancer survivors might be at increased risk of fractures in this paper,” he said, “cancer survivors may be at increased risk of bone fractures due to higher rates of osteoporosis coupled with lower muscle mass.” low and potentially also due to balance problems and unexpected gait changes associated with chemotherapy.”
Compared with cancer survivors who did not receive chemotherapy, the study found that people who received chemotherapy were more likely to have a fracture.
“Although we did not study why cancer survivors with a history of chemotherapy might be at increased risk for fractures, they may be at increased risk due to balance problems and unexpected gait changes associated with chemotherapy,” he said.
Rees-Punia said cancer survivors should try to adhere to the American Cancer Society’s physical activity guidelines.
Dr Thomas Buchholzthe medical director of Scripps MD Anderson Cancer Center in San Diego and a physician at Scripps Clinic, told Healthline that as more people with cancer survive and live longer, the bone health issue will only become more significant.
“The strength of the study is that it has a large cohort and strong comparisons,” Buchholz said. “It’s not surprising to find an increase in fractures among people with cancer, but the study confirms the importance of ongoing wellness and staying in close contact with doctors.”
“The disease itself can spread to the bones and predispose people to related fractures,” he added. “And our treatments can also weaken bones. Breast cancer patients, for example, are often treated with hormone therapy and this can reduce bone health, and chemotherapy can also affect bone health.”
The most important thing for people who have had cancer to know, Rees-Punia said, is that bone fractures, especially fractures of the pelvis and vertebrae, are more than just a broken bone.
“Pelvic and vertebral fractures can cause many problems later in life, including high health care costs, limited mobility and, as some studies suggest, an increased risk of premature mortality,” he said.
Understanding what factors may be associated with a reduced risk of fractures in cancer survivors is key, he said.
“Our study suggests that fracture prevention programs for survivors could include smoking cessation programs and referrals for physical activity with cancer exercise professionals,” Rees-Punia said.
The findings of this study are important, he added, as cancer survivors living in the United States are projected to grow to 26 million by 2040.
“Research like this is looking at ways for cancer survivors to have a better quality of life after their diagnosis,” Rees-Punia said in a news release.