Osteopenia at 47!

bluesatsuma · 20 May 2025 06:03

Hi. Following starting on letrazole, I held off starting on biphosphonates until my dexa scan came back. I was shocked to learn that I’m osteopenic. I’m 47, very active and eat a good diet. I run and go to the gym. Anyway, the oncologist said that running my numbers through Predict, there is a 1.6% benefit of going onto biphosphonates to prevent a recurrence, but presumably the other benefit is to prevent osteoporosis??

Part of me thinks I should take the biphosphonates, part of me thinks I should wait for the next dexa in 2 years and see what damage letrazole has done to my bones.

I thought when I finished my radiotherapy last week, that I was done with cancer treatment. She said I could have tablets but i think 6 monthly infusions would be better.

My questions are -

Do biphosphonates actually stop osteopenia becoming osteoporosis?

Is it normal for someone of my age to have osteopenia? Did chemo cause it?

Apart from my Adcal tablets are there any other foods or supplements that can help?

Do I really need biphosphonates?

Thank you

Tili · 20 May 2025 06:49

Dear Osteopenia at 47,

Sorry to read your post, I feel you are so young to have this worry, was wondering if you have been referred to a bone specialist, also I think it would be a good to see your dentist before taking diphosphonates, I’m not medically trained to give advice, just going through what I found with certain medications.

Wishing you health and happiness going forward.

Hugs Tili

laneycass · 20 May 2025 09:06

Hi, I am older ( 58 at the time) but had similar questions. I asked oncology about waiting, having dexa scans etc but I was firmly told that bisphosphonates were prescribed for prevention of recurrence, the bone strengthening was an added benefit. With such tiny preventative % benefits it’s really difficult to get your head around. There are some rare but terrifying side effects to consider! They also offered me a change to Tamoxifen at some point as apparently that doesn’t affect bone density as much but it does have worse potentioal side effects. These choices and decisions are absolutely mind boggling so I think the best thing is to get an appointment to go through all your options with an oncologist. I know I haven’t answered your questions but the oncologist will x

bordercat · 20 May 2025 13:35

@bluesatsuma Hi, like the others have said, best to discuss with your oncologist. After my surgery and oncotype score (it was 18, so high but not high enough to have benefit from chemo), my oncologist recommended bisphosphonates to prevent recurrence and to help with any bone density issues due to Aromatase inhibitor. So didn’t have DXA scan.
I have had 4 out of 6 infusions and no real problems. As expected a bit flu like after Cycle 1 but didn’t impact doing anything. I have them every 24 weeks and usually you have 6 in total.
Happy to have another ‘weapon’ to minimise recurrence but everyone has to make their own choice.
Hope the info helps if you go ahead. All the best.

Nurse_BCN · 20 May 2025 14:19

Hi bluesatsuma

Thanks for posting. It’s understandable that you’re asking if it’s necessary for you to take bisphosphonates.

As @tili says, you are young to have osteopenia. However, we do hear from younger women who are osteopenic as a result of breast cancer treatments such as chemotherapy.

Bisphosphonates slow down or prevent bone damage. They’re often given to people who have, or are at risk of, osteoporosis (when bones lose their strength and are more likely to break) or, as you’ve been diagnosed with, osteopaenia. You may hear bisphosphonates called bone-hardening or bone-strengthening treatment.

As @laneycass says, bisphosphonates may be used to reduce the risk of breast cancer spreading to the bones and other parts of the body.

It’s good to hear that you are physically active and have a good diet, which helps build up your bone strength. You may find it helpful to read our information about looking after your bones to learn more about how you can help support your bone health

Many people ask about vitamin and herb supplements as they want to do as much as possible to be healthy or to help manage the side effects from treatments. There is often the belief that vitamins and herbs are safe as they are considered natural.

However, herbal treatments don’t have to comply with the same regulations or rigorous testing that conventional medicines do. For many products there is a lack of research to support their use, and some can interfere with conventional medicines including cancer treatments.

You can search this American website, Memorial Sloan Kettering Cancer Centre, for information about individual herbs and vitamins. Each has sections on existing evidence and what known interaction there is with other medications. You may find that that some herbs have different names in America. You can also search herbal products and supplements on the European website Complementary and Alternative Medicine for cancer and on the American website Medline Plus

As @laneycass says, it’s important to speak to your treatment team about your concerns with taking bisphosphonates, as they are best placed to advise on your individual situation. They can also advise if additional supplements are appropriate.

We offer a range of free supportive services for anyone who has had a diagnosis of breast cancer which you may be interested in. They include face to face and online courses and events.

You’re also welcome to call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen, talk things through and signpost you to additional support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks.

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bluesatsuma · 20 May 2025 16:51

Thank you all for the replies. Is 47 very young for osteopenia then? My oncologist didnt say that so I assumed it was common.

I’m leaning towards taking it now, as I don’t want osteoporosis any more than I want cancer.

Thank you

bigpickle · 20 May 2025 22:02

Hi @bluesatsuma

I had my first infusion in the middle of April. I am having them every 6 months for 3 years. I am also taking letrozole. I was sent for a dexa scan, my first, a week after my first infusion. About 2 weeks after the scan I had a call from my gp asking me to get a blood test and then make an appointment to see him to discuss my dexa scan! I am assuming that it isn’t going to be good news. I see the gp this Friday. As you know I had chemo the same time as you. I was advised that the bisphosphonates do help to stop any cancer spreading to the bones as well as helping to strengthen them. I will let you know what my gp has to say.

Nurse_BCN · 21 May 2025 11:02

Hi bluesatsuma,

Thanks for your further question.

Osteopenia is when a bone density scan shows you have lower bone density than the average for your age, but not low enough to be classed as osteoporosis.

You can read more in the link above. As @tili and Addie said you are younger than average to have osteopenia. It is more common in postmenopausal women as we naturally lose bone rapidly in the first few years after the menopause, but there are other risk factors and medical conditions that can lead to women developing this earlier.

You may find it helpful to speak to your oncologist about this in more detail.

Do call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen, talk things through and signpost you to additional support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks.