Hi Ladies,
It seems there is some inconsistantcy on the the management of bone density is in the management of women on AIs (and those put into early menopause).It does, of course vary with individual situsations.
The guidelines from NICE seem to be pretty clear about how women should be managed who are on an Aromatase Inhibitor from reading these, if I have read them right, they appear to state:
“In premenopausal women ovarian suppression as a therapeutic strategy in itself or as a consequence of adjuvant chemotherapy leads to accelerated bone loss due to induction of menopause”.
“As a consequence of a reduction in circulating oestrogen levels, the use of aromatase inhibitors in the adjuvant endocrine therapy of postmenopausal women is associated with an increased risk of bone fractures. With the increasing use of aromatase inhibitors, bone health is becoming a significant clinical issue”.
“There is an increased risk of bone fractures due to osteoporosis associated with aromatase inhibitors and with chemotherapy induced menopause.”
If I have read these correctly, they seem to recommend and say:-
"Patients with early invasive breast cancer should have a baseline dual energy X-ray absorptiometry (DEXA) scan to assess bone mineral density if they:
- are starting adjuvant aromatase inhibitor treatment
- have treatment - induced menopause.
_ are starting ovarian ablation/suppression therapy".
postmenopausal women
"The use of an AI is an indication for evaluation of BMD (bone mineral density) by DXA. BMD assessments should be done at the lumbar spine and at one or both total hip sites. There is no requirement to obtain a DXA before starting treatment, but a baseline assessment should be obtained within 3 months of commencing an AI. Monitoring and treatment thereafter depends on the baseline age, and presence of any major risk factors for osteoporitic fracture ( one of these is such as diseases known to increae fracture risk such as premature menopause)
The link to these guidelines has been posted on here in an earlier posting by Sam so you can read them yourself and see what they say.
There have been many postings on here about peoples’ experiences regarding this, but it would be good to hear some more.
It would be really interesting if anyone out there who is taking AIs, to join in and let us know :
How long you have been on them - I am not sure how long this information has been available
Has your bone density been monitored
What advice/ideas have you been given for building up your bone strength/exercises etc?
As some ladies have rightly pointed out, there are many ways that we can help ourselves, with exercise, especially weight training, diet, etc. I guess we also have to bear in mind that we loose bone density as we get older anyway.
Do contact the Osteoprosis helpline for any advice about your bone health - they are absolutely brilliant and said that they have had a lot of women contacting them who are on AIs (and other treatments for breast ca) and concerned about thier BMD. They gave me alot of advice on what to do to help yourself, things to avoid, things to do,exercise, and sent me loads of leaflets too.
XX