Cancer Survivors May Face Higher Risks for Bone Fractures

Cancer Survivors May Face Higher Risks for Bone Fractures

Adult cancer survivors, particularly those who have undergone chemotherapy, have an increased risk for serious pelvic and vertebral fractures, new research shows.

“These findings are important as the number of cancer survivors living in the United States is projected to rise to 26.1 million by 2040. Research like this seeks ways for cancer survivors to have a better quality of life after their diagnosis,” said study lead author Erika Rees-Punia. She is a behavioral and epidemiology researcher at the American Cancer Society.

“Fractures of the pelvis and vertebrae are more than just broken bones — they are serious and costly,” Rees-Punia added in a society news release.

The researchers analyzed data from the Cancer Prevention Study-II Nutrition Cohort linked to Medicare claims from 1997 to 2017. Of about 92,400 participants they assessed, more than 12,900 had had a frailty-related bone fracture. Investigators compared that group to people without a history of cancer.

Cancer survivors who were more recently diagnosed within five years with an advanced stage cancer had the highest risk of fracture compared to those with no previous cancer.

Vertebral and pelvic fractures drove this higher risk.

Survivors who received chemotherapy were more likely to have a fracture compared to survivors with no past chemotherapy. Researchers found this association was stronger within five years of diagnosis but was still suggestive even after the five-year mark.

Physical activity may be associated with lower risk, researchers noted. Current smoking was associated with a higher risk of fracture among cancer survivors five or more years after diagnosis.

“We hope our findings will inform clinical guidance on fracture prevention, which could incorporate physical activity with exercise cancer professionals and smoking cessation programs, to improve quality of life after a cancer diagnosis,” Rees-Punia said.

The findings were published Nov. 3 in JAMA Oncology.

More information

MD Anderson Cancer Center has more on bone health and cancer.

SOURCE: American Cancer Society, news release, Nov. 3, 2022

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Tips on Keeping Joints Limber, Healthy as You Age

Tips on Keeping Joints Limber, Healthy as You Age

For many people, it is possible to slow the loss of joint cartilage as they age and avoid surgery to boot.

Certain steps can help with that, said one orthopedic surgeon from the Mayo Clinic in Rochester, Minn., who offered tips for maintaining joint health and also for managing pain in those who are already experiencing osteoarthritis.

Dr. Joaquin Sanchez-Sotelo said cartilage, that shock-absorbing, slippery tissue at the ends of bones, degenerates for various reasons.

Those reasons include being born with abnormally shaped bones or a tendency toward weaker cartilage. Obesity, overuse and injuries from accidents also can damage joints and cartilage.

“When cartilage degenerates, the body forms bone spurs,” Sanchez-Sotelo said. “This is a reaction to the main underlying problem, cartilage degeneration. Bone spurs can hit each other and become painful. Many patients get obsessed with bone spurs, but just taking them out won’t cure the problem, except in very rare circumstances.”

Osteoarthritis can cause symptoms such as achy and painful joints, stiffness and loss of movement. Sanchez-Sotelo often sees patients with osteoarthritis when they reach their 60s.

In the years before that, people can protect their joints by building strong muscle, which can take some of the pressure off joints. But those muscles should be built without intense exercise such as football or bodybuilding because those sports come with higher risks of developing arthritis.

“You have to exercise within reason,” Sanchez-Sotelo said. “Find that point where your muscles are healthy, flexible, strong and will protect the joints, but don’t overdo it.”

Sanchez-Sotelo also suggests maintaining a healthy weight. He’s not so sure about glucosamine and chondroitin, which are popular supplements for joint pain, because of a lack of evidence that they actually work.

People with arthritic pain can modify their activities. If the trouble is a knee or hip joint, try bicycling instead of running, the doctor suggested.

Use a cane to lighten the load on a sore hip, knee or ankle joint. A type of knee brace worn outside of clothes can shift the load to the healthier side of the knee joint, Sanchez-Sotelo advised.

Consider over-the-counter medications — including acetaminophen (Tylenol) and ibuprofen (Motrin, Advil) — for persistent pain. These can lead to ulcers, kidney or heart issues, he warned. Avoid narcotics for osteoarthritis.

Someone whose pain persists could consider injections into the affected joint with cortisone or Toradol (ketorolac) to relieve pain. In addition, hyaluronic acid can help lubricate joints when injected, especially in the knee.

Although some choose injections with stem cells and platelet-rich plasma, referred to as “regenerative medicine,” they are experimental without firm evidence that they work, he said.

“In the past, older people just accepted joint pain,” Sanchez-Sotelo said in a Mayo Clinic news release. “Now people are living longer and want to remain active as they age. We are not all destined for joint replacement. There are some people in their 80s and 90s who have great joints.”

More information

The U.S. Centers for Disease Control and Prevention has more on osteoarthritis.

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