Hormone therapy is often prescribed to menopausal women and also to young women: useful for reducing the risk of relapses, but it increases that of fractures. Exercising helps keep your skeleton healthy as well
With 55,000 new cases diagnosed in 2020 and 37,000 Italians living with metastatic neoplasia, breast cancer is the most common among Italian women. Thanks to the many advances made with prevention and early diagnosis, as many as 87% of patients live 5 years after diagnosis and the arrival of numerous new therapies now allows them to live for several years even with a disease that reaches its most advanced stages. . To guarantee patients not only long-term survival, but also a good quality of life, which allows them to lead a normal life, it is also important not to underestimate the health of the bones, often affected by metastases.
Risk of osteoporosis and fractures
One in four patients suffers a fragility fracture linked to adjuvant hormone therapies, life-saving drugs that cause bone hyper-resorption and consequent fragility of the skeleton, with an increased risk of fractures, explains Maria Luisa Brandi, president of the Italian Foundation for Research on Bone Diseases (FIRMO Onlus), specialist in Endocrinology. About 80% of breast cancers belong to the hormone receptor positive type and may benefit from endocrine, or hormonal, therapy. The goal of hormone therapy, also prescribed to young women and about the duration of which experts have been discussing for years (recently a study has indicated the advantages of extending it from 5 to 8 years) to reduce the risk of a relapse and therefore that of mortality. Aromatase inhibitors are the most frequently used endocrine therapy in postmenopausal women with early stage breast cancer – adds Brandi – and are associated with several side effects, and in particular osteoporosis and fractures. Bone fragility is a problem that also affects young patients because therapy and sudden estrogen deprivation cause premature menopause, which can weaken the skeleton. A timely intervention is therefore necessary which, with targeted anti-resorptive therapies, can reduce the risk of fractures by up to 50%.
The Ora pOSSO initiative
The Ora pOSSO initiative was born from these assumptions, promoted starting from 2018 by the pharmaceutical company Amgen, in collaboration with Europa Donna Italia, FIRMO Onlus, to inform and sensitize women on the risk of bone fragility and to help them become aware of how it is possible to intervene effectively. The project today also counts the adhesion of the Italian Society of Osteoporosis and Mineral Metabolism and Skeletal Diseases (SIOMMMS), with the patronage of the Italian Society of Endocrinology, Aiom Foundation (Italian Association of Medical Oncology), Women for Oncology and of CONI (Italian National Olympic Committee). On the website www.ossafragili.it/oraposso, which now hosts new services dedicated to physical activity and dialogue with doctors, a wide range of useful contents is available, from those of a directly informative nature on bone fragility, its causes, risk of fractures, treatments, advice for effective prevention, including nutrition and exercise, up to a section of frequently asked questions entrusted to specialists and the testimonies of the patients themselves. Several researches have shown that doing sport helps to improve the elasticity and quality of bone tissue, trains coordination and balance, thus becoming a factor in preventing falls, as well as contributing to psychophysical well-being. on the basis of this evidence that Ora pOSSO has dedicated the 2021 campaign to physical exercise with an indoor and outdoor training program dedicated to patients and available on the website, by the technical partner Progress Lab who has made available kinesiologists and trainers specialized in specific physical exercise for women with breast cancer.
Moving to keep your bones healthy
In addition to the targeted pharmacological therapies provided by the specialists, and on the advice of the doctor, patients should consider regular daily physical activity, even moderate, which helps to stimulate bone metabolism, preventing falls that are a frequent cause of fractures – says Vito Alfarano, president of Progress Lab -. The Ora pOSSO physical activity program, created by specialized trainers and kinesiologists, has already helped women to stay in shape at home even during the lockdown, alleviating anxiety and stress, and then continuing with exercises in the open air. Tackling the issue of bone fragility also means dealing effectively with the doctor (oncologist, surgeon or radiotherapist) and to facilitate dialogue on the site, a series of useful tips have been added to effectively address the different phases of the treatment path. The guide, which can be downloaded from the ossefragili.it/oraposso website and from the Europa Donna Italia Facebook page, was created thanks to the collaboration of Europa Donna Italia with Attivecomeprima Onlus: eight chapters to get all the answers of the different phases of the disease: diagnosis, surgery , clinical examinations, doctors, therapies, side effects, nutrition and quality of life. Starting the treatment path as facing a journey in which there are many problems to be examined together with the oncologist and the team of doctors committed to safeguarding the life and well-being of women – concludes Rosanna D’Antona, president of Europa Donna Italia -. A path often accompanied by anxiety and bewilderment because the extent of the disease, even on an emotional and psychological level, triggers a thousand questions and uncertainties to which one would like to have all the answers to be informed, reassured, understood. The guide designed to help patients contextualize and remember all the questions they would like to ask. Knowing how to ask is important to make the right decisions for your health together with your doctor.
November 21, 2021 (change November 22, 2021 | 12:02)
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