THEThe growing number of people living after a cancer diagnosis, in Italy in 2020 there were around 3.5 million, leads to the study of the health sequelae of cancer and anti-tumor treatments to protect long-term survivors from further health problems. Among these, there is also greater bone fragility.
Osteoporosis is a condition of deterioration of the density and structure of the bone whose prevalence is destined to grow also due to the aging of the population. It is estimated that in Italy it affects around 5,000,000 people, of which 80% are post-menopausal women.
Osteoporosis: bone fragility in cancer patients
According to a study published in Jama Oncologywhich analyzed the data of over 92 thousand subjects recruited in Cancer Prevention Study-II Nutrition Cohort and Medicare health insurance data, the risk of fractures from Bone fragility increases in older adults with a history of cancer compared to their peers who have never received an oncological diagnosis.
The risk of fractures increases with cancer
Furthermore, the analysis considered various factors, such as time to diagnosis, type of fractures – radial, pelvis and vertebrae (separately and combined), and subjects’ habits such as smoking and physical activity. It turned out that one cancer diagnosisespecially if in an advanced stage, is associated with pelvic and vertebral fractures. And that the risk of fracture is higher after diagnosis and remains so at least up to 5 yearswhich chemotherapy treatments they are a factor predisposing to bone fractures (they increase the risk of fracture by 31% 1 to 5 years after diagnosis), as does the habit of smoking.
Pay attention to the vertebrae and pelvis
Cancer survivors are at increased risk of bone fractures possibly due to higher rates of osteoporosis, associated with low muscle mass, already typical of the elderly without a diagnosis of cancer (sarcopenia), poor balance and instability in walking. This is in line with the results of the US analysis regarding the specificity of fractures (pelvic and vertebral, but not wrist) of those with a history of cancer.
Mapping fracture sites is important because the health and cost consequences for each are different. In general, fragility fractures due to osteoporosis have significant consequences, both in terms of mortality and motor disability, with high health and social costs.
Osteoporosis, the fundamental help of physical activity
The researchers invite you to think about prevention programs for bone health specifically intended for all those who have a history of cancer and which include thephysical activity. From the analysis it has in fact proven effective in ensure a protective effect on the maintenance of bone minerality. «Prevention should include indications for physical activity under the guidance of professionals expert in gymnastics and cancer as well as programs for help patients quit smoking».
A personalized approach
Participation in both moderate- and vigorous-intensity aerobic physical activity and strength training programs may reduce the risk of fracture after a cancer diagnosis, the study found. With a personalized approach: “The type of exercise (aerobic, such as walking, jogging and swimming, and strength training, bodyweight or weight training) and intensity are likely to play a role in the effectiveness of the exercise in preventing fractures in the survivors.”
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