- Question from Joy2: Has a yearly 15 ml infusion of Zometa or Aredia been approved? Do you know of any ongoing clinical trials for women with a previous history of early-stage breast cancer and osteopenia or osteoporosis?
- Answers - Charles Shapiro Zometa is approved for elevated calcium associated with cancer and for people who have cancer involving the bones that's painful. There is an ongoing study for which I'm the principal investigator. We take women over 40 who are about to receive chemotherapy and give them intravenous Zometa either early or later. That is, half the women get early Zometa (what I mean by early is during the chemotherapy) and half get the Zometa one year after the start of chemotherapy. We're measuring two things: bone loss at one year and bone loss at three years, because it's possible that this accelerated bone loss will tail down and you might not have to start the Zometa with the chemotherapy. That's what we're trying to find out in the study. Half the women will get Zometa during their chemotherapy once every 3 months for two years and half the women will get chemotherapy and Zometa starting one year after chemotherapy for 2 years.
- Marisa Weiss, M.D. For Dr. Shapiro and me as physicians, this is an exciting time because we are only now beginning to understand the impact of chemotherapy and hormonal therapy on women's general health. Also, we now have some tools, like the medications that we described to you, that we can use to help make a difference. It wasn't all that long ago that we were without effective medications to help women deal with this significant health issue.
- Charles Shapiro I might add two points. We worry about osteoporosis from early menopause due to chemotherapy because most people with early-stage breast cancer will be long-term survivors, and that's a positive message. You get a lot of negative messages when first diagnosed, but this is a potential side effect that we can treat. It's important because we expect you to survive breast cancer, and we just want to make sure that as a survivor you're not breaking bones. The second point is all the things we're talking about to prevent osteoporosis—lifestyle changes, not smoking and drinking, exercising, having a good diet—are general recommendations not impacting only osteoporosis but for overall health. We're focusing on osteoporosis in this session, but these recommendations are truly ones that lead to longer and healthier lives.
Marisa Weiss, M.D.
I also want to share two practical pieces of information. First, it's important for you to make your house slip proof. You really need to go through your house and make sure there are no loose carpets or things you can trip on and fall down and risk breaking a bone. I have many patients who come to see me all dressed up wearing high-heeled shoes. I usually scold them and tell them to please wear safe shoes where there's good contact between the shoe and the floor. Wear a solid heel rather than a stiletto, and try to wear rubber bottom shoes.
You should also be careful of wide-legged pants because you can trip on them when you are walking. Another thing that I talk to my patients about is maintaining good posture. These days, with all of us working so hard at the computer, reading, and doing other sedentary activities, our shoulders, heads and necks are often in a curled position. It is important to be aware of your posture, straighten your shoulders, and keep your head high and your back straight. Yoga can be very helpful in teaching you how to hold yourself and how to carry yourself and sit in a way that improves your posture. This can make a big difference over time.
On Wednesday, August 21, 2002, our Ask-the-Expert Online Conference was called Keeping Your Bones Strong. Charles L. Shapiro, M.D. and Marisa Weiss, M.D. answered your questions about how to measure the strength of your bones, how to find out your risk for osteoporosis, and what you can do to lower that risk.
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