Are You At Risk of Fractures After Cancer Treatments?

Older cancer survivors, especially those diagnosed within 5 years or who underwent chemotherapy, have significantly higher risks for pelvic and vertebral fractures than older adults without a history of cancer, a new study found. The study was published online on November 3 in JAMA Oncology.

About 1 in 7 cancer survivors experienced a frailty-related bone fracture, with several factors — including a more recent cancer diagnosis, distant metastases, chemotherapy use, and smoking — associated with a higher risk.

"Fractures of the pelvis and vertebrae are more than just broken bones — they are serious and costly," first author Erika Rees-Punia, PhD, MPH, senior principal scientist, epidemiology and behavioural research, American Cancer Society, Atlanta, Georgia, said in a statement.

Compared with adults with no history of cancer, cancer survivors diagnosed within 5 years with an advanced stage cancer had more than a twofold higher fracture risk. Compared with cancer survivors who did not receive chemotherapy, those who did were also more likely to suffer a fracture. This association was stronger within 5 years of diagnosis.

Additionally to chemotherapy, smoking was significantly associated with a higher risk for fracture

Physical activity appeared to lower the risk of fracture.

The importance of physical activity during chemotherapy is shifting. In the past, the mantra was to take it easy and rest, but there's a movement now to implement exercise early on in the cancer care continuum and get patients on an exercise regimen as they undergo treatment because we know that it works like a medicine. There are good randomized controlled data that shows exercise can actually improve cancer-related health outcomes, including osteoporosis and fractures.