D1 Sports Medicine is “going pink” for October, which is Breast Cancer Awareness Month, which might cause one to wonder why an orthopedic sports medicine facility would be involved in this issue. Well, not only do we as physicians and staff have friends and family members who have suffered from this disease, but there are also many important links between breast cancer and bone health that are extremely important to the orthopedic patient and doctor.
First, there is a significant incidence of osteoporosis (and its inherent problems of fractures) in breast cancer survivors. This has a number of causes: osteoclast stimulation by the cancer, a drop in estrogen production caused by chemotherapy (aromatase inhibitors) or surgery, and early menopause caused by the disease. Thankfully, there are a number of treatments and strategies that a breast cancer patient can undertake with the assistance of their orthopedist. These include nutritional assistance (with calcium and vitamin D maintenance), exercise programs to support bone health, smoking cessation, bone density test monitoring, and, if necessary, bisphosphonate medications. Furthermore, there are now some medications that can directly counteract the bone damaging affects of chemotherapy while one is in treatment. There are countless excellent resources for patient education on this issue, but my usual “go to” source on this is the National Institutes of Health:
Another big reason that breast cancer awareness is important to the orthopedic patient and physician is the fact that metastatic disease and recurrence most commonly occurs in the bone. One must pay very close attention to bone or extremity pain in a cancer survivor. Among patients who experience a recurrence of breast cancer, the occurrence is in the bones 70% of the time. Bony metastasis can unfortunately result in acute need for consultation with an orthopedist either as a result of a fracture or impending fracture. These often require surgical intervention with open reduction and internal fixation. Luckily, there are a number of diagnostic tests that can be run to assess for bony involvement in the survivor. There are also hormonal and chemotherapy adjuncts that are thought to reduce the risk of bony metastasis in the breast cancer patient. Another of my favorite sites for addition information is:
So, there are clearly many reasons for D1 Sports Medicine to “join the fight” against breast cancer, and we are proud to do so by “going pink” on our website, facebook page and twitter feeds for the month of October. So stay pink. Stay Well.