Bone health and cancer

How can I take the best care of my bones?

Sometimes cancer or cancer treatments can make bones weaker and more likely to break (fracture). Looking after your bones can help to reduce the risk of fractures and benefit your overall health.

Get physically active 

Physical activity is good for bone health:

• It encourages the production of bone-forming cells.
• It helps increase bone density.
• It helps to build muscles, providing more stability for your body.

Weight-bearing exercise

Weight-bearing exercise is the best for bone health. Examples of weight-bearing activities include  tennis, football, running, jogging and dancing, but some types of exercise may not be be suitable  for you if you are at risk of bone loss or have bone loss. 

In general, 30 minutes of weight-bearing exercise a day is recommended. 

It's important to check with your doctor before starting an exercise programme. Your doctor can also refer you to a physiotherapist who can advise you on the best exercise for you.  Walking is a weight-bearing exercise, but it is important to change your pace and route occasionally.  

Walking is a weight-bearing exercise, but it is important to change your pace and route occasionally.  

It is important to keep exercising regularly to get the greatest benefit.

Muscle strengthening activities and exercises to improve balance

Muscle strengthening exercises and exercises to improve balance also benefit your bones.

Gardening/digging, carrying groceries and lifting weights will all help to strengthen your muscles.

Yoga, backwards and sideways walking, walking on heels or toes and standing on one foot all help with balance.

Get enough calcium

Calcium is found in dairy products like cheese, milk and yoghurt. It’s also found in foods with vitamins and minerals like fortified cereal and oily fish such as sardines, pilchards and salmon.

It’s also found in green vegetables like spinach and kale. 

• Try to eat at least three portions of calcium-rich foods every day.
• A portion could be a matchbox-sized piece of hard cheese, 2 pilchards or sardines with bones, a glass of milk or a pot of yoghurt.
• Look for foods with added calcium, such as orange juice and milk.
• Choose milky drinks and include cheese and other calcium-rich foods in your meals.
• Calcium levels decrease as we age, so it may be necessary to increase your intake as you get older, or ask your doctor or dietitian about calcium supplements.

Stay a healthy weight

Being a healthy weight is best for the health of your bones. If you are underweight or overweight you may be more prone to bone loss and fractures. Ask your doctor for advice if you are trying to lose or gain weight. They can refer you to a dietitian.

Cut down on caffeine

Caffeine may cause you to pass more calcium in your urine. Limit your intake of energy drinks, dark chocolate and cola and do not drink more than 4 cups of tea or coffee per day.

Stop smoking

Smoking damages blood vessels, kills the bone-making cells and upsets the balance of hormones that bones need to stay strong.

Limit alcohol

Too much alcohol can increase your risk of osteoporosis. Limit your risk by avoiding alcohol or staying well within the guideline of no more than 11 standard drinks for women and 17 for men, spread out over the week. A standard drink is ½ pint beer or stout, 1 measure spirits, or a small glass of wine.

Prevent falls

If you feel unsteady on your feet talk to your GP. They can refer you to an occupational therapist (OT). The OT can assess your needs and organise equipment like walking aids and grab bars. This equipment can help to keep you and your home safe. 

Some medications can also increase the risk of falls (for example, enzalutamide), so take extra care if this applies to you. 

How to prevent falls – make your home and yourself safer 

Protect yourself at home

• Avoid slippery surfaces like icy paths and wet/highly polished floors.
• Get rid of tripping hazards, like loose cords or things lying on the ground, both in the house and the garden.
• Keep your house and garden well lit.
• Try not to rush, especially when getting out of your bed or chair – this can make you dizzy. Also take care when going up and down the stairs.
• Keep the things you use a lot in easy-to-reach places. Store heavy items in lower cupboards.

Tips to avoid falls

• Don’t be embarrassed to use aids to daily living – they can keep you safe and active.
• If you need glasses and/or a hearing aid…wear them!
• Comfortable shoes that provide good support can help to prevent falls.
• Find out about other gadgets that can make your life safer: reachers, anti-slip soles, hip protectors, etc.
• Always ask for help with any tasks that you feel you can’t do safely.

Ask your doctor about hormones

Oestrogen

If you are reaching menopause age or having cancer treatment that reduces oestrogen levels, your bones may become weaker, making them fragile and more likely to break. This is because oestrogen helps your body absorb calcium from your gut. Calcium helps to keep bones strong and healthy, so if your body is absorbing less, your bones may become weaker. 

Testosterone

Hormone therapy for prostate cancer can lower the level of testosterone in the blood. This can cause problems with your bones also.

Your doctor and your nurse will advise you about ways to manage any side-effects caused by hormone therapy. These side-effects happen because the hormone balance in your body will change. Not everyone experiences side-effects in the same way.