Breast cancer survivors, even after the cancer is a distant memory, may not realize the lingering effects of treatment: they now hold greater risk of bone loss and high cholesterol.
Researchers know that powerful chemotherapy drugs cause bone wasting, but they don't yet understand why survivors often show higher cholesterol numbers.
In testing a way to improve quality of life for cancer survivors, a recent UW School of Nursing study followed 121 long-term breast cancer survivors and monitored the effects of exercise and the osteoporosis drug raloxifene.
"We know that raloxifene can prevent osteoporosis," says lead researcher Anna Schwartz, a research associate professor in biobehavioral nursing and health systems and author of Cancer Fitness: Exercise Programs for Patients and Survivors. "We wanted to find out how exercise and raloxifene affect bone health and overall quality of life in breast cancer survivors."
The women who took raloxifene and also followed an exercise program had a 5 percent increase in bone formation over the course of a year and also showed a 39 percent reduction in bone loss. The results are a significant improvement in bone health that reduces survivors' risks for osteoporosis.
The study showed that exercise, regardless of raloxifene use, improved measures of quality of life such as mood, emotional outlook and cognitive function-additional evidence to support exercise as part of routine rehabilitation of breast cancer patients and survivors.
"A striking finding was that 100 percent of the women in the study had unusually high cholesterol levels," says Schwartz, who presented the preliminary findings at Oncology Nursing Society meetings.
Similar to osteoporosis and osteopenia, an increased risk of cardiovascular disease is a recognized side effect of cancer treatment. However, routine monitoring and treatment for high cholesterol was not part of the long-term follow-up care of the study participants.
"It should be," Schwartz says.
In the study, the women who exercised and took raloxifene showed modest declines in cholesterol. The changes were not significant enough to alter their at-risk status and other treatments for high cholesterol may be appropriate, Schwartz says.
Schwartz explains that after cancer treatment many breast cancer survivors don't want to take any more drugs-but a combination of exercise, diet changes and cholesterol-lowering medications is worth considering.