Bone Scan After Chemotherapy

Last week, I went for a post-chemotherapy bone density scan. At 42, active, regaining stamina, and dutifully taking my vitamins, why would I need to worry about my bones, especially after surviving breast cancer and chemotherapy, you ask? Well, please allow me to explain.

As you may recall, my form of FBC (f-bomb breast cancer) was estrogen positive. In other words, my form of FBC needed estrogen to grow and proliferate. As a result, my treatment aimed to get rid of the estrogen in my body. Now, getting rid of the estrogen in my body was a Silver Lining, but the thing of it is that estrogen is also the hormone that helps build up and protect your bones.

So, after having been (and continuing to be) without estrogen, my doctor wanted to see how my bones have held up. Go figure. I walked into to my appointment and looked at yet another exam table and thought, REALLY? Again? Sometimes FBC just ticks me off in a big way. No other 42 year-old women I know have to get bone scans. I mean, REALLY.

Upon entering, the technician asked me, “Are you premenopausal?””

I said, No. I’m in menopause.

“Why?” she asked.

Because I had estrogen + breast cancer (I refrained from dropping the f-bomb) that put me into menopause, I said.

“But that’s not real menopause,” she replied at which point my face turned instantly purple.

Well, hmmm, I said. I could fry an egg on my bald head and can still fry an egg on my bare stomach during hot flashes. Menopause – in whatever form it comes – is menopause, I said with a furiously shaking voice.

Now, I know that she didn’t intend or mean any harm, which is what prevented me from going all FBC on her. After I left, I thought about the injustice of judging levels of FBC and their treatment side effects.

I know lots of people who say, “She had breast cancer and only had to have a lumpectomy and radiation.” It’s never (ever!) a good idea to put “only” in front of treatment for any kind of cancer.

The bone density test is a painless and takes less than 15 minutes. The machine scanned my sacrum (the triangular bone at the base of the spine and at the upper and back part of the pelvic cavity) and my left hip because these are the first places where of loss of bone density will appear.

My test results showed osteopenia in my hip, which means that my bone mineral density (BMD) is lower than normal ideal BMD but not low enough to be classified as osteoporosis. In talking with my doctor, he suggested one of two options: 1) take a bisphosphonate (e.g., Fosamax, Actonel) which would be an aggressive approach or 2) take vitamin D and calcium supplements (to prevent further loss from occurring) and check again in a year. We both agreed that #2 is the best option for me.

In the grand scheme of things, this result was a Silver Lining for which I am incredibly grateful!

If you’ve recently finished chemotherapy for breast cancer, you might want to ask your family doctor or your oncologist about a bone density scan. It’s worth a discussion.

14 comments

  1. I am so sorry you had to go through that. Wow….. I am right beside you in the chemically induced menopause, FBC just keeps on giving. Thanks for all the information. I am so very grateful for everything you give. It really makes a difference.

    Take care,
    Jennifer

  2. Thank you for getting the word out on testing. I guess the only silver lining is that we can be tested, so we can make the adjustments for the ongoing issues. I know Hollye, as I have ongoing issues with some organs due to complications at the time of my cancer surgery. I get what Jennifer says about the gift that keeps on giving……..makes it hard to ever believe cancer is a gift. I commend you on your patience with the technician. Take good care,
    Kim

  3. The technician that did your bone density scan was an idiot! She should not have made a comment such as she did; it wasn't necessary. She should have just made small talk.
    I had a scan after my treatments and was diagnosed with osteopenia also.
    But during my radiation treatments I kept complaining how my bones and joints ached, so my oncologist ordered a full bone scan to check for bone cancer. During the test I had music of my choice, but the scan lasted so long I could have watched a movie. It was scary, but my results were negative for bone cancer. FBC can be a precursor to bone cancer. Treatments for any cancer are not subtle, and you can end up treating other deficiencies acquired due to your cancer treatments.
    I was prescribed fosamax, and took it for maybe a year, but didn't like what I read about it, so I quit taking it and just continued with my calcium/vitamin D regimen.
    Some good news is that last year I had another bone density scan and my reading showed no osteopenia or osteoporosis; at least as it compared to what is normal for my age group. I was very surprised at this.

    1. THanks so much for your note, Carolee. You know, I've come to realize that people say dumb things. They just do. Small talk would definitely have been preferable. So glad to hear that first and foremost, no bone mets, but also that your osteopenia disappeared. Wonderful news all around!

  4. Hollye ~
    Glad to know that you and your doctor decided to go with option (2). Be very very careful with the bisphosphonate , as my father had some extreme difficulties from this. Luckily, his peridontist is a cancer-survivor, so he knew the correct questions to ask, and then followed up with his oncologist. Bronj is not something you want to invite in as a possible side-effect. See link: http://www.sciencedirect.com/science/article/pii/

  5. OMG…I've had pain in my LEFT hip since some time last year. I had an xray in December which showed nothing (probably means no cancer which is of course a HUGE Silver Linging). But why didn't bells & whistles go off with my Doc saying…oh this is generally the first site for osteoporosis/osteopenia? Why isn't there a manual with ALL of the lessons & wisdom for each of us? Yes…once again I hate FBC!!!

  6. You are so incredibly strong! My mother was diagnosed at 36 with Breast Cancer. I think it was invasive ductile Breast cancer. A year later she was also diagnosed with Ovarian Cancer. It is the scariest thing I have ever witnessed a personal through. I hope you good health and a great future!

  7. A MAJOR Silver Lining to not have mets. Thank goodness. So glad you'll talk with your doctor about getting a bone scan. Please keep me posted!

  8. Thank you so much for your note, Jacqueline. I'm so sorry that your family had to endure that. Thank you for reading and sharing. Best wishes!

  9. I took fosomax and its generic for 11 years. I did not have osteoporosis but had had two stress fractures within a year and my doctor recommended it. After 5 years, and 6 years, etc. I questioned whether I should continue. However, the risks were calculated to be low and the benefits seemed better. However, after 11 years the femur in my right leg broke in two. I had amazing recovery, thanks to UCLA. A rod was inserted in my leg, I was walking within 24 hours, first on a walker, then with a cane. I am now trying to return to jogging at age 73. Fosamax is good for many people. But I won't take it again.

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