Patient Power®
Get Email Alerts!
Health Topics
Bone Cancer Health Center
Health Center Home Audio Programs Videos
Search by Keyword:
Search by Health Topic:
View all Health Topics >
Spring Survey 2012 Results

Hope for the Future

Program: Cancer and Bone Health
<< Previous   1   2   3   4   5   6   7   Next >>

Andrew Schorr:

Right.  Dawn, so let me ask you.  So we talked about really the importance of this discussion, how do you view bone health?  Obviously you wanted to beat the cancer??and I understand you had a party, right, a big party, as a ten?year survivor. 

 

Dawn:

I did. 

 

Andrew Schorr:

250 people there, something like that? 

 

Dawn:

Yes.  I had a great big party to thank all the people who helped me through those very difficult first couple of years with the treatment.

 

Andrew Schorr:

Right.  It really takes a whole community of people and congratulations on that.  I'm a survivor, too, over a decade now, so I know how you feel.  But how do you view bone health in the mix of your overall health now?  Because a lot of times people don't think about that.  It's not top of mind. 

 

Dawn:

Well, I think it's very important and as I'm sitting here listening to Dr. Gagel and recalling the, what, 15 years or so that I have been a patient of his I recollect that when I first met Dr. Gagel the doctors that had seen me for the bone condition told me I couldn't ever walk again, and in fact I was not walking very well.  I couldn't open a refrigerator door.  I couldn't hold my son.  I couldn't push a door open.  I couldn't do very much at all. 

 

And by actively discussing my bones and taking a very active role with Dr. Gagel's guidance and support, I go skiing, I do all kinds of things now.  And I think that it's very important for anyone who has either bone loss for any reason or as a result of taking drugs for cancer to pay a lot of attention to bone and to know that if you pay attention to your bones and if you're actively involved and you're proactive, it's a great result.  I don't seem to be concerned with the things I was concerned about 15 years ago.  I just do everything I want and I'm strong.

 

Andrew Schorr:

That's terrific.  Now, do you have any grandchildren yet? 

 

Dawn:

No, I don't want them yet.

 

Andrew Schorr:

No, no, but you're going to have to be active to chase after them, right? 

 

Dawn:

I will have to be active.  I sure will.  I have??one is out of college, one is in college and one is in high school, and I'm constantly on the go.

 

Andrew Schorr:

I'm there.  I know that.  Dr. Gagel, one other thing I just wanted to be sure we cover, and that is I mentioned at the beginning that it's not just drug therapy but it could even be radiation.  I'm not sure I understand that.  So am I right that radiation can affect bone health too in a cancer patient? 

 

Dr. Gagel:

Yes, and there is a mixed effect of radiation.  Paradoxically, radiation in younger individuals can actually affect the growth of the bone, and so you can see stunted growth of vertebral bodies or the spine as well as long bones that affect the growth plates in these structures. 

 

In an adult life or after the development of either androgenization or estrogenization there are different effects, and we can actually see situations where when a spine is irradiated the bone actually becomes denser.  We don't really understand why that occurs, but we also see some individuals and particularly those treated with high doses of radiation where the bone stops growing completely and actually fractures start to develop as a result of the radiation. 

 

So there's no consistency to the response, and fortunately serious problems are uncommon and most commonly seen in patients who have had larger than usual doses of radiation.

 

Andrew Schorr:

All right.  I think that's just, for our audience, one more reason, whether you've had radiation or chemotherapy, other targeted drug therapies, whatever it may be, you need to have this be part of the discussion. 

 

One last question for you, Dr. Gagel.  So Dawn kind of alluded to this as how much help you've been to her over the years, and I know she's very grateful.  With you and your colleagues do you feel encouraged now that you have the tools to help people to try to keep them out of the danger zone of fractures? 

 

Dr. Gagel:

For the most part, yes.  There's been a sea?change in our ability to treat osteoporosis over the last 15 years.  Prior to 1995 we had estrogen as a treatment for osteoporosis and another hormone that is the least effective of our therapies called calcitonin, and it is still available and is approved.  It's just the least effective of the therapies.  In 1995 we added alendronate or Fosamax and shortly thereafter risedronate or Actonel and later still ibandronate or Boniva.  And then later still we added Forteo and Evista, and the most recent addition just a few weeks ago is denosumab.  And there are more in the pipeline.  So this is our??our ability to prevent bone loss now has improved measurably over the last 15 years and is going to get better over the next five to ten years.  There are drugs in the pipeline that will add to our abilities.

 

Andrew Schorr:

What an encouraging story.  That's terrific.  So, Dawn, skiing.  Looking forward to grandchildren, and a great doctor who seems like he's helped you a tremendous amount.  That's a good story.

 

Dawn:

It is.  I'm very grateful.

 

Andrew Schorr:

Well, we're grateful for you to be with us and congratulations again on that ten?year survivor story, and let's talk again in another 10 or 20 years, okay, and then you'll show me pictures of the grandkids. 

 

Dawn:

Right.

 

Andrew Schorr:

Dawn Boren, thank you so much for telling your story here.  Dr. Robert Gagel, thank you so much for being with us.  And also your dedication and your whom team there and then the collaboration with Baylor College of Medicine as well to understand bone issues and also help us prevent them and us as individuals and your dedication in helping people who have been treated for cancer so we can do better.  Thanks so much for being with us. 

 

Dr. Gagel:

You're very welcome.

 

Andrew Schorr:

All right.  This is what we do on Patient Power. 

 

I just want to mention there's a vast library including our interviews with nutritionists at M. D. Anderson of course who look at diet related to your needs and that includes helping you with the vitamin D and the calcium you can get from your diet and all the nutrition to help you with your overall health also included in that, your bones.  I'm Andrew Schorr.  Thanks for joining us.  Remember, knowledge can be the best medicine of all. 

 

Please remember the opinions expressed on Patient Power are not necessarily the views of M. D. Anderson Cancer Center, its medical staff or Patient Power.   Our discussions are not a substitute for seeking medical advice or care from your own doctor.  That’s how you’ll get care that’s most appropriate for you.  

 

<< Previous   1   2   3   4   5   6   7   Next >>