Breast Cancer Archive

Strength training, weight-bearing exercise, a healthy diet, and medication can help.

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An estimated 10 million people in the United States are coping with the brittle, fragile bones of osteoporosis—a disorder that causes severe bone loss. It's most common in women, and the risk is higher in those who are thin, age 50 or older, or of Caucasian or Asian descent. It also occurs in men, who make up about 20% of osteoporosis cases. The condition puts a person at a high risk for bone fractures, disability, loss of independence, and even death. That's why it's important to make your bones as strong as possible. "There are many ways to build bone mass, and the people who do tell us they feel stronger and more capable on their feet," says Rachel Wilson, a physical therapist at Harvard-affiliated Brigham and Women's Hospital.

There isn't one magic way to build bone mass. It takes a number of the following strategies.

The belief that women should avoid exercise or athletics during their menstrual periods, because it can affect performance or increase the risk of injury, is not necessarily true. Good training may reduce the risks of injury and enhance performance much more than trying to time exercise around one’s periods.

Your dietary habits can promote cancer or protect against it.

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The link between cancer and diet is just as mysterious as the disease itself. Much research has pointed toward certain foods and nutrients that may help prevent—or, conversely, contribute to—certain types of cancer.

While there are many factors you can't change that increase your cancer risk, such as genetics and environment, there are others you can control. In fact, estimates suggest that less than 30% of a person's lifetime risk of getting cancer results from uncontrollable factors. The rest you have the power to change, including your diet.

The rates of heart disease have dropped over the past decade. How can you be part of this pattern?

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Heart disease continues to be the No. 1 cause of death among men, but there is some good news—fewer older adults have heart disease. A recent report from the National Health and Nutrition Examination Survey found the rates for this condition among people age 60 and older have fallen from 19.5% to 14.9% in the past decade.

What caused this downward trend? And how can you follow?

Once you've completed treatment, adjusting to a "new normal" can be challenging.

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Completing cancer therapy can feel like a graduation. You've done some hard work, it's paid off, and you may be ready to celebrate. But saying goodbye to treatment can arouse many of the emotions and uncertainties associated with beginning a new chapter in life.

Dr. Larissa Nekhlyudov is a general internist who works with cancer survivors at two Harvard affiliates, Brigham and Women's Hospital and Dana-Farber Cancer Institute. She acknowledges that cancer survivors have a lot to deal with. "Once you've had your final chemotherapy infusion or swallowed the last pill, you may find yourself facing a new set of challenges—monitoring yourself for signs of recurrence, getting recommended follow-up care, adjusting to the long-term effects of treatment, psychologically adapting to normal life, and working to stay in good health," Dr. Nekhlyudov says.

Some simple preventive measures can keep antibiotic-resistant bacteria at bay.

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Although the Zika virus got more publicity throughout the summer, another—and even scarier-sounding—microbe also made headlines. Dubbed a new "superbug," strains of E. coli resistant to the antibiotic colistin were found in the United States. Colistin is a drug often used when others fail to control a bacterial infection. Fortunately, the bacteria weren't resistant to other antibiotics, which cleared the infections. "Although this particular case of antibiotic resistance may not be as dire as the media made it sound, in general these increasingly high-level resistances are an enormous problem," says Dr. Sarah Fortune, professor of immunology and infectious diseases at Harvard T.H. Chan School of Public Health.

Why superbugs are such a problem

Like other forms of life, bacteria are always evolving to become stronger and survive longer. One of the ways they increase their chances of survival is to acquire genes that help them resist threats—including natural enemies like viruses and man-made weapons like antibiotics. These genes can spring up within a bacterium through mutations and are passed down to subsequent generations of the microbe. In addition, they can be found on rings of DNA called plasmids, which can be transmitted to other types of bacteria, enabling the resistance to spread wider and faster. The E. coli strains discovered in 2016 raised concern because they carry the colistin-resistance gene on plasmids and thus have the potential to transfer the plasmids to bacteria that are already resistant to several other antibiotics.

Many women may plan to start using birth control at their six-week postpartum checkup, but as many as 40% of women do not go to a follow-up appointment. The American Congress of Obstetricians and Gynecologists advocates for offering women the option of long-acting, implantable contraceptives in the period immediately following giving birth, before leaving the hospital. It’s safe, effective, and eliminates the need for an outpatient visit during a hectic time. Making postpartum contraception easily available and a covered benefit is essential to reduce unintended pregnancy and rapid, repeat pregnancy rates.

Strong core muscles and overall fitness are linked to shorter surgical recovery times.

Forgoing drugs that slow bone loss to avoid rare side effects can be the wrong decision for your hips and spine.

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A front-page article in the June 1, 2016, edition of The New York Times carried this headline: "Fearing drugs' rare side effects, millions take their chances with osteoporosis." The article described a situation all too familiar to doctors. Women are declining prescriptions of bisphosphonates—drugs that slow the rate at which the body breaks down bone—or discontinuing the medications far earlier than recommended. In fact, according to a 2015 report in the Journal of Bone and Mineral Research, the rate of bisphosphonate use fell by half between 2008 and 2012. That article documented a wave of media coverage of scientific studies that reported two rare side effects—osteonecrosis (bone death) of the jaw and atypical fractures near the top of the femur (thigh-bone)—and suggested that the reports had kindled fears that had led women to abandon bisphosphonates.

"The perception of risk is so much greater than the actual risk," says Dr. Meryl LeBoff, director of the skeletal health and osteoporosis center at Harvard-affiliated Brigham and Women's Hospital. Compared with many other common diseases, we are fortunate that we have good therapies to reduce the risk of osteoporotic fractures by 70% at the spine and 40 to 50% at the hip. She points to statistics referenced in the New York Times article: for every 100,000 women taking a bisphosphonate, fewer than three will have osteonecrosis of the jaw and one will have an atypical femur fracture, but 2,000 will have avoided an osteoporotic fracture.