In a nutshell
This study investigated whether baseline levels of the female hormone FSH (follicle stimulating hormone) can predict bone loss.
The study concluded that among premenopausal women with breast cancer treated with chemotherapy, baseline FSH levels were strongly associated with subsequent bone loss.
Some background
In some women, chemotherapy may cause a dysfunction of the ovaries. The ovaries normally produce both eggs and help to control levels of hormones involved in the production and release of eggs. Ovarian dysfunction may lead to an increase in the levels of FSH, the hormone that helps in the growth of eggs. FSH is also involved in the control of bone mass in the body.
Chemotherapy can lead to both ovarian dysfunction and loss of bone mineral density (BMD; the amount of minerals, such as calcium, in the bones). A low BMD can lead to brittle, easily broken bones. A method of predicting which women may lose BMD during breast cancer treatment would be useful, so that treatments can be used to prevent it.
Methods & findings
The current study looked at whether levels of FSH before treatment can predict bone loss in woman treated with chemotherapy.
The study included 206 premenopausal women, who had received chemotherapy and were at least one-year post diagnosis. Their FSH levels and their BMD were measured at the start of the study (an average of 302 days after chemotherapy). BMD was measured a second time 12 months later.
At 12 months, BMD had increased 0.007% for those with the lowest levels of FSH. BMD had decreased 0.96% in those with an intermediate FSH level. The largest decrease in BMD (2.2%) occurred in those with the highest FSH levels.
The bottom line
The study concluded that among premenopausal women with breast cancer treated with chemotherapy, baseline FSH levels were strongly associated with subsequent bone loss.
The fine print
One limitation of this study is that participants were not divided into those who had been treated with tamoxifen (Nolvadex) and those who had not. Tamoxifen is an anti-cancer therapy that has been shown to decrease levels of FSH.
What’s next?
Discuss the risk of losing bone density after chemotherapy and the possible treatments for this with your doctor.
Published By :
The Journal of clinical endocrinology and metabolism
Date :
Jan 12, 2016
