Breast Cancer Drug May Weaken Bones, Study Finds

TUESDAY, Feb. 7 (HealthDay News) -- A drug used to prevent breast cancer in women at high risk for the disease appears to cause bone loss in some postmenopausal women, a new study finds.

The drug, Aromasin (exemestane), has been shown to reduce the odds of breast cancer by 65 percent, but it also worsens bone density by about three times in older women who are taking it, Canadian researchers report.

"The drug did affect bone density at the hip and spine," said lead researcher Dr. Angela Cheung, a senior scientist at the University Health Network in Toronto. "It does not affect everyone; about 65 percent of women have some bone loss."

The fear of bone loss is not a reason not to take the drug, Cheung said. "You really need to pay attention to your bone health when you take this medication, especially for preventing breast cancer."

However, for women who are at high risk for fractures, other drugs should be considered, she added.

Women taking this drug should also be taking calcium and vitamin D supplements, and having their bone density monitored, Cheung said.

An older drug, tamoxifen, actually builds bone, but it is not as effective at preventing breast cancer, she said. "But, for someone with healthy bones it is worthwhile taking the medication."

Exemestane is an aromatase inhibitor and works by suppressing the female hormone estrogen. These drugs are standard treatment for postmenopausal women with early stage hormone-receptor-positive breast cancer.

It had been speculated that exemestane, a third-generation aromatase inhibitor, might result in less bone loss than other similar drugs and might even stimulate bone formation.

For the new study, Cheung's team looked at bone loss among the more than 4,500 women who took part in a trial that compared exemestane with a placebo.

Among women taking the drug, the risk of developing breast cancer was lowered 65 percent, compared with women taking a placebo.

Among the 351 women in whom bone loss was studied, the researchers found that after two years there was an 8 percent loss of cortical bone in women taking exemestane, compared with 1 percent in the placebo group.

Cortical bone is the outer shell of bone that provides most of the bone support, and its loss accounts for about 80 percent of fractures in older people, the researchers noted.

The findings were published in the Feb. 6 online edition of The Lancet Oncology.

Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, was somewhat cautious about the new research. She said that "the study needs longer follow-up to see if there is an increased risk of fracture."

"This study doesn't mean that we should stop using these drugs," she said. "We certainly rely on aromatase inhibitors more than tamoxifen in postmenopausal women, because the survival benefit has been proven."

The benefit of the drug outweighs that risk for most women, she said. However, if there is a family history of osteoporosis it may not be the best choice, Bernik said.

More information

For more on breast cancer, visit the American Cancer Society.

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Hard Drug Use in Middle Age Could Prove Fatal, Study Finds

FRIDAY, Feb. 3 (HealthDay News) -- People who start using hard drugs -- such as cocaine, opiates and amphetamines -- as young adults and continue to use them into their 50s have a fivefold increased risk of early death, researchers report.

The finding is from an analysis of hard drug use among 4,300 U.S. adults who took part in a long-term study of cardiovascular disease and risk factors. The participants, including blacks, whites, men and women, were recruited when they were 18 to 30 years of age and followed from 1985 to 2006.

The University of Alabama at Birmingham researchers compared those who stopped drug use early in life to those who continued, and calculated their risk of premature death.

"Fourteen percent of the people in the study reported recent hard-drug use at least once, and of these, half continued using well into middle age," lead author Dr. Stefan Kertesz, an associate professor in the preventive medicine division, said in a university news release.

Kertesz characterized most drug users as "dabblers" who used a few days a month, but not daily.

The researchers found that older drug users were more likely to have been raised in economically challenging circumstances in a family that was unsupportive, abusive or neglectful.

Those who were heavy drug users when they were young adults and continued into middle age were about five times more likely to die prematurely than people who didn't use drugs, according to the report published online Jan. 27 in the Journal of General Internal Medicine.

But, while the study uncovered an association between continued heavy drug use and premature death, it did not prove a cause-and-effect relationship, the study authors noted.

"We can't assume that drugs caused death, as in an overdose," Kertesz said. "Rather what we found is that middle-age adults who continue to dabble in hard drugs represent a group that is at risk of bad outcomes -- which could include death from trauma, heart disease or other causes that are not a direct result of their drug use -- at a higher rate than people who stopped using drugs."

About 9.4 percent of Americans aged 50 to 59 and 7 percent of those aged 35 to 49 reported use of a drug other than marijuana sometime in the past year, according to the U.S. National Survey on Drug Use and Health.

More information

The U.S. Substance Abuse and Mental Health Services Administration has more about illicit drug use among older adults.

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