Chapter 01 - Safeguarding Exercise Capacity Throughout and After Cancer Treatment
Hypogonadism and the subsequent oestrogen deficiency associated with cancer treatment (chemotherapy, hormone therapy) can result in an imbalance between function of the osteoblasts and osteoclasts, resulting in greater bone resorption than formation. The result is a net loss of bone density and an increased fracture risk. Patients with breast or prostate cancer in particular are at increased risk for reduced bone health. Premenopausal women who are treated with alkalytic agents are at increased risk for cessation of ovarian function, which reduces oestrogen levels. Also, men treated with androgen-suppression therapy experience a decrease in oestrogen that parallels the reduction in testosterone. Furthermore, a high incidence of osteopenia and osteoporosis is observed in long-term survivors of Hodgkin’s and non-Hodgkin’s lymphoma treated with stem cell transplantation.