Osteopenia

I have been on Arimidex for over a month now, and the side effects seem to be minimal although rather annoying (my urine smells unpleasant, and more days than not I have a feeling as if I have a UTI – urgency, an itch deep within – but I clearly do not have a UTI). I have not spoken to my doctor about it, but I will at my next appointment.

People with ER/PR+ breast cancer take Arimidex or other aromatase inhibitors in order to inhibit estrogen from being made in the body. One side effect of this is bone loss. Menopause also causes bone loss. I went through surgical menopause in 2013 when I had my ovaries removed, along with a hysterectomy, to prevent ovarian cancer due to my BRCA2 mutation. Those who take Arimidex often also take a biophosphonate, which attempts to stave off bone loss. They also have regular DXA scans to check for bone loss or osteoporosis.

Because I have RA, my rheumatologist wanted to have a baseline DXA scan on file for me when I had my ovaries removed back in 2013. That scan showed no bone loss. A follow-up he requested two years later also showed no bone loss. Last week, I had a DXA scan requested by my oncologist to get a baseline after chemo and as I started taking Arimidex. Well, what do you think it showed?

In 5 years, I have lost 12% of the bone density in my lumbar spine and 11% in my overall hip (most of it to the femoral neck). Both lumbar spine and hip are now considered “low bone mass,” with a diagnosis of osteopenia.

Osteopenia isn’t the worst thing in the world, but I’m not happy about it. I have suffered from pain in my lower back and my hip/groin for years now, had several cortisone injections, taken lots of different pain medications, done physical therapy, etc. I did finally find a medication that has worked for the last couple of years, although I’m starting to have break-through pain now. I will ask my rheumatologist (he prescribes it) for a higher dose when I see him in two weeks.

Osteopenia is not really reversible, but I can attempt to keep it from getting worse, and I can attempt to prevent it from developing into osteoporosis, which I certainly don’t want.

To be honest, what’s most upsetting to me about this is my age. I’m 43 years old. My son turned 9 earlier this week. I need my body to work for several more years. I have already spent a lot of his life in pain or recovering from surgery or cancer treatment. This diagnosis, more typical to a woman in her 60s, confirms that my body, as has been typical for the last ten years, continues to decline at a rate 20+ years faster than my lifestyle. And that’s really fucking frustrating.