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Chronic Conditions and Breast Cancer

Diabetes, Osteoporosis, and Heart Disease Can Complicate Treatment

By Betsy Lee-Frye

Updated August 26, 2008

(LifeWire) - When you're diagnosed with breast cancer, it may seem as though the world stops, but it will start spinning again. And for women with chronic conditions, such as diabetes, osteoporosis and heart disease, it means beginning breast cancer treatment while continuing to manage their pre-existing chronic illnesses.

A few of the more common chronic conditions are discussed here. Be sure to talk your physician about these and any other medical issues you may have during treatment.


Diabetes is one of the most common chronic conditions facing Americans. According to the National Diabetes Information Clearinghouse, more than 10% of all women and about 23% of Americans older than age 60 have been diagnosed with the disease.

New research suggests that women with diabetes are more likely to be diagnosed with breast cancer than others, and this may be due to insulin resistance.

Some breast cancer treatment options can worsen diabetes symptoms. For example, women who undergo chemotherapy may experience problems caused by the nausea and vomiting that so often accompany chemo. If a woman with diabetes is unable to keep food in her system, she may suffer from hypoglycemia, which is low blood sugar.

Talk to a physician if sickness during chemotherapy becomes a problem. Your doctor may prescribe antinausea medication or suggest high-calorie meals in liquid form that you can sip throughout the day. Be sure to talk to your physician about how your treatment may affect your needs in monitoring your sugar levels.

If you require insulin injections, you may need to be monitored during your first round of chemotherapy.

You should also speak with your doctor about how your diabetes may affect your response to various treatment options. In some cases, diabetes can cause inadequate blood flow, which could slow down the healing process after a surgical procedure.

A study published in 2007 of 119 patients followed for six years found that cancer patients with diabetes were more prone to kidney failure, inflammation of the heart muscle and other chemotherapy complications than those without diabetes. These complications can delay treatment, which can worsen a patient's prognosis.

Another potential problem is drug interactions. To avoid these, make sure your doctor knows what medications you are taking. It's important to mention all of your medications to your doctor, so keep a journal with the names and dosages of all your meds.


For osteoporosis, a condition that affects about 55% of adults age 55 and older, aromatase inhibitors are the number one cause of osteoporosis.

According to the National Institute of Arthritis and Musculoskeletal and Skin Disease, both chemotherapy and surgical treatment options have a negative affect on bone health.

Chemotherapy has been shown to reduce the body's production of estrogen. In addition, if women choose to have their ovaries surgically removed, they can also see a drop in estrogen production. Estrogen protects the bones; therefore, reduced amounts of estrogen can cause bone loss.

If you have been diagnosed with osteoporosis prior to beginning treatment for breast cancer, your physician is likely to pay close attention to your bone density. This can mean bone density scans or just regular X-rays. Be sure to mention your diagnosis to your physician before beginning treatment, and if you are on medications to treat osteoporosis, talk to your physician about possible drug interactions.

Heart Disease

According to the American Heart Association, cardiovascular disease is the number one killer of adults in the United States. The symptoms of heart disease — including high cholesterol and high blood pressure — are rampant among the U.S. population.

If you have heart disease, be sure to talk to your physician about any symptoms you've experienced. This is important, because some chemotherapy medications (anthracyclines and trastuzamab) can cause a condition called "cardiotoxicity."

Cardiotoxicity is a fancy word for heart muscle damage. It basically means that the heart has become less effective at pumping blood through the body. If you or a loved one already has heart disease and is beginning chemotherapy treatment, it's important to inform your physician of all your medical issues. Your physician may want to closely monitor your heart for signs of distress. At some point, cardiotoxicity can force a delay or discontinuation of chemotherapy.

It is important for chemotherapy patients to remember that heart-related issues can develop months after concluding treatment. Patients should mention any chest pain, shortness of breath or any other heart-related issues to their physicians immediately. Radiation can also cause damage to the heart tissue, which may worsen existing heart disease.

Keep Your Lines of Communication Open

As with any chronic condition, it's important to keep your doctors informed about any changes in your medications.

Encouraging your doctors to communicate with one another about the details of your treatment is also important. If this proves difficult to arrange, you can formally ask for a conference among your doctors, at which you and your significant others may be present.


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Lipscombe, L.L., P.J. Goodwin, B. Zinman, J.R. McLaughlin, and J.E. Hux. "The Impact of Diabetes on Survival Following Breast Cancer." Breast Cancer Research and Treatment. 109:2(2008): 389-95.

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"Osteoporosis and Breast Cancer." Ucsfhealth.org. 8 May 2007. The Regents of the University of California. 30 Jul. 2008.

Roychoudhuri, R., D. Robinson, V. Putcha, J. Cuzick, S. Darby, and H. Møller. "Increased Cardiovascular Mortality More than Fifteen Years after Radiotherapy for Breast Cancer: A Population-Based Study." BMC Cancer. 7:9(2007).

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Betsy Lee-Frye is an independent journalist living in Kansas City, Mo. Her work has appeared in The Dallas Morning News, The Corpus Christi Caller-Times and Better Homes and Gardens Special Interest Publications.

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