Cancer and Yoga
A year and a half ago, I had no idea that cancer treatments put patients at risk for osteoporosis or that one could do something about it.
After a fall on invisible ice resulted in pelvic fractures, I simply assumed that at 71 I had arrived a tad early in little-old-lady-land. Only medical appointments appeared on my calendar. After lacing my thick-soled shoes and straightening my wig, I got to the hospital by grasping the nearby walker which my stepdaughter had decorated with bling: purple and red plastic streamers.
The oncologist took one look and sent me for a bone density test and then to Dr. Theresa A. Guise, a specialist in bone disease at Indiana University. My bone problem was caused not by my ovarian cancer but by the seven years of medical responses to it, she told me. Radiation, chemotherapy and steroids can render bones brittle, Dr. Guise explained. Before and after I received recurrent infusions of Taxol and carboplatin, I was given the steroid dexamethasone to prevent nausea.
The literature on treatment and bone loss focuses primarily on prostate and breast cancer patients. In men, researchers have found a strong link between androgen-deprivation therapy, often used for prostate cancer, and osteoporosis. In women, an estrogen drop — when aromatase inhibitors or other interventions bring about the early onset of menopause — can compromise the strength of bones.
No, there was no history of osteoporosis in my family, I told Dr. Guise. Yes, I did eat yogurt and cheese, but I did not get out in the sunshine much. Dr. Guise nodded, ordered blood tests, and recommended Prolia, a twice-a-year injection to help fight osteoporosis, instead of the oral drugs available.
I had heard of the osteoporosis drugs Fosamax, Actonel, Boniva and Reclast, all of which have the potential to cause some deleterious consequences. Prolia’s side effects, though rare, seemed formidable: osteonecrosis of the jaw and fracture of the thigh bone. Since the blood tests showed that I had a vitamin D deficiency that had to be remedied before the injection could be administered, there was time to deliberate.
The vitamin dosing made me realize how often I ignore health issues because they seem trivial compared to the mortal threat of cancer. Stress tests, dental work, cholesterol checks: who cares? Just dealing with cancer had been enough for me. Clearly that had to change.
To avoid another catastrophe, I got the injection. A few months later I managed to jettison the walker by meeting with a physical therapist who is an expert in bone density issues. I wish I had seen her earlier. The youngest member of my cancer support group, Dana, consulted with medical professionals before she suffered a fracture.
By the age of 51, Dana had experienced three of what Dr. Guise calls “skeletal insults”: celiac disease, pelvic radiation and Arimidex (the estrogen suppressant she takes as a maintenance drug). Despite a careful diet and a rigorous workout schedule, Dana has osteopenia in both hips and osteoporosis in her spine. Like me, she was told to supplement weight-bearing exercises with calcium, vitamin D and walking as much as possible.
I used to love to walk; however, I had given it up after cancer. I understood why on the day I caught sight of my reflection in a storefront window. Without the walker, I stooped. The tilting embodied my dread of falling again. Along with neuropathies in my feet (also caused by chemotherapy), osteoporosis intensified my agoraphobia, a fear of going outdoors, as well as my tendency to look down at uneven paths instead of directly out in front of me.
Encouraged by Dana and my physical therapist, I have taken up a type of yoga that may benefit my bones, my posture, and maybe my confidence in walking: chair yoga. To my surprise, one can do many stretches either sitting on a chair or standing and using a chair for balance or ballast. In a nearby studio with women and men generally older than 12 or 20, this exercise feels less like a chore, more like a timeout from all the medical regimens. An added plus: It relieves back and neck pain.
The physical therapist also mentioned a vibrating board that may strengthen bones. So-called vibration therapy was discovered when astronauts needed to regain bone loss after spending time in a space station, or so the legend goes. It sounds intriguing, but I have yet to see such a board and besides, I would probably topple off it.
Though I still wear clunky shoes and a wig, my calendar now includes trips to my university office, the library, concerts and movies. I concentrate on sitting and standing as tall as possible. While cooking, I use the kitchen counter to do modifications of yoga poses like the tree, the plank and the downward-facing dog.
Should the walker be needed again, I will try to take it in stride, for the treatments that hurt my body have kept me alive longer than anyone ever thought possible. If it is possible to sign up not only for chair yoga but also apparently for yoga with cats or even with goats, why not classes with walkers, where — inspired by Mel Brooks’s hilarious production number “Little Old Lady Land” — I might just tap my bling till it swings.
August 15, 2017
I'm a yoga teacher and osteoporosis "sufferer" as well, age 68. Chair yoga is a wonderful, adaptive and welcoming practice that has so many...
August 13, 2017
I started doing astanga yoga 30 years ago, I was a runner, marathoner, etc. etc. Some years later I developed osteopenia and took fosamax...
Dr Rick Boulay
August 13, 2017
Susan,I am so grateful for you and your column. Your experiences and your powerful voice have opened many doors for conversations that may...View More Trending Stories »