by Nancy Burke, R.D., Danielle Karsies, M.S., R.D. and Melissa Shannon-Hagen, R.D., C.S.O.
U-M Comprehensive Cancer Center Symptom Management and Supportive Care Program
It’s officially fall. The leaves are changing and you've probably seen at least a few Halloween skeletons. Although they're great decorations and a timehonored costume, they're also important organs in our bodies that need special attention during and after cancer treatment.
Many side effects of treatment can induce bone loss, cause thinning of the bones (osteopenia) and increase the risk of fractures. There is also a connection between cancer-related bone disease and death. Keeping your bones strong and healthy is more than just a good idea. It can also be a lifesaver.
What cancer treatments affect bone health?
Milk and dairy products are one of the best sources of dietary calcium but are poorly tolerated by individuals with lactose intolerance. Lactose intolerance, which affects as many as 50 million Americans, results from the body’s inability to digest lactose in milk products. Symptoms include abdominal cramping, gas and bloating. Besides incorporating non-dairy, calcium-rich foods such as broccoli, navy beans and soybeans, using lactase enzymes or taking a calcium supplement, you might want to experiment with the following foods.
- Look for reduced-lactose or lactose-free milk in the dairy case or try small portions of dairy foods to test your tolerance levels.
- Drink milk with other foods. This may slow the digestion of dairy enough to prevent symptoms.
- Try eating aged, hard cheeses such as cheddar, colby, swiss and parmesan as they may be well tolerated since they are low in lactose.
- Cultured milk products such as yogurt or buttermilk contain friendly bacteria to help digest lactose.
- Hormone therapy, such as aromatase inhibitors for breast cancer or androgen deprivation therapy for prostate cancer
- Steroids, such as prednisone
- Blood thinners
- Radiation therapy, especially to the pelvis
What can you do to keep your bones strong?
Eat calcium-rich foods, such as turnip or collard greens, navy beans and milk or cheese to meet the recommended daily allowance (RDA) for your age. For most, this is 1000-1200 mg daily.
Get enough vitamin D to help the body absorb calcium. The RDA is 600-800 IU daily, depending on your age. A supplement may be needed to reach your goal.
Eat a nutritious diet of whole grains, fruits, vegetables and lean proteins to maintain a healthy weight. This will ensure you get all the other nutrients your body needs, including vitamins A, C, K, phosphorus and more.
Weight-bearing exercise, such as weight training, walking, hiking, jogging and climbing stairs, helps strengthen bones. If you have health problems, check with your physician before you begin a regular exercise program.
If you don't smoke, don't start.
Stick to no more than one drink for women, two drinks for men each day. One drink is defined as 12 oz beer, 1.5 oz of spirits or a 5 oz glass of wine.
Ask your doctor what you can do to keep your bones healthy.
How much Calcium and Vitamin D do I need?
|Life Stage Group||Calcium Recommended|
Dietary Allowance (mg/day)
|Vitamin D Recommended|
Dietary Allowance (IU/day)
|1 - 3 years old||700||**|
|4 - 8 years old||1,000||600|
|9 - 13 years old||1,300||600|
|14 - 18 years old||1,300||600|
|19 - 30 years old||1,000||600|
|31 - 50 years old||1,000||600|
|51-70 years old||1,000||600|
|51 - 70 year old females||1,200||600|
|71+ years old||1,200||800|
|**For infants, adequate intake is 400 IU/day for 0 to 6 months of age and 400 IU/day for 6 to 12 months of age.|