About bone health and cancer

Some cancer treatments can affect your bone health and increase your risk of a bone condition called osteoporosis.

What can I do to improve my bone health?

The following suggestions can help improve your bone health and reduce your risk of osteoporosis.

Keeping your bones healthy is important throughout your life, not just during cancer treatment. These changes are helpful for everyone, so your family and friends can benefit from them too.

Diet

Eat a balanced diet. In particular, make sure you eat foods that contain calcium and vitamin D. This will help keep your bones strong and healthy.

A balanced diet includes:

  • lots of fruit and vegetables
  • some foods that are rich in protein, such as meat, fish, soya beans and lentils
  • starchy foods (carbohydrates), such as rice, bread, pasta, potatoes and whole grains
  • milk and dairy products, such as yoghurt and cheese
  • only a small amount of foods that are high in fat, salt and sugar.

We have more information about healthy eating and cancer.

Calcium

Public health bodies in the UK recommend most adults should have 700mg of calcium a day. If you have osteoporosis, your doctor may advise having 1,000mg a day.

Eat foods that are rich in calcium, such as:

  • dairy products (these contain the highest amounts of calcium)
  • tinned oily fish where you eat the bones (sardines are particularly high in calcium)
  • leafy green vegetables, for example broccoli and curly kale
  • nuts
  • soya beans, tofu, kidney beans and baked beans
  • dried fruit, for example figs, apricots and raisins.

If you have a dairy-free diet, make sure you eat non-dairy foods that contain calcium. You may also choose to have products with added calcium. These include some types of fortified non-dairy milks and orange juice. Always shake the carton well before use. This ensures the calcium mixes throughout the drink.

Some foods and drinks upset the calcium balance in the body. Avoid large amounts of them. They include:

  • caffeine
  • red meat
  • salt
  • fizzy drinks that contain phosphates, such as cola.

The Royal Osteoporosis Society has more information about the amount of calcium in specific foods.

Vitamin D

Vitamin D helps your body absorb calcium. It is important to get enough of it to maintain healthy bones and muscles.

Sunlight is the best natural source of vitamin D. In the UK, exposing your skin to sunlight daily between 11am and 3pm from May until September increases vitamin D levels. It is recommended that adults get ten minutes of sun on bare skin (without sunscreen) once or twice a day depending on their skin type. But take care not to burn, especially during strong sunshine. On cloudy days, it will take longer than ten minutes to get enough vitamin D.

We only get a small amount of vitamin D from the food we eat. But it is important to include vitamin D-rich foods in your diet, such as:

  • oily fish
  • red meat
  • liver
  • egg yolks.

Some breakfast cereals and fat spreads have vitamin D added to them. You can check the labels to find out.

Supplements

During the winter months, when sunlight levels are low, it is difficult to get enough vitamin D from food alone. Because of this, it is recommended that people take a daily supplement containing 10mcg (800 IU) of vitamin D.

People who are more likely to have low levels of vitamin D are advised to take a vitamin D supplement all year round. This includes people who:

  • cover their skin when outside
  • have dark skin, from African, African-Caribbean and South Asian backgrounds
  • do not spend regular time outdoors every day, such as people who are housebound or in a care home.

You can buy vitamin D supplements from supermarkets, health food stores and pharmacies.

If you are having cancer treatment that increases the risk of osteoporosis, your GP or hospital doctor may prescribe vitamin D and calcium supplements for you.

Smoking

If you smoke, giving up will be good for your bones and your general health. We have more information about giving up smoking.

Alcohol

If you drink alcohol, stick to recommended guidelines. Current drinking guidelines recommend that men and women drink no more than two units of alcohol a day or 14 units a week.

There is more information about alcohol and drinking guidelines at drinkaware.co.uk.

Exercise and bone health

Physical activity and strength training makes bones stronger. It can also improve your co-ordination and balance, which makes you less likely to fall. Falls are a common cause of fractures, especially as people get older.

If you have not exercised much before, you will need to start slowly. Talk to your doctor before starting any exercise programme. This is especially important if you have, or are at risk of, osteoporosis.

It is best to do the following types of exercise:

  • Activities that raises the heart rate for 30 minutes, five times a week. The 30 minutes could be made up of three 10-minute periods of activity. This type of aerobic activity strengthens the heart and lungs.
  • Physical activity that improves muscle strength at least two days a week.
  • Exercises to improve balance and co-ordination at least two days a week.

You need to exercise regularly to get the most benefit.

Weight-bearing exercises

Exercise that is weight-bearing is particularly good for your bone health. Weight-bearing exercises include:

  • walking
  • jogging
  • skipping
  • climbing stairs
  • dancing
  • hiking.

Swimming and cycling are good for your heart and lungs but are not weight-bearing.

Weight-bearing exercises can be high-impact or low-impact. Check with your doctor if you are not sure if it is okay for you to do high-impact exercises. If you have a high risk of fractures or you have had a fracture in the past, you may be advised to only do low-impact exercises.

High-impact exercises include:

  • jogging
  • hiking
  • skipping
  • racket sports like tennis
  • some types of dancing.

Low-impact exercises include:

  • walking (either outside or on a treadmill machine)
  • using an elliptical training machine or cross-training machine
  • low-impact aerobics
  • stair-step machines.

Strength-building exercises

These exercises make your muscles work harder than usual, against some form of resistance. They strengthen muscles, bones and joints. They may also improve your balance. You can do them with hand weights, machines or elastic bands.

Exercises to improve balance and flexibility

Having flexible joints helps you stay supple and prevent injuries and strains. Simple stretching exercises are a good way to start. It is best to do these stretches as a daily routine. They will only take you a few minutes.

The following exercises are good for flexibility and balance. They can also help you relax and reduce stress:

  • yoga
  • tai chi
  • pilates
  • body balance
  • qi gong.

If you have osteoporosis or you have had a fracture in the past, avoid sudden movements or exercises where you bend forward and twist your waist. These movements can increase your risk of fractures in the spine.

You can get more information about physical activity and bone health from the Royal Osteoporosis Society.

Physical activity guide for adults

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