This information is an extract from the booklet Bone health. You may find the full booklet helpful. We can send you a free copy see page 5.

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1 This information is an extract from the booklet Bone health. You may find the full booklet helpful. We can send you a free copy see page 5. The bones Contents The bones Why bone health is important Factors affecting bone health The human body is made up of more than 200 bones of different shapes and sizes. They are made of collagen (a type of protein), calcium salts and other minerals. These make bones strong and rigid. The bones in the legs and arms are called long bones (see below). They have a hard outer shell made of compact bone. Each end of the bone is filled with spongy bone (called cancellous bone). The middle of the bone is filled with bone marrow, which is where blood cells are made. Compact outer shell The structure of a long bone Questions about cancer? Ask Macmillan Page 1 of 5

2 Our bones: provide support for our bodies, and the joints act as levers so we can move around protect various parts of our bodies from injury, for example the ribs protect the heart and lungs store important minerals that are used by our bodies, such as calcium are filled with bone marrow, which is where blood cells are made. Our bones are constantly being broken down and replaced with new bone. This helps maintain their strength and shape. There are two main types of cell that break down and replace bone: Osteoclasts break down and remove old bone. Osteoblasts make new bone. Why bone health is important Bone health is important throughout your life, but it s even more important as you get older. As you age, bone loss gradually increases, which means the bones get weaker. As this happens, some people may develop osteopenia or osteoporosis. Osteopenia happens when your bones become slightly less dense. It can sometimes develop into osteoporosis. Osteoporosis happens when your bones become even less dense and weaker. Weaker bones are more prone to breaks (fractures). becomes less dense A healthy bone A bone with osteoporosis Page 2 of 5 Questions about cancer? Ask Macmillan

3 Osteoporosis is not painful. It doesn t cause any symptoms until a weakened bone fractures (breaks). People with osteoporosis are more likely to have a fracture than other people. Fractures usually happen in the wrists, hips and spine, but they may also happen in other bones. A fracture can make movement painful and difficult. People over the age of 50 are more likely to develop a fracture because of poor bone health. About 1 in 3 women (33%) and 1 in 5 men (20%) over 50 will have a fracture. Younger people can also develop fractures due to weak bones. People who have cancer treatments particularly some types of hormonal therapy drugs are more likely to develop osteoporosis and fractures. A lot can be done to stop bone loss and osteoporosis. Your doctor can do tests to check the health of your bones. The results of these tests help doctors decide whether you need treatment to lower your risk of a fracture. Factors affecting bone health A number of factors affect bone health. We ve listed these over the next few pages. Age and gender Your bones are strongest when you re in your twenties. After this, your bones gradually become more fragile and likely to fracture as you get older. Women lose bone more quickly after the menopause. This is because their level of oestrogen falls after the menopause. Oestrogen is a hormone that helps keep bones healthy. Physical activity Physical activity makes your bones stronger. Regular exercise is one of the best ways to improve and maintain your bone strength. Weight-bearing exercises are particularly helpful, such as walking, climbing stairs or dancing. Questions about cancer? Ask Macmillan Page 3 of 5

4 Diet Eating a balanced diet helps keep bones healthy. It s important to get enough calcium and vitamin D because they help build bones and keep them strong. Calcium is found in things like dairy products and green vegetables. You mostly get vitamin D through sunlight. Family history of osteoporosis If you have a family history of osteoporosis, you re more at risk of developing it yourself. If one of your parents had a hip fracture as a result of osteoporosis, you re more at risk of having a hip fracture yourself. Fractures People who have weak bones because of osteoporosis are more likely to get fragility fractures. These happen after a fall from standing height or lower. People with healthy bones are less likely to break a bone from a fall at this height. Weight Being underweight or having a body mass index (BMI) below 19 can increase your risk of fracture and bone loss. BMI is a measure of healthy weight. Your BMI is based on your height and weight. Your GP or practice nurse can work out your BMI for you. There s also a BMI calculator on the NHS Choices website at nhs.uk/tools/pages/ healthyweightcalculator.aspx Illness Some illnesses can reduce your bone health. These include: rheumatoid arthritis inflammatory bowel diseases, such as Crohn s disease and ulcerative colitis diseases of the lung and liver thyroid diseases, such as having an overactive thyroid gland eating disorders, such as anorexia nervosa illnesses that cause disability and make a person less mobile. If you re a woman and you have an early (or premature) menopause, this can also reduce your bone health. Page 4 of 5 Questions about cancer? Ask Macmillan

5 Drugs Taking some drugs for a long time may increase your risk of developing osteoporosis. These drugs include the following: Steroids, which are given to treat a number of illnesses, such as rheumatoid arthritis and asthma. They may also be used in some cancer treatments. Some anti-epileptics, such as phenytoin. Anti-epileptics are mainly used to treat epilepsy, to help prevent fits (seizures). Smoking and drinking alcohol Several studies have shown that smoking reduces bone density and weakens bones. Drinking more than three units of alcohol a day also affects the bones and increases the risk of fractures. There are three units in one large glass of wine. Being drunk may also make falls more likely, which can cause fractures. People who drink a lot of alcohol also often have a poor diet. If their calcium intake is reduced, this can lead to bone loss and weaker bones. More information and support More than one in three of us will get cancer. For most of us it will be the toughest fight we ever face. And the feelings of isolation and loneliness that so many people experience make it even harder. But you don t have to go through it alone. The Macmillan team is with you every step of the way. To order a copy of Bone health, visit be.macmillan.org.uk or call We make every effort to ensure that the information we provide is accurate and up to date but it should not be relied upon as a substitute for specialist professional advice tailored to your situation. So far as is permitted by law, Macmillan does not accept liability in relation to the use of any information contained in this publication, or thirdparty information or websites included or referred to in it. Macmillan Cancer Support Registered charity in England and Wales (261017), Scotland (SC039907) and the Isle of Man (604). Registered office 89 Albert Embankment, London, SE1 7UQ REVISED IN MARCH 2014 Planned review in 2016 Questions about cancer? Ask Macmillan Page 5 of 5

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