Healthy bones and a happy body

Preservation of bone health is a body function that breast cancer patients can actively take control over during treatment through knowledge of exercise and supplements. 

Bones are the foundation of movement; they anchor our muscles and tendons and provide the solid framework upon which we walk and use to carry out our daily lives. 

Without a strong skeletal system, we can’t function normally; we feel pain, anxiety and discomfort. When it comes to chemotherapy as well as prescribed hormone blockers, the skeletal system can take a lot of strain during and post treatment. 

Patients often report experiencing bone pain or discomfort. This can occur at rest as well as when doing a task of daily living. From a rehabilitative aspect, the two key factors in preventing bone degeneration as well as improving bone health are exercise and supplementation.  

Negative effects of bone pain in life

The vicious cycle of bone pain results in patients not wanting to do physical activity (in fear of feeling pain) and in turn this only worsens the discomfort and stiffness felt at the bone site. 

Physical inactivity can be associated with a loss in physical function, balance, mobility, general muscle mass, muscle strength and bone mineral density. This not only hinders your quality of life but furthermore dangerously increases the risk of a pathological fracture.

This increased risk coupled with the difficulty in maintaining balance, decreased strength and coordination may result in you falling and breaking a bone, worsening recovery and quality of life. 

Prescribed exercise

Prescribed and monitored exercise is a vital part of active patient participation in not only maintaining bone health but ultimately preventing the onset of bone density deterioration. 

It’s important to discuss this with your oncology-trained rehabilitation therapist as there are certain movements that should be avoided where as others are encouraged. 

Exercise is prescribed in a tailor-made manner to ensure that patients are performing safe and effective exercises without putting them at risk of attaining injuries. 

Tips to consider when exercising

  • Exercises should be predominantly weight-bearing in nature.
  • If you’re experiencing fatigue or weakness as a clinical side effect from chemotherapy, always perform exercises in a seated or lying position and ensure that you’re not in an open space where you could fall easily.
  • Having external support, such as a chair nearby to sit down on, will also prevent any secondary injuries.
  • Under the guidance of a healthcare professional, progressive resistance training should be discussed as it addresses bone density and health as well as the enhancement of muscle growth and strength.
  • Rest is a vital and often overlooked aspect of training. Exercise is truly beneficial when there is an element of rest and recovery in training.


The second pillar of bone health is supplementation. All supplements taken during and after treatment should be discussed with and regulated by your oncologist. 

When it comes to maintaining the mineral density of bones, calcium and vitamin D are often prescribed. 

Chemotherapy may result in a weakening of the skeletal structure, resulting in the breakdown of calcium. Calcium is a major component of bones and allows the skeleton to maintain its strength and structure. Vitamin D also plays an important role in supplementation as it assists the body with the absorption of calcium. 

If you’re currently taking supplements, then it’s important to discuss the amount and frequency at which you’re taking them with your oncologist. If you haven’t discussed supplementation with your treating doctor, it’s worthwhile doing so at your next treatment or follow-up appointment.

Another important supplement to consider is iron. This is an important mineral for all cells including osteoblasts, which are a key component in bone formation. Patients who have lower iron levels present with fatigue and low energy and drive. 

Speaking to your oncologist about your iron levels and the possible indication to take a supplement will result in a decrease in fatigue and ultimately an increase in active participation to work towards maintenance of bone health.

Gabriella Kourie is a qualified occupational therapist. She further trained and qualified 
as a PORi oncology and breast cancer rehabilitation therapist and is currently qualifying in Lymphoedema Assessment 
and Treatment.

MEET THE EXPERT – Gabriella Kourie

Gabriella Kourie qualified as an occupational therapist in 2017, and further trained and qualified as a PORi oncology and breast cancer rehabilitation therapist in 2020. Most recently, she qualified as a PINC & STEEL oncology rehabilitation therapist in 2021. Gabriella is still continuing her studies in Lymphoedema Assessment and Treatment.

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