I believe this to be a very good resource for an important concern for all men with any type of PCa. The statistics are somewhat staggering, and apparently a great many Docs are giving this topic too brief a mention during consults. I recently advised a GP of my PCa situation, and my request for DEXA scan was approved. My results were not desireable at all....unfavorable " t- scores" and FRAX risk of major fracture of 13% and of hip fracture approx 7%. My blood Vit D had recently tested at severely low, though blood calcium normal. I have started Ca and D supplements...obviously D should have been started much earlier, but I have learned that measuring D is not, for some reason, standard of care for preventive health measures?? Going into ADT + radiation, and with a relatively poor bone scan test result ( osteopenic, though not yet osteoporosis), drug therapy might be called for......but side effects??
I would say all men with PCa can benefit from taking a look at this. The author's credentials are impressive.........
" Written by: Fred Saad, MD, FRCS, is Professor and Chairman of Urology and Director of G-U Oncology at the University of Montreal Hospital Centers (CHUM). He holds the U of M Endowed Chair in Prostate Cancer Research and is Director of the molecular oncology research lab in Prostate Cancer. He is also Director of clinical cancer research at the CHUM. Between 2007-2013 he served as Chair of the National Cancer Institute of Canada G-U Group and the Canadian Urologic Oncology Group. Dr Saad has been intimately involved in almost every important clinical trial in castration resistant prostate cancer over the last 20 years and presently sits on 6 steering committees of international clinical trials. He leads the Canadian Prostate Cancer Biomarker Network and is a principal investigator with the Movember bio-marker initiatives in prostate cancer.
Thank you for that link! My understanding is that DEXA scans and Vit. D testing are not standard for PC patients starting ADT. Those tests seem to be initiated by MOs only rarely, since they are not covered by all insurance plans as normal SOC, so it is up to the patient to request them if they want them.
Appears to me that is a big mistake, and I don't let Docs off the hook re " it's not covered"...they should provide all relevant info and let the patient decide re out-of -pocket.....BS excuse IMHO!! Obviously I expect to much from our " healthcare" system, and yes I'm repeatedly disappointed but do my best to hold my tongue with Docs..with nurses not so much!! Fractures are a HUGE problem for men....not just women....check the stats!! and then PCa and ADT do their dirty work!!
DEXA scan was done very early if not pre ADT for a base level by my urologist some 11 years ago. I have not been tested for Vit D so will ask for. Now I am castrate resistant and have DEXA every year. I am in sun 4 hours most every day as a Gardner so I suspect I will be Okay for vitamin D. I work hard most days an some gym so bone is good always.
My blood D was 12 units....below the minimum 30 !! My Ca in middle of norm......but still do Ca supplement? Hmmm?? At 8 years younger, my wife had same low blood D, but very good DEXA results!! My sis lower hip fracture risk 3% than me 7% !! She had higher major fracture risk 17% than my 13%...before ADT would further worsen!!
Wonder why cheap blood D test isn't SOC ..at least for age>50????? How many folks later have problems due to low D? In overcast Pacific NW, MANY !!?? Plus I avoid the sun as very white former carrot top.
Great post. I am a BIG fan of the DEXA. As many post here, we are "data guys" in a society that's increasingly hungry for data (yes, in good and bad ways).
I understand care teams' reluctance to engage in discussions with us on very biochemically-complicated and outcome-murky (for a specific person) mainline mPCa treatments. But DEXA has provided straightforward, focused data that has formed the basis of beneficial discussions on my bone strength and the use of supplemental medications like Xgeva.
Specifically not that I’m aware of. But there are plenty showing that lifting preserves bone density in older people, with or without Pca.
So given that less than 15% of cancer survivors exercise at all (I have supplied studies for that before in other replies here), and ADT drugs decimate bone density, feel free to take a deep dive looking for it.
Personally I would gladly add a bisphosphonate if I was developing osteopenia, but not if I didn’t try upping my workouts first. With regular Dexa and checks of my vitamin D levels of course. What I would not do is just start taking more stuff.
well, at least I do walk 40-50 minutes almost evry day. NOT a weightlifter, and probably not going to start at almost 74. Making it to10 pushups would eba huge accplishment for my physique....... relatively have always been a 98 pound weakling and have never cared...cept when others pushed me around on bball court!! 6' 1+ " tall, and 160 at 19.......currently 196 after losing 10 pounds in last 7 months, and trying to get back to 185? 175 or so at age 42 when married....the start of my weight problems !!!
I am trying to motivate myself to do types of resistance exercise at home...not interested in driving to a gym...maybe 15 pound items I can repetitively lift one arm, or 30 pound both arms..more if I became stronger....plus stretch bands.......but wouldnot discard advice for D supplements. Guess need to discuss Fosamax, etc drug therapy with oncologist and/or GP...have avoided all prescription drugs so far in life!!! always surprises the nurses when they ask about medications!! seems like I have obsrved that starting one long-term medication always leads t more and more medications???? Treating SEs of previous medications??? So, ADT VERY scary !!
I understand sir, believe me. Take anything you think will help and track it.
I encourage you not to think of yourself as either a weightlifter or not a weightlifter.
Starting lifting when you’re older may seem more than a little daunting, but it’s transformative. There is better and faster improvement from zero to the first rung than between any other 2 adjacent levels.
You don’t need weights. Bands calisthenics etc work very well. You just have to do it that’s all. Life on Lupron sucks way way less if you do. Onward!
This is a recent Danish study on Vitamin D and PCa. It seems to indicate that a range of 50 to 75 is associated with better survival rates than other ranges.
Yes. I haven’t posted a link on here before. I’ll check it next time. I hope the info adds to the body of knowledge. Best to you and all the guys trying to beat this beast!
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