DEXA results, HELP-should he start Pr... - Advanced Prostate...

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DEXA results, HELP-should he start Prolia?

sjc2 profile image
sjc2
17 Replies

Finally got the DEXA results and still not sure if he should start Prolia yet! Of course his MO will say yes, since she wanted to start Prolia without even doing a DEXA first! His appt with MO is this Monday and we need to decide if he wants the Prolia shot or not. His T-scores were Spine 0.6, Left Femoral Neck -2.0, Right Femoral Neck -2.6--- as you can see it's not straight forward! His Spine is normal, his left femoral neck is Osteopenia and his right femoral neck is Osteoporosis! Since Prolia has some nasty possible side effects with the jaw and Tall Allen mentioned side effects (like osteonecrosis) increase over time, should he start it now because of his right hip reading? Any of your experiences with this or opinions on the matter would be greatly appreciated!! As always, thank you to everyone that always listens and replies, this is such a great group and a blessing to us!!

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17 Replies
Tall_Allen profile image
Tall_Allen

Is he doing weight-bearing legwork (running, squats, etc.)? I think the osteoporosis risk of fracture is greater than the risk of jaw osteonecrosis. Make sure his blood levels of calcium and Vitamin D are adequate when taking Prolia.

sjc2 profile image
sjc2 in reply to Tall_Allen

He travels for his job and uses the elliptical at the hotels each weekday, also he has to walk a lot with his job approximately 2 miles a day (that isn't all at once, it's broken up during the work day).

His MO only had him get a letter from his dentist that all his dental work is up to date and no work needs to be done at the present (which he did). She never said anything about his calcium and Vit D levels, she did do blood work and I do know calcium was included but don't remember Vit D. She does have him taking calcium and I started him on Vit D when the calcium began. Do I need to question his levels before he starts the Prolia?

Tall_Allen profile image
Tall_Allen in reply to sjc2

No need to supplement unless low

sjc2 profile image
sjc2 in reply to Tall_Allen

He will start Prolia on Monday & we requested his Vit D level to be added to his calcium level blood work, thanks!

Now that you know his DEXA results, if it were you, how often would you get the DEXA done... yearly or every two years, as most say they're having it done?

Tall_Allen profile image
Tall_Allen in reply to sjc2

I would ask for a scan after a year to make sure there was some effect. If so, every couple of years sounds good- whatever your MO wants.

Sunseaandsand profile image
Sunseaandsand in reply to sjc2

Hi I'm new to the forum and doing the search on Prolia brought me to your question regarding how often for the scan.

First Let me say what a wonderful job you are doing in supporting your husband.

That's the best medicine anyone can have.

I consider the bone treatments a difficult choice made harder by the people who do suffer side effects (I am one of those people)

I am still persevering despite them.

The results at the moment don't sound too bad from the dexa but depending on other treatments he receives could worsen.

I used to have my scan every 18 months but then it changed to every year as they wanted to keep a closer eye on it.

If I was to continue with the Prolia it will be next year which will be 2 years from the last one.

They usually leave the longer the gap as this is much more beneficial for the readings.

Good luck with your decision and I'm sure the positve experiences all be a big help to you both.

tango65 profile image
tango65

A T score of -2.6 indicates that there is osteoporosis. If he is on ADT those reading are going to get worse. Besides vitamin D, Calcium and exercise the treatment with Prolia is effective. Osteoporosis is a complication of ADT and it should be treated. The incidence of osteonecrosis of the jaw is less than 5% and it usually occurs in patients having extractions or dental surgical procedures. He should be sure that his teeth are fine before starting the Prolia.

sjc2 profile image
sjc2 in reply to tango65

Yes he's had all dental work done and all looks good at present, so he will start Prolia on Mon. at MO visit. Thanks!!

tallguy2 profile image
tallguy2

Please start Prolia! No side effects for me, covered 100% by my insurance. A no-brainer!

sjc2 profile image
sjc2 in reply to tallguy2

We have decided to start the Prolia, thanks for your reply!

efsculpt profile image
efsculpt

I've had 4 Prolia shots (6 months) over the last two years (started Lupron/Zytiga then). I haven't had any problems with it. You don't want to have dental problems while on Prolia.

My friend started Lupron same time I did, no Prolia, he now has osteoprosis.

Pierreb profile image
Pierreb

When my Dad started on Lupron in December of 2018 they also started giving him Prolia at the same time (In Feb thanks to suggestions from this site they added Zytiga and Prednisone). He has not had any complications from the Prolia.

MateoBeach profile image
MateoBeach

My vote would be "Yes". Prolia is better at strengthening bones and decreasing adverse "skeletal events" in PCA than alternative regimens. And there is also preliminary thought that it may make bones less hospitable for metastasis in the micro-environment. For these reasons I opted for Prolia when only one site on Dexa scan showed osteopenia: just enough for Medicare to approve treatment for me. And yes Calcium and vitamin D should be supplemented and monitored going forward on Prolia.

We're you given a choice of Prolia or Xgeva?

sjc2 profile image
sjc2 in reply to HopingForTheBest1

No, he doesn't need Xgeva... he doesn't have any bone mets. Everything was clear on the nuclear bone scan and all clear on the Axumin scan except one small pelvis lymph node.

HopingForTheBest1 profile image
HopingForTheBest1 in reply to sjc2

That explains why I am on Xgeva, and not Prolia. Best of luck.

sjc2 profile image
sjc2 in reply to HopingForTheBest1

Best of luck to you, also!

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