Zoledronic acid

[Fdccs]

Hi guys,

Is it normal to be prescribed this with no bone mets? My husband has been on Lupron for 15 months and recently had a DEXA scan

Thanks

[Magnus1964]

Zoledronic acid is used to treat high calcium levels in the blood. Is he still on Lupron?

[Fdccs in reply to Magnus1964]

Hi Magnus,

Yes he's done 15 months of 36 on Lupron for pelvic lymph nodes along with radiotherapy and chemotherapy.

He is very slim and as he's been on Lupron for over a year so his consultant ordered a DEXA scan so I guess he has some thinning from ADT treatment

Thanks for your reply

[Pleroma]

I needed zoledronic acid after 15 months on ADT. My DEXA scan showed that I had lost enough bone density to cross the line into osteopenia (the precursor to osteoperosis).

It is a bone strengthening drug - an important part of our arsenal in the fight against the effects of cancer treatment.

After the infusion of zoledronic acid, I had flu-like symptoms for about 2 days. That was it.

[Fdccs in reply to Pleroma]

Aw thanks Pleroma.

Osteopenia sounds a bit better than osteoporosis so hopefully it's that and we've caught it in time. Just goes to show it's worth keeping an eye on these things as otherwise we'd of had no idea.

Best wishes

[Hidden]

ADT causes bone density loss, so it's not unusual for men on it to be prescribed Zometa or Xgeva.

[pjoshea13]

Estradiol [E2] is essential for bone health. Men get E2 from the aromatization of testosterone [T]. When T is very low, E2 will generally be low too. This is why ADT causes rapid bone loss. Calcium comes out of bone to maintain blood levels, but can't be put back.

Bisphosphonates & Zoledronic acid are very poor solutions.

I would get E2 tested. If it is <12 pg/mL, I would ask for a low-dose E2 patch.

Note that, apart from the usual bone health supplements, vitamin K2 is needed for calcium transport to bone. & boron is good supplement too.

-Patrick

[Tall_Allen]

What were the results of the DEXA scan? Zometa is only indicated for men with bone metastases who are castration-resistant. Prolia is indicated for men without known bone metastases who have osteoporosis.

[Fdccs in reply to Tall_Allen]

Sorry Zoledronic was the one I knew. His doctor said a Bisphosphonate might be of some advantage after DEXA scan.

We're in the UK.

He's still HS and finished chemotherapy and radiotherapy last September. They did the scan as he's been on ADT for over a year and is slim

[Tall_Allen in reply to Fdccs]

What did the DEXA scan show- osteopenia? osteoporosis? If he had chemo, I assume he had metastases.

[Fdccs in reply to Tall_Allen]

TA we need to find out. I hate it when doctor's write letters without any detail as it just causes stress and anxiety.

He had 1 pelvic lymph node on diagnosis.

I presume the scan saw osteoporosis because he's recommending Bisphosphonate might be beneficial

[tango65]

Zoledronic acid is used to treat osteoporosis or prevent fractures/pain in patients with bone metastases. If he had a DEXA scan and the doctor order zoledronic acid, the scan most probable showed osteoporosis or a marked decline in bone density indicating rapid loss of bone tissue.

[Fdccs in reply to tango65]

Rapid loss of bone tissue from ADT?

There was no other comment just DEXA scan due to being on ADT for over a year and recommending Bisphosphonate may bring some benefit

[tango65 in reply to Fdccs]

If the dexa did not show osteoporosis or a significant osteopenia and he does not have bone metastases, the zoledronic acid may not be indicated.