Like Tom of MA, the scans for my road warrior from MA came back as stable. He hadn't had a CT or bone scan since June, 2020 because he broke his collarbone and bruised a couple ribs bicycling last August. So the bones needed to heal before any imaging could be done. (Some may recall my bragging about him doing some big bike rides last summer--shouldn't have tempted fate because he had the accident not long after that posting.) It's possible some horrible thing is lurking under the healing fractures on that side, but his PSA has been stable for many months: .38 though they didn't take a PSA this time.) His ALP is still low, 38, and all other blood work totally normal.
As always, I'm sharing the details for some of you facing chemo or undergoing it right now. The 10 Docetaxel rounds over 7 months was a slog, but my guy's had stability for the 7 months plus 8 months post-chemo--15 months total. He does have manageable, but annoying, neuropathy from all that chemo even with cold mitts and socks. He can't do any cycling now due to all the snow we have, and gym's a Covid no-go, but he gets out walking about four miles a day. He takes Lupron and Xgeva--hates both due to aches, pains, moodiness, but that's the current treatment. So whatever chemical experiment is going on in his 76-year old body is keeping the beast in check for now. So we're relieved.
Oh, while I'm on the line, I'm curious about any new studies regarding the optimal length of time of Xgeva. He's been on the stuff for nearly three years. His oncologist is willing to consider tapering back, but if anyone has recent research on the stuff, we'd welcome the information. Thanks.
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spouse21
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I'm surprised he needs Xgeva with all that bike riding. Bicyclers usually have strong bones. Bone strengthening agents should not be prescribed for men who don't have osteoporosis. Side effects increase with time taking them.
He had developed osteoporosis. Maybe it's time for a DEXA scan to see where things are. What I'm curious about is whether Xgeva actually helps prevent mets from developing. He did so poorly on Zytiga--after three months he developed mets all over. So expectations were low for the next treatments. However, he's gotten a bit more mileage with Docetaxel + Lupron + Xgeva than many men get. Hate to mess with the mix while it's working but he hates the side effects and thinks it's the Xgeva. Would it make sense to ask about estrogen patch to take with Lupron? Sorry, I'm asking a lot of questions here.
No, Xgeva doesn't prevent metastases from developing or slow the cancer down -that was proven by two major trials. There is good evidence that Zometa combined with Celebrex improves survival by 22%. IMO Xgeva+Celebrex might work as well.
Estrogen patches can help relieve hot flashes, retain bone density and lean body mass. It might have some good psychological effects too. There is a major trial in the UK to see whether it can replace Lupron entirely.
Thanks for clarifying that Xgeva can't prevent mets. I didn't even ask about Lupron though I know about the UK trial on estrogen patches. So maybe a possible scenario going forward is: check out bone density with a DEXA first. Then either cut back on Xgeva (with Celebrex in the mix) or go over to estrogen patches since they're bone strengthening. Someone on another site is doing Lupron & the patch. Lots to consider. Have a good weekend everyone.
In regards to cycling and bone health; "Because cycling is non-weight-bearing and largely impact-free, cyclists can suffer from a weakening of bones called osteoporosis. ... If you lose more bone than you replace, bones slowly become weaker, which can lead to osteoporosis — sufferers have thinner, more fragile bones."
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