I haven't weighed in on this list for about 8 years. My beloved husband, George Martin, passed away on this day in 2012, but not before benefitting more life giving information from this group than I can list. He lived 7 good quality years with advanced PCa.
Today I have 2 questions:
1) Does anyone have/know of a dosing schedule (maybe metronomic) for zolendronate infusion? Our daughter has Stage 1 breast cancer and must have Zometa, but none of the drs know about reducing the individual doses. She needs some official reference article in order to convince the medical establishment that she didn't just make this up to annoy and challenge them.
2) Is it typical/possible for someone with what his son describes as "mid-grade level" PCa who had radiation and some sort of "chemo" (they really don't know except he received injections, which I believe could have been one of the various testosterone blockers. He now takes no treatment. I'm thinking PCa clients must take the periodic shots to keep their PSA score low.
Please fill me in if anyone knows the answers to my questions, and will provide an official gradual dosing schedule for zolendronate. Thank you.
Best wishes for continuing remissions, a healthy life, and years of happiness.
Sandy
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Sassy45
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God bless , you and your family ,have most definitely been through it. I don't know the answers to your questions. But there are some incredible people on here, that l would think that do. Sending love & hugs that you get the correct advice. SheilaFxxx
However, none of those had follow-up longer than 2 years. So a new clinical trial has been started in Canada to determine if it is still safe for patients treated for more than 2 years.
"And you and I have heard many people say, "Well, maybe we don't need to treat them that intensely. We can maybe spread out the number of doses." And we actually did it in several analyses, and when you dose de-intensify, the risk of these events increases significantly and so, I think in that state, every four weeks remains important. The question is how long? And, obviously, people are worried with long exposures of osteonecrosis of the jaw, among other issues, and so personally, after two years, we take a step backwards."
2) His father probably had intermediate risk PC for which he was curatively treated with radiation and adjuvant (limited term) ADT. It's not at all unusual.
Not a doctor, but a survivor, I might be able to clear up some of your confusion regarding your son. Correct me if I am wrong, anyone, please.
ADT (android deprivation therapy) which you refer to as "hormone blocker", I have occasionally seen considered a "type of chemotherapy", as it is a "chemical therapy". also called "hormone therapy", It blocks testicular production of testosterone by controlling the pituitary gland in the brain. It can be applied in either intermittent doses (as needed to control PSA), or continuously, depending on the patient/physician decision. Sounds like your son is applied intermittently. Intermittent application is every three months for three injections, while continuous is every three months forever. Whether to go intermittent or continuous really depends on the Doctor/patient's judgement regarding what level or rate of increase in PSA is acceptable. Scan results also factor in the decision, so it is a complex but orderly decision that requires experience, monitoring, and judgement. Your son's PCa must be hormone (testosterone) sensitive at this time, meaning it is under control while testosterone is low, but could rise if T increases, that is, as the ADT wears off.
As for your daughter's dose question, as I understand it, dose is pretty much standard, based on effectiveness. So dose might be changed depending on whether the cancer grows or shrinks. spreads or retracts. Side effects might factor in.
It is essential that we "annoy and challenge" our doctors. We are our own best advocates (thank you Rick Davis). Pursue second opinions. Dr Pamela Munster at UCSF is a great resource for breast cancer patients. You can get a telemed appointment with her, without having to go to San Francisco.
For all patients facing hereditary cancers you will find useful info from facingourrisk.org
If the aim is to decrease the risk of osteonecrosis of the jaws, I am not aware of any studies demonstrating decreased risk from decreased dosing. There IS evidence of increased risk based on the length of therapy. Also, the half-life of bisphosphonates in bone is measured in years. This is obviously going to be far longer than the half-life in circulation. So I suspect that the total dosing is more important than the specific schedule with regard to this specific risk.
In any case your daughter's oncologists should be able to answer her questions, including explaining the need for a given dosing schedule.
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