Very important to ALWAYS use a bone-strengthening agent with Xofigo

[Tall_Allen]

I added a section to my article on Xofigo, highlighting the results of the REASSURE trial. They used frequent whole-body mpMRI to show that all men who are on long-term hormone therapy for mCRPC should be taking a bone-strengthening agent (like Xgeva or Zometa) but particularly if they are using Xofigo.

prostatecancer.news/2021/02...

[Ahk1]

Thanks, TA. Does this also apply for those who are still sensitive to ADT please ?

[Tall_Allen in reply to Ahk1]

No - Xofigo is not indicated for men who are still hormone-sensitive. It is only indicated for men who are mCRPC, symptomatic, without visceral metastases.

[Yorkielover2 in reply to Tall_Allen]

Thanks for the information. Still doing research also waiting for consult on this treatment.

[cesanon]

Thanks.

Your blog is getting better and better.

[wpopomaronis]

Thank you

[MiRob]

Thanks TA for this impressive overview

[Tall_Allen]

פקוח נפש

[Haniff]

Thanks for sharing ❤️

Haniff

[MateoBeach]

Side question regarding your excellent summary, Allen: I notice so many men report seriously painful side effects from their Zometa injections. Since it is a bisphosphonate, could a lower potency orally available bisphosphonate reasonably be used instead? Such as the very inexpensive Alendronate and others at appropriate dosing schedule?

[CSHobie in reply to MateoBeach]

That's a great question. And also thanks TA for very thorough writing

[Tall_Allen in reply to CSHobie]

Mateo Beach and CSHobie:

In that study in the UK, they mention that their current protocol is to .use alendronate. Bisphosphonates increase bone mineral density (BMD); however, Zometa and Xgeva have demonstrated superior results in preventing fractures and spinal compression.

Although it doesn't help with injection-site reactions, Fred Saad advocates a vacation after 2 years. The most serious side effect, osteonecrosis of the jaw, increases with duration of therapy.

Another possibility is the combination of an estrogen patch and weight-bearing exercise. Estrogen and exercise increase BMD, but I don't know if it will also prevent fragility fractures from long-term ADT use. I would guess they would, but this requires further trials.

[garyjp9 in reply to Tall_Allen]

TA, does Fred Saad similarly recommend a vacation after 2 years on Prolia? How long should these vacations last, if you still have osteopenia or osteoporosis?

[Tall_Allen in reply to garyjp9]

I really don't know. Prolia might be weak enough and given infrequently enough to lower the risk. But is it working for you?

[garyjp9 in reply to Tall_Allen]

Yes, but for the moment I am on a drug holiday, which certainly helps, as well. G

[Johnstonearch]

PLEASE, research BRONJ Bisphosphate related Osteonecrosis of the Jaw. It only happens to some 10% of us but I almost lost me mind with the pain for over a year when my mandible, the horse shoe shaped bone that hinges just below your ears started to die. Ask your Doctor if he is aware of that risk. Then decide for yourself. Zometa almost killed me buy I am 21 years out now from a terminal diagnosis and getting along just fine.

[Tall_Allen in reply to Johnstonearch]

See my reply to Mateo Beach and CSHobie, above. It is controversial to use it while hormone-sensitive - better to do a DEXA scan before deciding.

[CSHobie in reply to Johnstonearch]

John, BRONJ is something I am very scared of. I have a bad root canal in one of my molars, 20 years old already. My dentist says I should do something about it. My tooth is fine, no pain at all, but there is a dark spot in the bone from 20 years of infection. This worries me. Should I just get the tooth removed, or can a re do, of the root canal clear up the bone problem. I am leaning towards getting the tooth extracted. Any comments?

WOW, 21 years out, from a st4 diagnosis, that is amazing. I am 1 year into a 3-5 year prognosis. Still not sure how to plan my future life.

[Johnstonearch]

DO NOT have the tooth extracted. It cost me one year of agonizing pain and 5 infections in a row. Go to the NYU Dentistry website and put in Jaw Necrosis and the finest Doctor/Dentist and Cancer PHD can answer your questions. Even if you have to go to NY do it. That trip saved my life, once again.

[j-o-h-n]

You're getting right down to the bones....

*** To play the video just click on the name of the video ***

youtube.com/watch?v=gvPMVKU...(Not working as expected?)

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 05/09/2021 10:44 PM DST

[ahjab]

How often you're suppose to take xgeva with xofigo? Our doctor told us every three months

[Tall_Allen in reply to ahjab]

Here's what Fred Saad says about monthly vs quarterly:"we did an analysis looking at different centers in Canada, some that give every three months and some that give every four weeks, and we saw that patients that were getting it every three months that needed it, were actually having almost the same event rate as patients not treated at all."

urotoday.com/video-lectures...