Skelton brittleness from Lupron

[Burnett1948]

I have been on Lupron for about 16 months. About 7 weeks ago I had a fall on to a hard floor. I landed on my hand. In doing so I twisted my body but didn’t land on body but broke my fall with my hand. I had a X-ray which showed I had crushed my vertebrae. My GP put me on pain killers. We have had a discussion about the effect if any of Lupron. He has told me to discuss the issue with my Radiation Oncologist who I see in early December. He said the Oncologist might be able to give me medication etc to help. It is still debilitating and painful getting in and out of bed. I have been told not to walk distances. So I haven’t been able to exercise for 7 weeks. I am asking for helpful comments please. Burnett1948.

[meowlicious99]

Curious why this is being discussed with an ro vs mo.

Were you able to get a dexa before starting Lupron? Maybe you can compare now vs back then and see if it more than just age related degeneration.

[Burnett1948 in reply to meowlicious99]

The fall happened about 15 mounths after starting Lupron

[Burnett1948 in reply to meowlicious99]

Was not relevant

[Magnus1964]

You should have a dexa scan and if needed, go on xgeva injections.

[Burnett1948 in reply to Magnus1964]

Thanks

[Burnett1948 in reply to Magnus1964]

Thanks Magnus 1964, I am seeing my RO on the 6/6/2021.

[Tall_Allen]

You should have a DEXA scan before you meet with your doctor. 16 months of Lupron is not enough to cause significant bone loss, particularly in a man who has always exercised. Perhaps you can get a NaF(18) PET scan to see if you have significant infiltration into your any bones.

[Burnett1948 in reply to Tall_Allen]

Thank you.

[timotur]

Possibly you had osteopenia/osteoporosis before starting ADT, and it got worse like mine did. I was -1.8 Dexa before ADT, and after 18 months of Lupron it dropped to -2.2, borderline osteoporosis. If you could, try to stabilize the situation by increasing calcium intake through diet and supplements that aid bone formation, particularly calcium, Vit D/K2 (I take a Ca-supplement-- Jarrow BoneUp). Also, it would help to do some non-load-bearing exercise, keeping the load off your spine, such as pull-ups and dips, and exercises lying on the floor with your spine supported. Best-- Tim

[Burnett1948 in reply to timotur]

Thanks

[Hidden]

One of the wonders of Lupron! You need a dexa scan and probably to start prolia of Xgeva if you have bone mets . I had a fractured rib I didn’t know about and all of my joints are collapsing on the recent nuclear scan . Kinda like Humpty Dumpty ! 😳✌️

[Burnett1948 in reply to Hidden]

Thanks

[Burnett1948 in reply to Hidden]

Thank you

[Hidden in reply to Burnett1948]

Hang in there Burnett!

[Burnett1948 in reply to Hidden]

Lulu700. Thats my plan to keep going.

[Hidden]

I am new to all this and not very good at it, started reading these because of my dad, just trying to get a handle on what to expect moving forward, Sir my dad has a lot of outside stuff going on besides his prostatic problem and we were able to find some relief, Is there a way to share in private?

[j-o-h-n in reply to Hidden]

You can send private messages.... Look at your home page to see how. I really think you should post openly for more help... Here is what you can fill out for your Dad..... It is all voluntary....

Please tell us his bio. Age? Location? When diagnosed? Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)?

All info is voluntary, but it helps us help him and helps us too. When you respond, copy and paste it in his/your home page for his/your use and for other members’ reference.

THANK YOU AND KEEP POSTING!!!

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 11/19/2021 10:10 PM EST

[Exrunner]

ADT is known to cause bone loss...and the doctors know this and should have advised you of the side effects of extended treatment. A DEXA scan prior to starting treatment should be SOC but is not to my knowledge. As already mentioned xgeva or Prolia etc. is an option. Life Extension came out with a simple guideline:

"We have recommended that ideal ranges for estradiol for most aging men are between 20 and 30 pg/mL of blood. Below 18 pg/mL increases osteoporosis risk, while levels greater than 32 pg/mL increase heart attack and stroke incidence." [2]

Secondly, it has been pointed out that total E2 will be misleading when SHBG (sex hormone binding globulin) is elevated. free E2 is better, but I don't believe anyone has come up with a number.

My suggestion, where bones were healthy before ADT (but not during ADT), is to use the lowest dose E2 patch that raises total E2 to the LEF 20-30 pg/mL range.

So far I have not found a doctor that will prescribe the E2 Patch.

[MateoBeach]

I have a different, more pro-active view on this. Your spinal compression fracture PROVES that you are already at high risk, regardless of what a Dexa scan will show. ADT causes bone mineral loss, period. You should insist on a bone protecting regimen, denosumab (at the lower Prolia dosing at least, or better at the higher Xgeva dosing especially if you have metastasis). Zometa is also an acceptable option. Calcium and adequate Vitamin D are also important but not sufficient in themselves. Estradiol patches added to ADT help protect bone mineralization while also reducing side effects from ADT.My posture is that every man with APC who is on ADT should be on a bone protective regimen. Caveat is that dental status affects risk of ONJ. See your dentist and have all needed teeth and gum issues addressed first.

[B8ssist]

I was the one who asked my GP for a Dexascan and found out I have Osteoporosis of my spine. Both UOs didn't mention it. So now I am on Boniva for 5 years minimum. I wonder why that isn't a prerequisite before starting on ADT since it is well documented that ADT causes Osteoporosis.

[tallguy2]

You might ask about Xgeva shots to help with bone strength.