Get a bone density test if you have PC and are taking Abiraterone etc

[Derf4223]

ADT leads to accelerated bone loss. So does being 70 years plus of age. A bone density test is painless and quick and can see signs well before osterporesis fractures etc. I'm on 5 months of ADT (Firmagon first, RT with Lupron, then after RT added Abiraterone plus Prednisone.) GLTA

[monte1111]

i am typing with one hand because of sprained wrist. very painful. had t12 compression fracture almost 6 years ago. i still have 6 teeth.

[DJBUNK]

My MO ordered a Dexa scan at the beginning of my ADT. Interestingly, when I finished ADT 2 years later, he said I didn't need one then but should get a scan in a year (which will be next spring). I had heard that a bone density scan should be done after ADT so I was surprised when he said I should wait.

[MateoBeach in reply to DJBUNK]

suggest you insist that you want it now. So you can start appropriate protective therapy if needed promptly and not a year down the line.

[DJBUNK in reply to MateoBeach]

Thanks MB, I'll do that. Looking back at my baseline scan T scores, all are normal (between 0 & -1) except my lumber region (L1-L4) which is +2.0. From what I can find, the +2 indicates that my lumbar bones are much stronger than normal so I assume I'm in good shape (or was at the time of the scan).

[Huzzah1]

Yes, I'm only 5 months into ADT but requested a DEXA Scan just after I finished IMRT to get a good base line. All is well so far.

[Emmett50]

My husband started ADT in February 2018 and continued that until March 2020. Unfortunately, he developed osteoporosis. He now has PCa recurrence confirmed by recent CT scans and PSMA. No treatment has started until results from L3 biopsy and inguinal lymph node biopsy on Monday.

Besides the risk of broken bones, osteoporosis may affect the ADT used. He is not castrate resistant but he can't use Casodex. We will know more after the biopsies. Also, he needs two top front teeth implants and that's gotten complicated with this recurrence.

My suggestion to any man on ADT is to do weight bearing exercises. My husband started way too late in the game.

[edgeh]

Just discovered after a DEXA scan and four years of bicalutamide and Eligard that l have osteoporosis in spine and hips. I was scheduled for a hip prosthesis but it's now questionable if l can proceed.The first line defense is weight bearing exercise but if you are in danger of breaking bones the hip etc., is this advice not contradictory?

[London441 in reply to edgeh]

‘Questionable if I can proceed’ is a question you want answered asap. Getting a hip replacement when you need one is more than a little desirable. Hopefully you have a orthopedic surgeon who is experienced in treating osteoarthritis in osteoporotic patients.

[MateoBeach]

DEXA scans can offer much information besides bone density. With the same scan they can determine or calculate. Total and appendicular (arms and legs) lean body mass (essentially muscle) and total and vis eral body fat mass. These are also important and very pertinent to ADT, diet and exercise regimens.

However, some DEXA centers only report the bone density scores. Find a DEXA center that gives the complete report.

[London441]

I think we should get regular Dexa scans (every year at least) if we have taken or are taking ADT drugs. Doctors don’t always order them at diagnosis, which is negligent, and even more often don’t order follow up dexas later.

You can always get one on your own, you don’t need a doctor’s order.

Regular Dexa scans are very important. As has been noted, so is weight bearing exercise. Unfortunately, some guys include walking and running in that category. Great as those activities are, they are not weight bearing by proper definition.

Calisthenics, bands or especially weights are essential for protecting bone strength. This is true of all older people regardless of the presence or absence of disease and their treatments.

[NewPotatoCaboose]

I had one earlier this year and was officially diagnosed with osteoporosis. I've been on Orgovyx around 13 months. But because I have a n On-X aortic valve replacement and have been on warfarin since 2013, I was not surprised. So I have 2 drugs attacking my bones. And warfarin is the only blood thinner approved for my valve.

[Teacherdude72]

I get a dexa every two years. On Lupron & Nubeqa. Former for years late 8 months. Vitamin D every day.

[garyjp9]

I was unaware of this forum when I started ADT/Zytiga/Prednisone in 11/20. My MO at Hopkins never mentioned a dexascan, and I did not know to ask for one. I did not have one until 6 months into the ADT treatment, just before radiation, and only by asking for it. It showed osteopenia in my lumbar spine, but no one mentioned the possibility of adding a bone strengthening agent. In March, I suffered a collapsed L-4 vertebrae lifting an object that was not heavy at all. Only then did my MO add Prolia to my drug regimen. Once you break one vertebrae, you are at high risk for breaking others down the line. My sense is that many MOs are negligent about monitoring bone health during ADT.

[dockam]

Hi y'all, been on ADT since 01/2015 and This is my DEXA results from 06/21:

Low bone mineral density (Osteopenia) with low risk of fracture, no

Rx recommended. No treatment required, letter sent to patient.

FRAX - Ten year risk for hip fracture: 0.5%

FRAX - Ten year risk for other major osteoporotic fracture: 3.2%

and this is compared to the 2018 DEXA:

BMD CHANGE from DXA on 08/06/18:

4.3% AP Spine L1_L4

5.7% Femur NECK Left

-2.2% Femur TOTAL HIP Left

-5.9% Femur NECK Right

-5.1% Femur TOTAL HIP Right

-0.7% Forearm RADIUS 33 Left

Treatment Recommendations (Men and Women):

All Patients: Calcium 1,200 mg/daily; vitamin D 1,000 IU/daily;

Weight-bearing and muscle-building exercise; Counsel to stop smoking.

I do body weight workouts, elliptical, calisthenics, weights, and pm hikes

Fight on, Hike on, Cardio On

Randy