Brittle Bones

[OFPF16]

62 y/o aPC with Mets. I’ve been on the Lupron, Abiraterone, and Prednisone treatment for about 7 months. I just broke a rib leaning on a chair. Do these drugs cause your bones to become easier to break? Luckily I get an MRI and the PSMA PET Scan tomorrow. Should be interesting to see I hope. Thoughts? Thanks! I hope everyone has a great and Happy New Year....Cheers!

[GP24]

This is not caused by seven months of ADT. You can get a bone density measurement to see if you have lost bone mass.

[6357axbz]

You need a dexa scan to determine your bone density. You may have osteoporosis

[Tall_Allen]

Get a DEXA scan to check your bone mineral density. Did the rib break at the site of a metastasis?

[OFPF16]

Thank you for your thoughts! I meet with my Onc tomorrow after my scans. I’ll find out exactly where the break occurred. The Dr wants to run additional tests tomorrow due to the rib issue! We will see where this new adventure takes us! Thank you!

[Hidden]

Yes, adt causes castration and that hits first the muscles then bones and teeth. After 4 yrs of osteo depletion -25% 1 st 2 yrs then -15% the next two on dexa scans I was started on prolia . Two yrs later I got a non displaced fracture on l-3 rib. I didn’t even know it . I thought the prolia was to stop fractures? For some of us it’s dammed if you do dammed if you don’t . Dx d n 2015 I did Lupron for two yrs then an orchiectomy let me drop Lupron .I’m 61 now . I stayed on a now failed test adt drug until seven months ago . I’m not on adt for the first time and I dropped prolia too . I’m thinking I might start it again? My new mo is wishy washy on it !

[Grandpa4 in reply to Hidden]

It is important to know that you can not stop Prolia with adding a bisphosponate for a time. This was discovered about 5 years ago. Bone densities drop dramatically when you do this. If you want to stop you would take a bishosphonate for a year then stop. I would get the opinion of an expert in osteoporosis. The other point is that Prolia is there to prevent fracture but only reduces the risk by 50%. It is not perfect.

[Hidden in reply to Grandpa4]

Thanks Grandpa4! I’ve heard this . I’m off to my new mo today . I’m going ask him for prolia again . It’s not perfect , but what is? Take care .

[Grandpa4 in reply to Hidden]

me too. I got stress fractures in my sacrum from pickel ball.

[Hemoon]

the treatment can definitly decrease bone mass. When I started treatment, prolia was started too. Doc also told me to start taking calcium supplements with D3 every day as well. The vitamin D helps calcium absorb into the bones, because it does not absorb easily on its own. In addition, putting pressure on the bones on a consistent basis was also recommended . Since you have this break I'd definitely get the density scan first and work with your doctor before doing that though, since you had this break.

Wishing you the best

[KocoPr in reply to Hemoon]

Vitamin K2 causes calcium to be absorbed into the bones from your blood serum not the Vitamin D. Always take K2 with vitamin D

[sjc2 in reply to KocoPr]

How much K2 should he take? He's been on calcium and vitamin D, since ADT started and also on Prolia.

[KocoPr in reply to sjc2]

im not sure of the best ratio but i use dr bergs Vitd with K2 and here is the ratio they use

Dr. Berg's Vitamin D3 K2 w/ MCT Oil - Includes 10,000 IU of Vitamin D3, 100 mcg MK7 Vitamin K2, Purified Bile Salts, Zinc & Magnesium for Ultimate Absorption

[KocoPr in reply to sjc2]

here is a cardio doctor i watch often. He is amazing. Also this video he taljs about K2 and calcium. Also go into descriptions and he has the links to several studies including “epic” study

youtu.be/z3njgh2nFRk(Not working as expected?)

[edgeh]

When it is known that ADT causes osteoporosis, why is a DEXA scan given always too late? In my case, Bicalutamide and Eligard for 4 years, loss of muscle mass, and after 4 years, doctor orders a DEXA scan. Too late. High risk of hip break, osteopenia in spine. Now on 6 month Prolia injections.

[Hidden in reply to edgeh]

Agreed! Why? Did my mo let me slip into osteopenia for 4 yrs before Prolia? It seems that preventive would have been better . After two years on prolia I re-gained 10 % density ..After a lose of 35% .. I also started bone nutrients with the prolia ? How can one regain the loss ?. Beyond that? I dont think it’s possible without testosterone?

[Grandpa4 in reply to Hidden]

in my case I did get one before starting.

[MateoBeach]

Those of us who have APC and do not have bone Mets yet? 90% will get them by the journey’s end. So get out ahead of it and protect those bones from weakening and maybe from mets by starting Prolia or similar early. That is my opinion as I have discussed previously.

[SkylerG]

I took a break from Lupron (ADT) after my PSA was down to 0.4. That was 4 years after diagnosis and a round of docetaxel. I knew something was going on around my right shoulder AC joint as there was a bit of pain to the touch. I was too busy setting up my wife's new Esthetician Studio April 2021 after the first round of Covid was lifting to see my doctors. I was on my knees and leaning forward when I heard it snap. No need to call Elon to see stars. Turned out I fractured my clavicle. Who knew the mets had gone there and turned that bone brittle!! I was eventually put on Zometa injections to strengthen all my bones. I have one or two more infusions left in the 2-year therapy. I know it has helped. You will most likely be offered that as well. If not, ask about it. Good luck!

[spencoid2 in reply to SkylerG]

i also had a pathologic fracture bumping a wall at a met site

want to hear more about Esthetician Studio April 2021

[KocoPr]

Here are a few articles on the roles of Vitamin D, K2, and calcium on bones health.

ncbi.nlm.nih.gov/pmc/articl...

lifeextension.com/search#q=...

[edgeh in reply to KocoPr]

Thank you. It appears that vit d + k2 are essential in working against osteoporosis. The article also briefly mentioned the incidence of high alkaline phosphatase in conjunction with osteoporosis and the benefit of k2 in reducing the ALP. I wished a doctor had educated me on these facts somewhere along the journey.

[KocoPr in reply to edgeh]

unfortunately that’s not in a doctors training. A Naturopathic doctor would know, but it is mandatory for one to be there own advocate and research research and research.

[cancerfox]

Doesn't seem like only 7 months of ADT in itself would cause enough bone loss for a rib to break. Maybe you had osteoporosis before the ADT, or something else is going on. Perhaps a bone scan would give you some answers if the scans you are already getting don't. 🦊

[Abcsoup73]

My father has had three vertebral compression fractures due to osteoporosis/Lupron injections. Be well.

[KocoPr]

Estrogens may play a more important role in bone health during ADT treatments.

Published online 2020 Jun

Pathophysiology of Bone Loss in Patients with Prostate Cancer Receiving Androgen-Deprivation Therapy and Lifestyle Modifications for the Management of Bone Health: A Comprehensive Review

ncbi.nlm.nih.gov/pmc/articl...

Accumulating evidence supports the hypothesis that compared to testosterone, estrogen plays a more influential role in the regulation of bone metabolism in males [24,25,26].

[OFPF16]

All.. thanks for the outstanding replies. For me it’s been a very good thread since I didn’t know most of what everyone wrote about, I do now, thanks! For an update, the prostate MRI I received last week, showed a reduction in size. The PSMA PET Scan only highlighted 2 of the 7 Mets. (BTW, how do I explain that to people? It’s not called durable remission is it? ) The rib issue was reported to me to be cartilage movement. There was no evidence of a fracture or crack from the X-rays. The rib pain is on the other side from where my met is in the 9th rib so that is a relief. I learned I need a Dexa Scan and I should probably consider taking vitamins D and K2. This might help my cholesterol levels since I’m already on Lipitor and Zetia for high cholesterol. Thanks for taking the time to reply to my concerns during the holidays. This group means a lot to me!