Bone Problems

[Lion321]

4 years on ADT and Abiraterone. Had spine fracture and now have osteopenia due to medication.

has anyone else suffered bone issues with this medication.

[PSAed]

I was on Lupron for two years and had BMD scan last year which showed a T-score of -0.8 at the Femoral Neck while it is within the clinically lower 'Normal' range, the report also showed that for a man my age i.e. the Z-score, it should be -0.1 The other test points were within 'normal' but less favourable compared to a man my age.

I am now eating calcium rich foods eg, Cheese,Greek Yogurt, Milk etc and have slashed my coffee consumption (excessive caffeine disrupts Calicum absorption ). I would rather get my calcium from food as opposed to taking supplements as pointed out by others in posts here. But I would not rule out supplements in all cases! I hope to have another DEXA scan this year to see if any improvements.

[Derf4223 in reply to PSAed]

PSAed, for whatever it's worth, I'm roughly in the same boat as you. Last fall after about 6 months on ADT, my DEX showed -1.3 at femoral neck and lumbar. I had been taking Calcium and D from ADT onset. Meeting with my MO, reviewing my DEX numbers, I said "I take maximum Calcium and D3 and exercise". She said I also need BMD medicine, suggested denosumab Prolia, which I have been on since. My next DEX will be in 2024.

Basically, ADT'ers stand no chance of maintaining (let alone rebuilding) BMD without medical help. If one doesn't add a BMD med, one stands good odds of osteoporesis by their late 70's. I saw a chart of bone density by age and gender. Women's BMD crashes after menopause and they get bone problems in their late 70's. Normal non-PCa men's BMD falls at a shallower rate and end up with bone problems in their late 80's.

Here's the kicker, on ADT sans bone medicine, men's BMD crashes harder and can end up with bone problems in their late 70's.

I don't like these facts at all, but tell myself fairly regularly "Suck it up buttercup" and get on with doing what my doctors recommend.

[Lion321 in reply to Derf4223]

thanks for all that info. I’ll definitely take it onboard.

[PSAed in reply to Derf4223]

Thank you very much for that detailed report I will certainly take it onboard and have a long chat with my PCP. I was completely unaware of the need for further medications as I wrongly thought I could repair the damage done just by exercise and diet! I am a bit shocked to be honest as I got little or no medical advice from them as to the seriousness of this issue. Thanks again Defr4223.

[Lion321 in reply to PSAed]

Thats really good news for you. I like the idea of calcium from diet. I have read that Greek yogurt hasn’t as much calcium as plain yogurt.

[PSAed in reply to Lion321]

Yes Low fat ( Plain ) Greek yogurt does have calcium in it , I should have mentioned that,but in addition I use it for the high protein content for my gym resistance exercises as well.

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

Eating Greek yogurt was responsible for me being handsome..... (at least that's what my mother used to say to me)....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 02/07/2023 11:18 PM EST

[Lion321 in reply to j-o-h-n]

Mothers are always right !!!!

[Gearhead]

Sorry to hear that. I hope your spine fracture isn't as bad as it sounds.

Men are often prescribed Xgeva or Prolia (bone-strengthening drugs) when abiraterone or other ADT drugs are prescribed. Were these prescribed for you?

I've also been on abiraterone and Lupron for 4 years. I received Xgeva injections for about 2 years. Stopped because of ONJ concerns. Then fractured a bone in my foot, which may not have had anything to do with stopping Xgeva. Bone scan showed mild osteopenia. So started Prolia injections (same denosumab as Xgeva, but lower dose rate. So I'm extra careful doing things like climbing ladders.

[Lion321 in reply to Gearhead]

Thank you for your reply. No I wasn’t offered anything for bone health. I guess they didn’t know how long I would be on medication for.

I had to arrange my own MRI and Dexa scan.

I’m now taking bonebalance adding more yogurt, milk etc to increase calcium and will have another Dexa scan in the future.

My spine has healed so it’s more comfortable walking now

T

[gsun]

I have been on ADT+ABI for over four years. Some of my bone mets are in the hip socket on the left side. There is osteopenia there and have been on Prolia for three years. It hasn't gotten worse in that time.I'm sure it's the Prolia.

[Lion321 in reply to gsun]

That sounds really good. Side effects worry mr though. Thanks for your reply.

[gsun in reply to Lion321]

I have. had no side effects.

[Lion321]

thanks il definitely look into that.

[TLate]

I was on ADT for two years now off of it for about a year finally got a bone scan and was prescribed Fosamax due to osteopenia in left hip. They could not check the right hip due to implant. I am 63 and exercise frequently, cardio, impact exercises and weightlifting so am hoping the Fosamax, combined with exercise, will help slow the bone loss. I am taking the once-a-week pill.

[garyjp9]

I had similar issues but much sooner. Never given a DEXA scan until after being placed on ADT + Abi + Pred for 5 months. Showed up as osteopenic in my lumbar spine. Doc did nothing more until I suffered a collapsed L-4 vertebrae 10 mos later. Only then did he put me on Prolia, and I had not found this site yet to know better. Too many docs do not pay attention to bone health until some trauma occurs. So yes, I would encourage you to discuss Prolia with your doctor. Sounds like you are doing everything else.

[PSAed in reply to garyjp9]

Sorry to hear about your delayed treatment. I have learned more from this site than all the pamphlets I was given during my Pca treatment. It really is a case of knowledge is power, in our case it means with that knowledge we can be proactive in our treatment.

[Lion321 in reply to PSAed]

you are right but it’s still sad to know that with something so serious we are not being helped and advised as much as we should be.

[Lion321 in reply to garyjp9]

so sorry to hear about that. You must have suffered so much. Thanks for sharing I will definitely push for more treatment.

[garyjp9]

And I was at a first tier center (Hopkins) with a well-regarded MO, so this was probably the norm rather than the exception. I have read about some docs lately who say there should be a discussion of bone health and options with any patient starting on ADT. I agree.

[pe43]

Vitamin D is usually taken along with calcium to prevent osteoporosis.