Treatment Options

[Carplake]

I have MPC . My PSA was as high as 102 6 months ago. I have been on Lupron for 1 year and and had to stop xtandi for arrhythmias. I have added amiodarone to my intake list and it seems to be working, no more arrhythmias. I have started back on xtandi 3 months ago. My PSA is now 0.2 My OC wants me on prolia now. My question is shouldn’t I have a bone density test first? And second if the bone density is good should I even have to take prolia at all?

[Tall_Allen]

Prolia is for non-metastatic men, Xgeva or Zometa for men with metastases. Certainly have a DXA scan first. How many bone metastases did you have? Painful? A new study from STAMPEDE (not published yet) showed early use of Zometa can prevent fractures.

[Carplake in reply to Tall_Allen]

thank you Tall-Allen. I have left and right pelvic metastases and sternum. No pain. Does Zometa have less side effects than prolia and is there a cost issue?

[Tall_Allen in reply to Carplake]

It sounds like you don't have a lot of bone metastases, and if your DXA scan shows normal BMD, you may not be in any danger of a fracture. I think the side effects are similar but increase with time taking the drugs, so it may be prudent to not use it until you need it.

[Carplake in reply to Tall_Allen]

Thank you Tall_Allen

[Hidden]

As we age, and 82 is certainly when the category for risks of falls and fractures. Injections may be precautionary or not. A Dex Scan would certainly reveal your bone health at this time. Case in point, my WWII Army Nurse mother started scans at 80; she lived until 101 with Breast Cancer. Congratulations on being 82. Wishing you many more years. Enjoy life, you deserve it.....

Gourd Dancer

[Carplake in reply to Hidden]

Thank you for your words of encouragement

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

I wish to thank you for your mother's service in the military. Those Army nurses were a God sent during WWII. May she be with the angels smiling down on you every minute of the day..... God Bless Her...

j-o-h-n Friday 05/05/2023 9:45 PM DST

[NecessarilySo]

I am taking Prolia every 6 months for past couple of years because my bone density scans T-score showed an increase in 2020 from -2.3 (ostopenia) to -2.6 (osteoporosis), after many years on and off of Lupron. My latest bone density test 12/22 showed that the Prolia, plus 5k Vit D3 daily, reduced my bone density T-score to -2.3. I suggest you derive your own conclusions.

[Carplake in reply to NecessarilySo]

Thank you for your comments. I do take 6k of v d3 daily and 21k vitamin C daily.

[Kevinski65]

Here is what I learned about Zometa vs Prolia. Zometa goes through your kidneys, Prolia does not . They’re both effective. Prolia is more expensive. As far as Zometa is concerned you can only take it for 5 years. First time you take either you might develop a fever. Reclast is the generic form of Zometa. I don’t know how long you can take Prolia.

[Carplake in reply to Kevinski65]

Thank you for your reply

[Carplake in reply to Kevinski65]

Thank you

[FigureGround]

For some people, myself included, Zometa can lead to osteonecrosis of the jaw (ONJ). Another approach to bone health could be low-dose estradiol gel.