bone mets

[dnmrk]

Does anybody here has obsteoblastic lesion on the first diagnosis then osteolytic and sclerotic lesion after some few years on bone mets? How are you managing bone mets? Xgeva? Zoledronic acid? Xofigo? Appreciate your inputs in here.

My dad is on 1st line ADT since 2021 and just started 2nd line(abiraterone) last month.

[Tall_Allen]

Osteoblasts is sclerotic. Lytic is rare.

[6357axbz]

I only had 3 bone mets. All zapped (MDT).

[j-o-h-n]

I hate to be a PITA but would you please provide us with your Dad's bio. All info is voluntary but helps us help him/you and helps us too. Thank you! BTW good idea to copy/paste it to his UserID bio area.

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 10/27/2023 8:18 PM DST

[Seasid]

If he is still in a hormone sensitive prostate cancer phase and his Dexa scans don't show osteoporosis than your bone Mets are still healing and you don't want to interrupt that process.

As a result of low testosterone his dexa scan results will worsen if he is not doing weight bearing exercise.

I am doing running only if I feel well.

I have no plans of starting Denosumab as it would interfere with bone healing.

In a castrate resistant phase of the cancer you could consider using this bone medication if your blood calcium levels go up and the cancer treatment will not stop a growing bone Mets.

That last phase in prostate cancer you could use Denosumab etc. In order to halt the high calcium levels in your blood when everything else fails

Denosumab does not prevent Mets forming.

If you are unlucky and you break a bone than bone strengthening medications will negative interfere with bone fusing and healing.

If you are osteoporotic on dexa scan and your are in a CRPC phase with lots of bone Mets than you could consider Denosumab.

Talking to your doctor and asking him questions would help you to make a proper decision. Everything depends on your specific situation and your preference.

Before starting Xofigo it is highly recommended to start Denosumab in order to prevent alpha radiation induced fractures.

Your first step should be to get a dexa scan now and use it as a baseline.

Try to improve bone density with exercise, exposure to sunshine and calcium rich diet.

Some people could lose bone density even on bone strengthening medication if they don't exercise.

If your baseline dexa scan is bad than you should go to an endocrinologist to eliminate all the reason for low bone density other than a lack of testosterone.

Don't jump into Denosumab if you don't need it.

If you should stop Denosumab than you should switch to zoledronic acid if you can tolerate it.

After stopping Denosumab you could be more fracture prone in your spine.

You could stay on prolia up to 10 years.

Only 8 % of people with osteoporosis are on a bone strengthening medication. They usually rearrange their life and home to avoid falling.

With growing bone Mets it is a totally different situation and you should ask for input from your medical oncologist.

Good luck

[Amadeus71 in reply to Seasid]

Hi Seasid,

Do you have links to studies or articles to support your comments? I searched and wasn't able to find much. Any additional info would be appreciated.

Thanks!

[Seasid in reply to Amadeus71]

Could you ask your doctor? I really don't have any information.