Bone density loss

[alperk]

After my second rougue clone radiation I am hopefully looking forward to next blood test which will show PC back in remission. THEN, I get a routine bone density result! Left Femoral neck T Score goes from 1.7 on 11/2021 to 0.3 on 7/2023 to-0.2 on 11/23. If you've read my prior posts I am quite active but 5 miles of daily walking for the last 2 years haven't seem to help. Expecting bone strenghtening drugs in my future. Any recommendations ot thoughts ?

[PCaWarrior]

You could ask about estradiol patches.

STAMPEDE used high dose in lieu of ADT. This isn't your situation but might be useful info.

E2 addresses ADT osteoporosis/fracture risk, lipid changes, fat accumulation, insulin resistance and hot flushes: Transdermal oestradiol as a method of androgen suppression for prostate cancer within the STAMPEDE trial platform

stampedetrial.org/media/187...

1-yr change in LS BMD mean percentage changes were −1.4% and +6.0%, respectively, with an estimated difference between arms of 6.7% (95% confidence interval [CI], 3.7–9.7) in favor of transdermal estrogen therapy. A Randomised Comparison Evaluating Changes in Bone Mineral Density in Advanced Prostate Cancer: Luteinising Hormone-releasing Hormone Agonists Versus Transdermal Oestradiol - PMC

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

Low dose:

0.9mg E2 gel: E2 treatment increases some measures of bone density and bone strength in men and reduces bone remodeling. E2 also reduces FSH; a potential oncogenic hormone: Effects of estradiol on bone in men undergoing androgen deprivation therapy: a randomized placebo-controlled trial – PubMed pubmed.ncbi.nlm.nih.gov/356...

[RyderLake2]

Hello,

I have taken Prolia (denosumab) every six months since my diagnosis ten years and six months ago. I think Prolia is a little easier on the kidneys than Zoledronic acid and other competitive bone strengthening drugs. It come in a 60 mg/ml prefilled syringe. My family doctor does the injection. Hope that helps!

[Kaliber]

I have had over 50 infusions of Zometa and my bone thickness is pretty good. My bones being possibly brittle is another thing. My understanding is that Zometa is well tolerated by most , but some ( me ) experience intense side effects, for up to 8 days after an infusion ( this part is highly varriable from zero SEs to SEs that last 3 weeks or more ) Starts , heavy, around the 2nd - 3rd day. I jokingly call Zometa the “ Zometa pain train “ . I consider Zometa an essential part of my treatment….. both due to bone loss from ADT and because i have Mets at nearly joint of my body. some Mets have caused serious malformations in my knees …feet and spine. Mostly Zometa is intended to address my bone loss from ADT says my oncologist.

❤️❤️❤️

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

Zometa = combination of two Greek words:

Zo = live, Meta = after.

Not a very encouraging name for a med.

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 11/29/2023 7:24 PM EST

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

lol …. Somehow… buddy, when you say it .. it sounds encouraging. Yayahahahaya

❤️❤️❤️

[Tall_Allen]

Too soon for bone strengthening agents. The side effects increase with time on it, and with your very slight osteopenia, there is no need to start it yet.

[alperk in reply to Tall_Allen]

Thanks TA. I had a terrible reaction to Zometa when it was infused 2 years ago when my lowest T score was 1.0 and I was hormone sensitive. I have a new MO now.

[Radars in reply to Tall_Allen]

there are people who do really well on zoledronic acid infusion, bad side effects doesn't happen to everyone there are people who have been on a long time.

[Tall_Allen in reply to Radars]

As with all drugs, the patient has to make a risk/benefit assessment. Before taking it or Xgeva, patients should always look at FRAX/DXA scores, serum Vitamin D and calcium, extent of bone lesions, castration-resistant status, and time on anti-resorptive therapy.

[dixiedad]

Calcium supplement, vitamins D3 and K to aid in absorption. Weight lifting. My last density reading showed 5% INCREASE. Good luck.

[FigureGround]

I was diagnosed with osteonecrosis of the jaw (ONJ) after being on monthly infusions of Zometa for 1.5 yrs, which I subsequently discontinued. (The MO failed to give me a baseline bone density scan prior to beginning the treatment.) I have moved to exercise and transdermal estradiol gel for bone maintenance (and a different MO).

[j-o-h-n]

Legs? It's walking............. Neck? It's necking....... You sure you've been around since 1940?

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 11/29/2023 6:28 PM EST

[FreddythePig]

I'm on Evenity for severe osteoporosis. Due for my 3rd monthly injection next week. So far no side effect other than a bit of soreness near injection site that lasted a couple of days. The plan is for one year treatment. Of course, at this point there is no way of knowing if the drug will help. I walk with a cane and look like a cashew nut.