strontium or reclast

[Radars]

I have been reading some really good results from people taking strontium, I have had 1 reclast infusion last April, would it be ok to take strontium citrate while on reclast or would I have to stop reclast, any help please.

[Tall_Allen]

Strontium replaces calcium in bones and may be the opposite of what you need. Discuss with your oncologist before taking anything.

[Radars in reply to Tall_Allen]

what do you mean the opposite of what I want it can't be any worse than reclast which only strengthens old bone, and later makes it worse, there's people on strontium who have had osteoporosis meds with good results.

[Tall_Allen in reply to Radars]

I mean strontium makes bones fall apart. Just because you see patient anecdotes doesn't mean it's true.

Reclast strengthens bones and prevents fractures. I think it's a good idea to take a break after 2 years if your oncologist agrees.

[Radars in reply to Tall_Allen]

have you read on here about how many people are having really good results better than meds

[Tall_Allen in reply to Radars]

"Read on here"- is that how you study medicine? You have been warned, but you will take any foolish steps you want to. It's your body and your life.

[Tall_Allen in reply to Tall_Allen]

Read this:

americanbonehealth.org/medi....

[Radars in reply to Tall_Allen]

Yeah, but reclast doesn't make new bone.

[Tall_Allen in reply to Radars]

That is incorrect. Well, it allows healthy bones to make new bone and gets rid of excess bone from PCa metastases.

PCa bone metastases make too much bone (osteoblastic) -the excess bone is brittle and fractures easily. Reclast inhibits osteoclast (resorption of bone tissue) activity, so the bone doesn't deteriorate any further, allowing osteoblasts to make new healthy bone tissue.

Discuss this with your oncologist instead of taking idiotic advice from random people on the internet. Self-medicating can harm you.

[corvid54 in reply to Tall_Allen]

There are two sides to bone metabolism - creation and destruction. Both are part of health bone function. Osteoblastic and osteoclastic actions are both essential.

Our bones are not like furniture. They are continually made and reshaped, healthily adapting to muscle and connective tissue activity, adjusting to our needs. Dietary factors - omega-3 oils, calcium, D, magnesium, vitamin K and phosphorus among them are important to bone health - most of those work on the bone production side of the equation. In a seemingly strange quirk, very high D supplementation with inadequate calcium intake paradoxically leads to thinned bones because with inadequate intake coupled with excessive D the body then leeches calcium from the bones. I've seen that with some female vegan and vegetarian patients (those diets can be excellent though if done right).

Old thick bone looks better on DXA but can be more fragile. We used to do that unintentionally w flouride. Reclast, like almost every other osteoporosis drug, slows bone resorption, making them thicker and hopefully also less likely to break. While that can go wrong and even backfire rarely, clinical research does support the benefit of these drugs in cancer patients.

Re strontium although I recommended for a decade + to patients as an adjunct to every else, I share the concern about it. Admittedly I could be wrong. I have seen a couple of studies showing decreased fracture rates with strontium, very importantly not just denser bones on DXA.

With patients over the years I've found using bone metabolism biomarkers helpful in advising how to perfect their diet, supplementation and activities (especially resistance training) to help their bones. When people take medicines that harm their bones, sometimes we have to take other medicines to counter the effects but it is vital to attend to the diet and exercise components.

FYI I am a medical doctor and also a prostate cancer patient (and consequently retiring tomorrow).

[Radars in reply to corvid54]

thanks, do you think I should stick with reclast and not strontium, I have prostate cancer dx 2014 finished treatment in 2016 rt/ht t3b no mo my testosterone has never recovered that's why I have p/c I have asked for some trt but no because there might be some sleeping cancer cells not good with no testosterone but what can you do. with severe osteoporosis you can't strengthen the bones with weight training you have got to be careful.

[corvid54 in reply to Radars]

there is always uncertainty making decisions against the flow. In medicine we draw our best conclusions but they are colored by assumptions and the direction we are led by research dollars. I love evidence. We reasonably presumed that testosterone treatment caused prostate cancer because suppressing it slows prostate cancer. Recent data are showing that it generally does not and it can be safe to administer in some men post prostate cancer hormone suppression. You can strengthen bones with weight training even w hormone suppression. DXA scans are very much like snapshots taken at very wide intervals. They are not sensitive. They are slow and can be misleading. We want healthy, nonbreaking bones. Density is not the same as fracture risk but just one semi-helpful measure. I would try to get blood tested for metabolic bone markers - especially osteocalcin and bone alkaline phosphatase, omega-3, and magnesium as we can influence those markers of bone formation. The tests on the other side of the equation (C telopeptide etc) shouldn’t tell you much right now on Reclast. I dont like taking medication period and find that my profession is not adequately critical. There are though many times when we need to use them.

[j-o-h-n in reply to corvid54]

Welcome aboard Doc, to the Titanic......And Congratulations on your retirement.

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 12/28/2023 5:48 PM EST

[tango65]

Do you have osteoporosis (T score < -2.5) or is your cancer castration resistant with bone mets or both situations at the same time?

If the cancer is castration resistant with bone metastases the recommended drugs are zoledronic acid and denosumab.

If you have only osteoporosis you could use the same drugs or other medications, so consult with a doctor.

If you have just osteopenia without castration resistant cancer with bone mets, no treatment is indicated.

[Vangogh1961]

americanbonehealth.org/medi...