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Bone Scan and FRAX score

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

I just had my second bone scan with my oncologist. First one was completed at my primary OB's office prior to my treatments March '09, showing "thinning at top of hip area". Most recent one came back marked "normal".

My primary OB who did the first one didn't request this one as it's easier to go with my oncologist. Apparently my OB really wanted me to have it done in his office and get another score called FRAX, then can compare this with first one. When I go on line and research this score, it's drawn off the bone scan....is this correct?

My question, anyone know if they have had the FRAX completed as well? Curious if my doc is just trying to gig me to go into his office and pay out of my pocket to him, or really concerned telling me the FRAX score is the "national standard". I can see his point of view, as likes to do same testing for comparison from first test to second, but I have a trust factor with so many docs.

Chao!

Jan

Rewriter's picture
Rewriter
Posts: 496
Joined: Dec 2009

bother paying out-of-pocket to compare the two scans if your most recent bone scan was marked "normal"? I could see getting a FRAX score if your first scan was normal and the next was not; why mess with a good thing?

Maybe other women here have a different perspective. Good luck finding an answer.

Jill

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

This story gets even more interesting. I called the hospital where the scan was completed and asked them about the FRAX scoring. Lady told me she has NEVER heard of it???? What.... Now that makes me feel even more confused. Suggested I have my docs office call them and possibly speak with one of the technicians.

Next I called my OB's office to confirm next step and to see what they suggest. That RN didn't know what the FRAX score was either, but would check and get back with me, along with my '09 scan and explain further and how to get FRAX from hospital.

Crazy isn't it...just another issue I just learn to handle. Yes I do agree, why bother if my bone scan was NORMAL. Should be interesting to see what the scan shows from '09...if it reads "thinning in hip area" then I know this doc is off his rocker worrying about the FRAX scoring.

Thanks so much,
Jan

Rewriter's picture
Rewriter
Posts: 496
Joined: Dec 2009

I found this information, and I still can't understand why your OB would suggest getting this score. A calculation is made for ten years down the road. You're normal now. This is one case where I advocate living in the moment, enjoying your normal bone scan, and leaving it at that. Why borrow trouble? Sure, it's always a good idea to do whatever is necessary to keep your bones strong--as a preventative measure--but wouldn't you be doing that anyway? Just wondering; I don't mean to come on too strong with my opinions. I am NOT a doctor.

General Information about FRAX®

The launch of the World Health Organization (WHO) technical report, Assessment of osteoporosis at the primary health care level1 and the related FRAX® tool are major milestones towards helping health professionals worldwide to improve identification of patients at high risk of fracture. The web-based FRAX® calculation too assesses the ten-year risk of osteoporosis fracture based on an individual’s risk factors and femoral neck BMD if available. The values are entered into the website tool, followed by clinical risk factors which include a prior fragility fracture, parental history of hip fracture, current tobacco smoking, long-term use of glucocorticoids, rheumatoid arthritis, other causes of secondary osteoporosis and daily alcohol consumption. The FRAX® tool then provides a figure indicating a ten-year fracture probability as a percentage, which, together with a clinical assessment, provides guidance for determining access to treatment in healthcare systems.

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

Living in the moment...that's me all the way!!! Isn't that what we're taught to do as cancer survivors/patients...enjoy each day and not worry about future? I'm with you on this doc. He was the one who pursued my cancer diagnosis, etc, which I'm ever grateful, but some things about him I just don't agree and this being one.

When I researched FRAX I did see the 10-year outlook and wondered why fret now as in 10 years it may get better. I've seen women who have osteopenia diagnosis start an intensive exercise program (weight bearing) and up the calcium and vit D levels and see improvement in bone health.

Keep educating ourselves....
Jan

culka's picture
culka
Posts: 158
Joined: Oct 2009

or bone density?
I got both and both came back OK. My first BMD right after radiation was almost excellent. Second in February was significantly worse, but still OK.

Jan, your OB needs some income too, can't you understand that?

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

This is what I had done as yes the bone scan is different isn't it?

Did you ever hear of the FRAX score? Hum...not many people I run into are aware and basically tells me things that "might" occur in 10 years. Doesn't that seem odd?

Oh I know about income for docs and that's why I'm always so taken back when these things happen. Now if he's up front on the testing, etc, okay, but so many just try their best to jab our pocketbooks...not my idea of a good doc!!

Thanks
Jan

Songflower's picture
Songflower
Posts: 632
Joined: Apr 2009

You are getting a bone density. I suspect FRAX score is your risk of bone fracture as you age and other risk factors. I haven't worried about osteoporosis since I got this cancer. I use to take boniva. There is some problems with bone necrosis in the jaw with biphosphenates. I went to a conference about three years ago and they said this bone necrosis only happened in people with cancer, particularly breast. So I stopped the boniva while in cancer treatment. I don't think anyone knows if its best to treat us with our cancer diagnosis for osteoporosis. With a bone scan they give you radioactive dye IV and it checks for cancer of the bone. There is a big difference with a bone density and bone scan.

I think the bone density is given in some OB offices. I think the body bone density is much better than the type that just measures with your foot. I think with all of my problems to worry about that bone density is an "extra" I don't need right now. The last time I went to my regular OB Gyn's office they also had a sign up that give botox. I think they should worry more about finding cancer in women early!
Diane

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

My OB told his RN that not to worry about the FRAX score as the hospital apparently isn't up on that testing yet. But...my bone density shows 'NORMAL' which is excellent!!!

A lot of running around for nothing, as the FRAX scoring isn't as nationwide as my OB thinks. Anyway I'm more concerned with today, vs. 10 years from now on my bone fracture risk. Just glad that 2 years ago the density was "thinning of hip" and today "normal"...think that's a great accomplishment. I bumped up my vitamins D and calcium and weight bearing exercises as the experts have suggested.

Thanks everyone for your input...helped me a lot~
Jan

kkstef's picture
kkstef
Posts: 706
Joined: May 2008

Jan....good job on getting your bone density back to normal....that is great! YEAH!!

Karen

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