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Jul 08, 2018 - 7:56 pm
Hello, all! My dad was diagnosed in October after a spine fracture sent him to the ER, caused by bone metastasis. Surgery and radiation on the spine eliminated the pain. Last week, discovered a stress fracture in the hip. No surgery recommended, 15 rounds of radiation ordered. He is on quarterly Lupron and daily Casodex. Hot flashes and bone pain are primary complaints. I guess my question is, when would be appropriate for administering a new Rx for bone strength and what has been your experience with any of those? Oncologist recommended calcium + vitamin D supplements. Hormone therapy is working (PSA falling- 60 at Dx to 6 at last check) but don’t want to waste a chance to intervene on osteoporosis early if possible. He is now at a research hospital with a new oncologist and we feel great about them! He recently turned 60 and is in good overall health aside from PCa. |
Joined: Aug 2014
Exercise for sure
Several on this Forum have mentioned Prolia (denosumab) to counteract osteoporosis.
Personally (diagnosed with osteoporosis of the spine and osteopenia in my hips), I had an infusion of zoledronic acid (a bisphosphonate) and continued with daily vit D and Ca supplements.
I also joined an exercise group (2x a week; Bone Builders). One or the other did improve my DEXA scan results.
Clearly, my situation (no metastasis and no fractures) wasn't as dire as that of your Dad, but I do recommend a multiple approach to strengthen his bones. In that context, XGEVA (also denosumab) is closely related to Prolia. Not sure which one would be better for him; his oncologist should know though.
Xofigo is another drug that is used. It's a radiopharmaceutical that hones in on metastatic lesions.
All the drugs mentioned have side effects! I repeat the recommendation for weight-bearing exercises.
Joined: Oct 2017
Did you have any trouble with
Did you have any trouble with the Zometa? I don’t think we are there yet, just wanted to make sure we are armed with the right questions once we do get there! (A Prolia commercial came on my TV while I was typing this. Maybe it was a sign! Haha.)
Joined: Aug 2014
No side effects for me
But they do happen to a minority of patients. THe best known one is ONJ (osteonecrosis of the jaw). I discussed this issue with my dentist. He pulled up the latest recommendations of the ADA (American Dental Associaion) about this and we both felt that the chance of a bad side effect was reasonably low for me.
https://www.ada.org/en/member-center/oral-health-topics/osteoporosis-medications
However, if a patient anticipates a major dental procedure, it should be done well prior to administration of zoledronic acid or Prolia.
PS: I choose zoledronic acid over Prolia because it is available as a generic and Prolia is expensive. It seems though that Prolia is preferred by others.
Joined: Jan 2017
Prolia for Osteopenia
Hello, new to forum. I had a bone scan done in May 2018 found Osteopenia in left thigh. Doctor wants to put me on Prolia. Trying to decide. Have read about people having terrible side effects. Already on Lupron and doctor wants to add Apalutamide. (More side effects.
Joined: Oct 2017
Oncology hasn’t recommended
Oncology hasn’t recommended it yet for my dad, just calcium + vit D and I’m going to make him some homemade berry gummies with gelatin. I suppose you won’t know if you’ll have side effects until you try it. I hope you aren’t in much pain!
Joined: Jan 2017
Prolia
Thanks, no real pain yet, also on calcium and vit D. I think that bone loss and other side effects are from the Lupron hormone shots. All of the listed side effects just worry the heck out of me. Have enough just from the Lupron.
Joined: Oct 2017
Yep my dad’s bone health was
Yep my dad’s bone health was fine prior to Lupron / Casodex, and side effects aren’t fun— that’s why I came here to talk about Prolia/Xgeva/etc. I’m hoping supplements help so we don’t have to introduce potential new side effects. It’s been a long 9+ months with this.
Joined: Jan 2017
Prolia
Ya bone problems just found this year. Had RP 1/2016, been on Lupron since 9/2016. Side effects ie.. mem loss, weakness, tired. Now doc wants Prolia which has similar and new side effects. Hard to decide, other meds for bone loss not much better in reguards to side effects. Maybe I'm just worring to much? Read on other web sites about people having horrific side effects. Havent found much here.
Joined: Aug 2018
My husband is on Xgeva and
My husband is on Xgeva and has been since he was diagnosed in Dec 17, he is stage IV w mets to bone, lymph nodes and lungs, PSA was 1550. Is responding well to hormone therapy and the Xgeva has not caused any issues so far.