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Bone Density, non metastatic, on ADT. What are you taking?

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Posted 8/9/2017 2:14 PM (GMT 0)
A new article just came out:
Bone Health and Bone-Targeted Therapies for Nonmetastatic Prostate Cancer: A Systematic Review and Meta-analysis
/www.ncbi.nlm.nih.gov/pubmed/28785760

My husband is on long term ADT but we were told there was nothing to take for bones.

Anyone who is non-metastatic taking something for bones?

Thanks!
Posted 8/9/2017 2:28 PM (GMT 0)
I did not. I did have several density tests and all were normal and did not indicate any reduction.
Posted 8/9/2017 2:39 PM (GMT 0)
My Onco prescribed taking three 500mg calcium tablets W/ vitamin D. I've been doing that for 5 years, latest bone density test was normal...

I buy a jar of 500 tablets at COSTCO for $6 or $7 ...
Posted 8/9/2017 2:42 PM (GMT 0)

Fairwind said...
My Onco prescribed taking three 500mg calcium tablets W/ vitamin D. I've been doing that for 5 years, latest bone density test was normal...

I buy a jar of 500 tablets at COSTCO for $6 or $7 ...

Same here.
Posted 8/9/2017 2:57 PM (GMT 0)
I took Boniva (once a month dosage) when I was on my HT. I also had a bone density scan prior to starting my HT as a baseline and another at the end to see if there was any loss. (Turned out there was no loss over the 18 months I was on HT.)
Posted 8/9/2017 3:17 PM (GMT 0)
Hmm, now I'm feeling unlucky.

My baseline DEXA scan was normal. After 18 months on Lupron+Casodex, a repeat scan showed osteopenia (T of -2.3), just a couple tenths of a point away from actual osteoporosis (T of -2.5)! That was a fast drop in density. Admittedly, I wasn't exercising much, and not conscientious about calcium or D apart from regular multivitamins.

So, we started Prolia (denosumab), once every six months. Prolia has a specific usage indication for men on hormone therapy for prostate cancer. It's expensive, and requires insurance pre-approval (my Blue Cross policy), so it was a bother. Had to get a "clearance letter" from my dentist to verify I didn't have any expected major oral work since osteonecrosis of the jaw is a risk of that treatment.

Also, I started a strenuous weight-bearing exercise routine twice a week after that initial surprise, and have a fairly active job. I take 1200 mg Calcium daily, plus 1000 units D3.

Two years later, and about 8 months after the end of hormone therapy, my bone density was somewhat improved (T of -2.0), though still osteopenic. We stopped the Prolia, too. I'll get a DEXA density scan every two years to monitor this.

If hormone therapy has to be started again someday, I'll probably go for the Prolia right away. For some reason, it seems my bone density is more at risk from it than most. Yay.
Posted 8/9/2017 4:08 PM (GMT 0)
My baseline was -2.1. Because of other digestive issues, didn't take heavy calcium. My blue shield did not cover prolia so I have been on zometa IV every 6 months. Haven't had my post treatment dexa scan yet.
Posted 8/9/2017 5:20 PM (GMT 0)
He can take Prolia. It's the "lite" version of Xgeva. It's specifically indicated for non-metastatic PC. He can also take any of several bisphosphonates. He may not be able to get Zometa, but there are several others.
Posted 8/9/2017 8:46 PM (GMT 0)
I had a Dexa scan twelve years ago following a severe leg injury and was osteopenic. Fast forward to HT and I requested another Dexa. My GP told me I am still osteopenic but as neither doctor told me the numbers I don't know if I am better or worse. I investigated Prolia but declined that therapy due to the risk of ONJ. My dental hygenist applauded my decision, and told me her father is stage 4 PCa and has lost teeth due to ONJ. My oral surgeon recently told me that if I'd had bisphosphonates then I would never be able to have any oral surgery.

My RO suggested that I get a personal trainer and exercise to build bone. Unfortunately that would probably require four healthy limbs. My GP, who is a little more familiar with my situation, prescribed 5000 units of vitamin D daily. I take 2000 plus calcium. I figure it's a fair compromise.

When I was told by my Uro last month that I would be on HT for three years I began to worry, but then my RO told me a couple weeks ago that it would be only one year. So end of this year, I'll finally have that monkey off my back. For now I try to be very careful how I walk... learned that the hard way twelve years ago. Hopefully no trips or falls and no broken bones. Taking these things one at a time.
Posted 8/9/2017 9:50 PM (GMT 0)
FYI, for whatever reason my insurance would pay for Boniva, but not Prolia. Maybe just one of those weird insurance things, but we unsuccessfully pushed back on that...
Posted 8/10/2017 3:08 AM (GMT 0)
Thanks so much for your response JNF, Fairwind, Michael_T, John, RobLee, Redwing and Tall Allen.

Redwing, your experience has certainly encouraged me to ensure my husband takes something, although he does weight bearing exercises most days. I'm glad you managed to turn it around.
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