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Prolia For Prostate Cancer ?

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Posted 12/9/2014 10:09 PM (GMT 0)
Hello !

My oncologist wants to give me an injection of PROLIA to strengthen my bones. I just finished chemotherapy (Taxotere) treatments last month and am also on ADT (Lupron) hormone shots.

He is concerned about bone strength, due to the long-term effects that ADT has on bone density.

Have any of you had PROLIA shots to boost bone density ?

Did you deal with any adverse side effects from the PROLIA shot ?

Thanks for any light you can shine on this question !

My best to all,
Cyclone
Posted 12/9/2014 10:28 PM (GMT 0)
Have you had a bone density scan to show you have osteopenia, or osteoporosis? That may be necessary before insurance will agree to the Prolia treatment.

I just had my first Prolia shot about a month ago. I made sure insurance had preapproved it. I am osteopenic, and on ADT2, still hormone sensitive. This is an approved use for Prolia.

No side effects yet, but I wouldn't expect any yet. The drug works by messing with metabolic pathways needed to make the little cells that tear bone down (osteoclasts). This same pathway also is important for immune system cells, like T cells for example.

It worries me a bit to be on something, treating a side effect of something else, that could mess with my immune system. The medical oncologist thinks it is important for me to stay on ADT2, and that the risk of Prolia is warranted by my nearly osteoporotic bone density.

I've also increased my calcium (400 mg 3xday), and D (about 3500 IU/day). Some weight bearing exercise too, but I should be doing a lot more for sure.

If you search the web, you'll find people who have no issues with Prolia, and also people who think it was created by Satan himself and should be banished from the planet. Your mileage may vary!

Jerry
Posted 12/9/2014 11:10 PM (GMT 0)
Dear Redwing,

Thanks for the reply --- I truly appreciate it --- yes, I have had the bone density test and the oncologist also now has me taking daily calcium supplements and Vitamin D, just as you described.

I know that we all need to be concerned about the dangers of falling and breaking bones --- with winter weather approaching and ice and snow to deal with in many areas, we all need to use care and caution !

If any other readers out there have experiences with PROLIA for prostate cancer patients, we as readers would value your input !

Take care and thanks for the response,
Cyclone
Posted 12/9/2014 11:35 PM (GMT 0)
Cyclone:

I'm on Prolia's big brother, Xgeva (twice the dose and monthly instead of every 6 months). When i was getting Rx for the meds, this is what i remember from arguing with insurance:

* Prolia is indicated for osteoporosis,like Redwing stated. Many insurances require to fail on the generic Fosamax pills or Zometa IV first. I couldn't get Prolia, because my bones had held up with Zometa and Fosamax.

* Xgeva is indicated for those of us with bone mets, and the NCCN prefers it. There's some data that it can delay further bone mets as well. Once they found one bone met on my collar bone, i was approved quickly.

Either one that you end up on, you'll want to get dental work all done before starting, since it can cause dental problems if things aren't shipshape.

Ray
Posted 12/10/2014 1:17 AM (GMT 0)
You may be interested in the discussion of Zometa/Xgeva and Prolia in the following thread. Although it is mainly about men who are already metastatic, it references a recent Australian study in non-metastatic men.

advancedpcatalk.freeforums.net/thread/187/zometa-mhspc
Posted 12/10/2014 2:36 AM (GMT 0)
Steelguy, thanks, yeah I forgot to comment about the dental bit.

My MO's office contacted my dentist for a "clearance letter", saying I'd been examined recently and was not likely to need significant dental work in the near future. Or, something like that anyway.

The dentist's office contacted me separately, and prescribed a high-fluoride (1.1%) tooth paste to best prevent any decay from happening. I use it twice a day, and am not to rinse for 30 minutes after each time. It was only $5 for a 1.8 oz tube (with insurance), so it won't break the bank.

It's a low risk side effect, but they took it pretty seriously.

Jerry
Posted 12/10/2014 3:03 AM (GMT 0)
Hey guys
I had several Zometa infusions (I think 6 or 7) but stopped them when I was having a lot of bone pain prior to my RP. I too, went in for a dental checkup before beginning the infusions.
That reminds me, do you guys know if there is any restriction on getting back to the dentist for a regular checkup after receiving this type of infusion? I haven't been back for about 18 months and was just thinking it might be a good idea.
I think I need to check to see if I need to get another dose of Zometa or Xgeva but I do remember my doctor saying that just a couple infusions would make my bones so hard they would last longer than King Tut's.
Posted 12/10/2014 3:08 AM (GMT 0)
We had a great conversation about Xgeva and Prolia (Both are Denasumab) on my site. It might make for good reading here...

advancedpcatalk.freeforums.net/thread/187/zometa-mhspc
Posted 12/10/2014 6:35 AM (GMT 0)
Cyclone

My MO says if I stay on HT for more than a year he wants me to have a Prolia shot. RO wants me to stay on HT for 21 months.
also send me an email, I am an Iowa guy.

Carl
Posted 12/10/2014 12:07 PM (GMT 0)

Tony Crispino said...
We had a great conversation about Xgeva and Prolia (Both are Denasumab) on my site. It might make for good reading here...

advancedpcatalk.freeforums.net/thread/187/zometa-mhspc

Thanks for the link Tony! That's quite an interesting thread.

My the way, Dr. Maha Hussain, mentioned in the thread, is my MO so I feel I'm in pretty good hands there!

Jerry
Posted 10/8/2015 5:04 PM (GMT 0)
I get a denosumab shot every month. For me, it is no big deal. They draw blood first to check on creatinine and calcium levels before giving it to me, so the whole thing ends up taking close to an hour. The denosumab needs to be warmed up from the pharmacy. The first time we did the shot, they were very careful to check how I did immediately afterwards, but I've always been fine with it. They use a very small needle and the shot goes in the back of the upper arm.

We did delay it a month so that I could get to see the dentist before starting. Some nasty stuff can happen if you have bone-related dental issues. I've switched my schedule of seeing the dentist now from every 6 months to every 4 months under the thinking that it is better to keep any problems at bay early.

And as others have said, it is fairly expensive stuff, but insurance covers it for me. My doc tries to bill about $3800 a month for it and insurance pays about $2800 as per their negotiated rate. I also take calcium and D3 supplements.
Posted 10/8/2015 9:39 PM (GMT 0)
Gunner, I don't think there is any Xgeva/Prolia issue with regular dental checkups, just no extractions or root canals except by a very experienced endodontic specialty practice who you make aware of the shots.

I stopped taking Xgeva when I was confirmed to not have nay bone mets and stopped Prolia after my SBRT/Provenge presumably eliminated the 3 micro lymph nodes involvement.

As I recall they are to prevent adverse skeletal events like spinal compression and fractures, not necessarily to strengthen the bones, just arrest further erosion.
Posted 10/9/2015 9:49 PM (GMT 0)
Hello !

To add a bit onto this threat about the PROLIA shot to strengthen bones for those of us on ADT shots ...

I've continued getting the PROLIA shots for bone strength every six months. I was concerned about possible side effects, but I haven't detected any issues.

I will say that for maybe three days after each shot, I can feel a "tingling" sensation in my bones that my oncologist and the nurses warned me about --- it's not anything unpleasant --- apparently, it's the PROLIA working its way into the bones, from what they said.

I continue to take calcium pills each day, from my doctor's orders. A bone density scan after I first started the ADT shots showed that I was in need of calcium and also the PROLIA shot.

An important word of caution to all readers who are on ADT shots ... my doctor has reminded me many times to be very cautious of falls and accidents. Our bones are more fragile from the ADT shots. I know I am especially careful in the winter time, watching for snow and ice. I have heard stories of others on ADT shots who suffered broken bones in a fall, and it took a longer time for their bones to heal afterwards.

My doctor plans to keep me on the PROLIA shot every six months, going forward.

Thanks to everyone who has contributed to this thread over time !

Sent with my best to everyone,
Cyclone

Post Edited (ISU-CycloneFan) : 10/9/2015 5:30:43 PM (GMT-6)

Posted 10/9/2015 10:59 PM (GMT 0)
Unfortunately, with severe osteoporosis, bones (e.g., hip, vertebrae) can break even without falling.

Post Edited (Sr Sailor) : 10/9/2015 5:06:25 PM (GMT-6)

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