Bone Health and Advanced Prostate Cancer

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HughGunn
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Joined: Sat Nov 09, 2013 1:14 pm
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by HughGunn on Sat Nov 09, 2013 1:49 pm

Bone Health and Advanced Prostate Cancer

Every other cancer has a NICE treatment pathway for bone health when it has metastasised. Not so with prostate cancer!

The only treatment for advanced prostate cancer is hormone treatment, which causes osteoporosis and eventually skeletal related events (SRE's). This means bone fractures and the possibility of spinal compression. This will become even more of a problem with the advent of new, very successful life extending drugs like abiraterone and enzalutamide. These problems can be greatly avoided if treatment is also given for bone health.

Therefore, It is very important, that if you have advanced disease and are being give hormone treatment, you are also being treated with bisphosphonates or the new drug, denosumab to protect you bones.

Until NICE changes the recommended treatment pathway for advanced prostate cancer, you may have to fight for it.

Hugh Gunn
Hon. Treasurer
Prostate Cancer Support
Federation

Stotty 1935
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Joined: Sat Nov 09, 2013 5:00 pm
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by Stotty 1935 on Sat Nov 09, 2013 5:45 pm

Re: Bone Health and Advanced Prostate Cancer

Hugh, although I agree in principal with your comments, I think there is an alternative approach to help protect your bones. Listed side effects of hormone therapy state the that a man could loose from 0 to 5% of bone density. After over 2 years on hormones it was planned that I have a knee replacement, an un associated problem. I thought drilling and hammering! how strong are my bones, so I asked for a bone scan which showed that my bone condition was good for my age. After being in remission and off hormones for over 3 years, my rapidly rising PSA means I am back on hormones. I intend to have a bone scans in the future to check the condition of my bones, so is it not better to monitor the situation rather than take an expensive drug (Denosumab) that may not be necessary.

Colin
Vice Chair. Bolton PCSG.

HughGunn
Posts: 5
Joined: Sat Nov 09, 2013 1:14 pm
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by HughGunn on Sat Nov 09, 2013 6:27 pm

Re: Bone Health and Advanced Prostate Cancer

Hi Colin, you are quite right, yes of course bone health should be monitored, but the fact remains that hormone treatment causes osteoporosis and this could be avoided. After 5 years on hormone therapy, a man could lose considerably more bone density than 2%. This becomes much more of a problem with abirateron and enzalutamide, because men can live so much longer that SRE's become more common.

I have been (and am still) part of a trial which has shown that Zometa reduces SRE's by 50%.

Zometa (zolodronic acid) is now out of patent and the price is dropping rapidly. Zometa is given in all other cancers as a matter of course. Also, in the event that your bone scan shows you do have a problem, would it not be a good idea to be able to have something done about it?

Good luck with the PSA

Hugh

Nellysierra12
Posts: 39
Joined: Mon Oct 21, 2013 10:25 am
Location: USA
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by Nellysierra12 on Thu Nov 21, 2013 1:18 pm

Re: Bone Health and Advanced Prostate Cancer

HughGunn wrote:Hi Colin, you are quite right, yes of course bone health should be monitored, but the fact remains that hormone treatment causes osteoporosis and this could be avoided. After 5 years on hormone therapy, a man could lose considerably more bone density than 2%. This becomes much more of a problem with abirateron and enzalutamide, because men can live so much longer that SRE's become more common.

I have been (and am still) part of a trial which has shown that Zometa reduces SRE's by 50%.

Zometa (zolodronic acid) is now out of patent and the price is dropping rapidly. Zometa is given in all other cancers as a matter of course. Also, in the event that your bone scan shows you do have a problem, would it not be a good idea to be able to have something done about it?

Good luck with the PSA

Hugh

I am in agreement on this.

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