OSTEOPENIA,OSTEOPOROSIS AFTER BREAST CANCER...
hi all......
my mum had triple negative breast cancer sept.2009 and at her follow up on jule 2010 she had a DEXA test which was normal. now, may 2011 she repeated the DEXA test and showed osteopenia, very close to osteoporosis....
her oncologist gave us 3 option for prevenative treatment and i need your opinion if any of you have osteopenia or osteoporosis and are under treatment. the drugs talked to us for the FOSAMAX or ZOMETA or PROLIA.
Does any of you take any of these medications?
thank you all...
Comments
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I am on Arimidex which the onc says may have caused osteopenia.
I am up to 1200 mg of calcium a day. The doctor prescribed Actonel once a month, but I am weary to take it...it has side effects. I am trying to do weight bearing exercises as well. Still trying to figure out the right way to go. I know that you need to do something or it will lead to osteoporosis and that is another scary thing.
I am sure other ladies here will be able to share their info with you.
Best wishes to your mom.
Karen
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I have a little ostoepenia in my spine..I just take calcium..
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hi and thank your for the reply....
can you please tell me the quantity of calcium you are having daily? what brand name do you use?
thank you
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Karen thank you for the reply....
It is really difficult to decide what to choose and which thing is best to do and follow....
Do you check the levels of calcium with blood test? Does your doctor teels you to takke 1200mg of calcium?
Did you changed your diet?
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I take 4000 ius of vitamin D3 per day...plus calcium with Vit D and a multi Vitamin..I usually buy Citracal or another name brand..I don't spend alot of $$ on this...I started out with a D3 level of 41 and now up to 57..would like to be higher but whatever.
I do have a little ostopenia but even with chemo it did not get worse...I think exercise helps build the bones also...
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thank you titan for the reply,
how many mg calcium do you have per day?
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I had a dose of Zometa when I cracked a rib a year ago, which would be a year and half out. I was all prepped and ready to go in to have that rib cut out. I just looked up and saw a half dozen doctors shaking their heads and was ready for the worst. They said that doing the preop CT while holding my breath gave them a better picture and the rib was healing up well and showed no lesions. No need to go in and chop it. I was thankful, but also out megabux and weeks of sleep. A year later, I did a dose of Reclast (same as zometa, slightly different dose).
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thank you yellowdoglady for your reply.....
did you had osteoporosis when you had the zometa or did you had it just as an anticancer?how many doses of zometa did you had and did you had any side effects?
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I was diagnosed with slight oesteopenia just before I started chemo (at age 49, at the time peri-menopausal). My onc put me on 1000 mg of Calcium a day. I'm also taking a total of 1800IU of D or D3 a day. I used to have low vitamin D, but not any more.
I have also started Anastrozole which could make the problem worse. I will get another bone scan in a year. I do weight bearing exercise.
All bisphosphonates are associated with weakening bones but mostly for long term use (over 5 years). I did read somewhere they recommend after 5 years to take a break from the bisphosphonates (although not an option for everyone). Don't remember how long though. sorry don't have the link.
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(hi lago!)
I'm just chiming in here with my two cents....
I am tiny (5' nuthin) and caucasian and small boned. I was informed that when we get a bone scan and it reads as "osteopenia" this may just mean that, and is not a definitive diagnosis of any issues with the bones.
My 80 year old mom, who is 4'11", small boned and caucasian still moves her fridge to dust behind it. Her bone scan says osteopenic and has for years and years. Her GP told her this also.
Good to know that a diagnosis of osteopenia doesn't mean it must be treated. I was told "watch and wait" is AOK (and of course, 1500 mg. calcium, weight bearing exercise or yoga, and D 2,000 ius. My GP added magnesium to this mix, as she told me that all the calcium and D in the world cannot help unless magnesium is taken to let it be absorbed. Interesting.
Lago, are you feeling better?
xoxo
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Anniealso that's exactly what my GP said. I too am small boned, white yadda yadda. According to my numbers my chance of a mjor bone fracture in 10 years is 4% (hip fracture .3%… yes you saw a decimal point before the 3). Granted my mom had osteoporosis and now I'm on Anastrozole so of course they are going to watch.
According to the letter I got with my test results it states:
"In the US, recommended to treat those with 10 year hip fracture risk >3% or those with overall fracture risk >20%). I'm no where near those risks!My shingles are getting much better. Still burning some and can be itchy but with some ibuprofen I'm almost fully functional… OK I'm not going to the gym yet but hope to be there in a few days. Thanks for asking.
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My sister-in-law, who had been on Fosamax for several years, fell and fractured her femur in March. In Mexico! Surgeon there who operated said that her femur was VERY osteoporotic -- this despite a DexaScan in November which didn't show it at all! When she got back to Toronto, her surgeon said "Throw away the Fosamax -- you're not the first, and sadly won't be the last".
Osteopenia has been a clever marketing tool to sell these bisphosphonates. The "determination" of osteopenia was made by a panel of docs (probably paid by the drug companies). If you fall slightly under the line determined by this panel, your doc almost automatically puts you on them. It's true that the AIs can contribute to bone loss, but I'm betting that weight-bearing exercise, a healthy diet plus calcium, magnesium and VitD3 are more beneficial. I haven't taken my Fosavance since I started to hear of all these fractures. My sister's doc also told her to stop taking Actonel (she had been on it for 7 years!).
It's very, very troubling, and I'm sure the PSPs and orthopaedic surgeons are wondering what they should be telling their patients.
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nastasia_s:
I have no idea if I already had osteopenia before treatment. I did after, so that is being treated. I have heard that some oncologists will administer a dose of zometa/reclast just to toughen up the bones after because they can become weak during treatment and because TNBC so likes to eat bones.
I've had two doses now, and no side effects except to be thirsty to no end. You can get an IV saline alongside, but I just drink a lot of water.
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Lindasa,
The larger issues are with the pills, not the annual infusions. And the insurance companies that want to pay only for the pills that cause random leg fractures because they are less expensive. We are sure to hear more about this in the next few years.
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yellowdoglady: how many doses of zometa your doctor recommended for you to have?
do you drink any pills together with zometa so not to have side effects?
is it reclast or zometa this you take?
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lindasa:
why you have taken fosavance?it was for osteopenia?how long did you took them?
did you had any side effects?
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I don't have osteopenia that I'm aware of...but my doctor is going to have me do Zometa infusions every 6 months as a preventative for bone mets. Even though TN doesn't like the bones as much as ER+, it still goes there, and she feels it is worth it.
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Did your doc offer other ideas, like calcium, Vit D and exercise (walking 30 mins a day) and other lifestyle changes, like limiting coffee? These can help and don't have the potential side effects of those of the bisphosphonates. Vit D seems to be the new wonder "drug" for preventing bad bones. You might still decide that a Rx is right for you, but I wouldn't ignore these other ideas.
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Suze thank for the reply...
How many zometa infusions you are going to have?
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Peggy thank you for the reply...
My mum's doctor offer other ideas which include Vitamin D3, Calcium exercise(walking).
She's having 1-2 coffees a day so is not so much...
She's mostly on a healthy diet...
Do you have osteopenia?
What supplements are you having?
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Well, I was diagnosed as osteoporotic about 2 years before BC. And I'm 5'8" and come from a family of professional athletes - mostly, football players. And this was before menopause. Go figure.
I went on 2 years of fosamax - am now on Boniva. After BC treatment, I took no bisphosphonates because I was on tamoxifen for 2 years, and it's very good for postmenopausal bones. Very similar to a med called Evista, which your mother may want to ask about.
I have no problems with these meds, and have reversed the osteoporosis to osteopenia levels. I will take another vacation in a couple of years
Jeez, people - broken hips are what kill most old ladies like me (well, I'm in my early 60s). It's what starts the whole downward spiral into nursing homes and that whole mess.
I'm sorry for those who have gotten whapped with side effects, but a good doctor can work with you to take precautions, like vacations, like changing treatments.
I take vitamin D3 in large quantities, with magnesium and Vitamin K2, which are both required for calcium absorbtion. I take low levels of calcium supplements because I drink milk and eat yogurt daily. And walking is the best.
I don't like taking pills, either, and sure don't trust the whole medical industrial complex, but I also don't believe in rejecting everything. I don't want a dowager's hump, or recurrent fractures of my vertebra, or fractures in my feet from walking.
Triple negs trust their doctors to give them chemo, even though it can have devastating side effects, because it saves lives. Well, so does keeping osteo at bay.
Your mom sounds like a sensible woman, weighing her options and taking time to make the right choices. With proper management, this can never be an issue in her life.
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I was 39 when dx the Chemo sent me into menopause (2 yrs ago) and my estrodial level was undetectable while taking Arimidex, I am small framed causasan very fit and healthy.
I had a base line Dexa before commencing Arimidex, it showed osteopenia, so I commenced on calcium, vitD3 and increased the weight bearing exercises. I had a repeat Dexa scan after 1 yr which showed a whooping decrease in bone mineral desitiy of 11-13% in all measurements of the hip and spine so now I fall into the osteoporsis range
My Onc ceased the Arimidex and I am having 6 monthly infusions of Zometa x 4 and hoping the next Dexa shows improvement.
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Icandothis, thanks for your helpful msg and that note that Tami helped your bones. I wasn't sure what to expect; whether it would avoid hurting my bones the way AIs do, or whether I might see an actual improvement. Interesting and good to know.
natazia. Sounds like your mom is doing the right things. 1-2 cups of a coffee isn't bad. I've heard that they recommend a max of 2 8-oz cups of coffee a day. I'm trying to wean myself down using decaf (only 50% of the caffeine). In my case, bad bones run in my family (inherited issue) so I've been concerned about it long before my BC DX. I've been taking lots of calcium (1200 mg) for years (I try to avoid dairy cuz I'm lactose intolerant), and recently added in Vit D. (BTW, I heard that the body can only absorb 500 mg of calcium at a time, so it's better to take it 2x/day). I also found a list of calcium rich foods, like sesame seeds (I'm eating more tahini). Before my surgery I asked for a DEXA scan. They claim it's in the normal range for my age, but it's the far far bad end of normal. I'm premenopausal so they are recommending Tamoxifen. Originally my MO suggested following 5 yrs of Tami with 5 yrs of AI, but when I showed her the results of my DEXA scan, she backed off and said she'd recommend another scan in a few years. She seemed as concerned about the rate of bone loss as much as the absolute number. As an FYI, my non-BC mom has osteopenia and her doc recommended a bisphosphate, but after my mom did research, she didn't want to take it (due to potential risks with the jaw and dental issues). I heard that some of these drugs do build bone, but it's not very high quality bone. (the analogy I heard was that it was like "balsa wood" vs. oak). Not sure if any of this is helpful. Hope it is. This stuff is confusing and it's hard to know what actually will help. Good luck with all of this.
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I had Zometa a year ago. Reclast this year. I take vitamin D every day, Caltrate as well.
I heard all the bad stuff about the infusions for osteopenia/osteoporosis. I asked a lot of questions, and you all should a well. Stuff like will it degenerate your jaw into an oozing sore that must be removed? Not unless there is a longstanding problem and threre is an infection beforehand.
I also learned that most of the bad side effects are related to the pills, not the infusions. People with fewer health risks have to take those pills until they can't. We can get access to the better thing, right away.
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yellowdoglady: why you have chenged from Zometa to Recalst? What is the reason?
How many doses of Vitamin D and Caltrate do you have?
Different opinions for Infusions and pillas my mum's is hearing from doctors and she doesn't know what to do..
We hear both for infusions and pills side effects but i think doctors prefer to choose infusions for women who had a history of breast cancer. We have heard that pills maybe cause fractures and at the end , perhaps cause her harm and not good...
I don't know if it is better to choose Reclast which is once every year or Zometa twice a year.
Reclast is an infusion or an injection?
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Loulou40 how many units of Vitamin D3 and mg of Calcium do you take daily?
Do you have any side effects of Zometa?
What exercise are you having ?(pilates,aerobics etc)
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peggy_j: i have heard that calcium is not absorb with coffee and i don't know if this is correct...do you have tha calium supplement with your coffe or do you leave to pss some time between having them?how many units of vitamin d 3 do you have?
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icandothis: how many mg of calcium do you have?
your doctor didn't recommend anything for osteopenia?
how did you cope with fosamax?
we are going to search for evista.....thank you!!!
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Risk Of Fractures In Later Life Not Reduced By High Daily Calcium IntakeIf you are already taking moderate amounts of calcium, increasing it will not lower your risk of osteoporosis or fractures when you are older, researchers from Uppsala University in Sweden reported in the BMJ (British Medical Journal)....The researchers found that those who had been consuming approximately 750mg of calcium per day had the lowest risk of fracture. Those who started having more calcium (than 750mg) over time did not experience any improved risk, the authors added.
In fact, some evidence exists suggesting that perhaps a very high calcium intake may result in a greater risk of hip fractures. However, the authors advise readers to interpret this evidence with caution.
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Nastazia,
I take 2000IU of Vit D3 per day and 1200mg of calcium with magnisium and D3 added.
The first infusion on Zometa gave me flu like symptoms for a couple of days but the next one was OK. I weighed up the long term risk of SE's against having decreasing BMD at 40 and decided the benefits of a course of 4 Zometa infusions far out weighed the small risk of developing ONJ and renal problems. My Onc explained that the risk of long term SE's was much greater in women who had it monthly and long term.
I walk/run for 30 mins 4-5 times a week and do weights 3 times a week. I also try and do a yoga or Pilate's class a couple of times a week.
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