Prolia vs Zometa

ijl
ijl Member Posts: 897
edited June 2020 in Bone Health and Bone Loss

I have been diagnosed with stage 1 ER+ IDC. I had my second mastectomy ( I had DCIS 12 years ago).

I am post-menopausal so the oncologist wants me to take Arimidex. And since I have ostopenia in one hip she prescribed Zometa as well. I see that a lot of people here are on Prolia. As I understand it Zometa further reduces chances of the recurrence in bones. What are the drawbacks?

I would like to hear from this community fellow members on what rationale their oncologist gave them when prescirbing Prolia

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  • edj3
    edj3 Member Posts: 2,076
    edited June 2020

    Interested in this also. I had two rounds of Prolia and with the second injection I had an allergic reaction. My MO has suggested Zometa. My endocrinologist had also suggested Forteo.

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  • ctmbsikia
    ctmbsikia Member Posts: 1,095
    edited June 2020

    Great edj3, I'm due for my 2nd injection of prolia this month. I never really asked or researched the difference between the two medications other than Zometa is an annual infusion?

    I was told when I'm done with the AI -I can stop the bone meds but will still need something. I'm a few years away from that though, so always interested in these topics as well. Some of it maybe the physicians preference? I was found to have osteoporosis in my left hip at diagnosis, and osteopenia in my spine. My MO never mentioned any other meds except the Prolia and that it could change to another one in the future.

    I've read where the Forteo is a daily injection you give yourself. I remember you're a runner, and as I read about that one, the OS is pretty severe if you were offered that.

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  • edj3
    edj3 Member Posts: 2,076
    edited June 2020

    Yeah my pelvis fractured from running in 2018, and now I have a broken bone in my foot from running. I'm damned if I give this up, so I'll inject myself every day if that's the best option.

    Prolia was fine for me, no side effects. But the needle is housed in natural rubber, which is related to latex and I'm allergic to latex. So I suspect the reaction was to that, not the drug. But my endocrinologist said since I did have that reaction, no more Prolia.


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  • LillyIsHere
    LillyIsHere Member Posts: 830
    edited June 2020

    I had my bones checked during the month I started AI in December and I had normal results with no sign of ostopenia. However, while in AI, I imagine my bones are not like 5 months ago and I will get to osteoporosis one day or another from constant use of letrozole. MO recommended Zometa, 2xyear for 3 years to protect the bones from cancer he said. I do have it as optional though. I am not sure if I should do it or not.

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  • ijl
    ijl Member Posts: 897
    edited June 2020

    I asked my oncologist and she said that Zometa is the only one that was shown in studies to protect against bone mets recurrence.

    I made an appointment with an endocrinologist next week to learn more about all the options. I am also curious to see what he will say about the supplements like magnisium and calcium

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited June 2020

    This is a study done on the Prolia and AI combination and DFS.

    https://www.medpagetoday.com/hematologyoncology/breastcancer/78184

    This link from BCO references the same study but also gives a good explanation of the way Prolia works.

    https://www.breastcancer.org/research-news/prolia-reduces-recurrence-risk-for-some

    I was osteopenic many years prior to diagnosis with breast cancer, mainly due to a complete hysterectomy and oopherectomy when I was 45. That said, I also fit the description of those who would be prone to osteoporosis. My oncologist wanted me on Femara because I was Her2+ and he did not like his Her2+ post menopausal patients on Tamoxifen. After six months I had demonstrated bone loss, and I had a good baseline due to a DEXA scan on the same day as the imaging that led to the breast cancer diagnosis. I started Prolia, after the fourth injection I had recovered 29% of density and was now in the normal range. I continued Prolia for six years and as of my last DEXA 18 months ago have not lost any density. I'm no longer on AI or Prolia, I stopped at 7.5 years.

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  • ijl
    ijl Member Posts: 897
    edited June 2020

    I had a video visit with endocrinologist today. So he in general is in favor of bisphpshonates. I particular he was suggesting Fosamax. He said it might be more convinient to take a tablet once a week than have Zometa infusions.

    He also stated that bisphpshonates allows for a drug holiday. So I can stop taking it after 5 years and for the next 5 year ti will offer protection. Apparently this is not the case with Prolia. Its benefits stop once a patient stops taking it.

    So I guess it is between Fosamax and Zometa for me. I will do more research on this topic.

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