Preventing Osteoporosis While on Hormone Therapy for Prostate Cancer | Prostate Cancer Staging Guide
11.2 هزار بار بازدید -
5 سال پیش
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PCRI’s Executive Director, Mark Scholz,
PCRI’s Executive Director, Mark Scholz, MD, continues his overview of the side effects of hormone blockade by describing the dangers, detection methods, and treatment options for Osteoporosis—a common, pernicious, and fortunately treatable side effect of androgen deprivation therapy.
0:21 Men with low testosterone levels from hormone blockade will experience a loss of calcium in the bones called Osteoporosis. This condition weakens the bones and without proper surveillance, it can advance without any symptoms until there is a dangerous and sometimes even fatal bone fracture or compression of the spine. Fortunately, there are ways to diagnose and treat osteoporosis, and in general, men should consider going on medications with the initiation of hormone blockade.
1:24 Physicians can check for pre-existing loss of bone density by using one of two bone density scans: The DEXA scan and the QCT scan. The DEXA scan is good for the hip but less accurate for the back. The QCT scan is accurate for the back but not as widely available. Either scan is reasonably accurate and helpful, but even if scans show normal bone density it is still wise to go on treatment to prevent the loss of bone density that comes with hormone blockade.
2:10 There a several treatments for Osteoporosis. Everyone should be taking vitamin D, perhaps 1,000-2,000 units per day. Your physician can check your blood to see if you are getting enough vitamin D. The use of around 250mg-500mg of calcium at bedtime is also advised. These supplements alone, however, will not be enough to prevent bone density loss, and so men need to be taking a pharmaceutical agent. There are two types of pharmaceutical agents to consider: Bisphosphonates and a medicine called Denosumab. Denosumab is an injectable medicine that is given monthly or once every 3-6 months. It comes in a low-dose form called Prolia and a high-dose form called Xgeva. Bisphosphonates come in an IV form called Zometa or in oral forms called Fosamax, Boniva, and Actonel. As of now, there is no evidence that any one of these pharmaceutical agents works any better than the others, so cost and convenience are reasonable considerations when deciding which to use.
3:38 These pharmaceutical agents have potential side effects that men need to be aware of. The oral bisphosphonates can irritate the stomach, so men with a history of stomach ulcers should consider injections or infusions instead of pills. Osteonecrosis, or the recession of the gums to the point that the jaw bone is exposed to infection is the main concern with all of these pharmaceutical agents. Fortunately, Osteonecrosis can be stopped with the cessation of the medicine; however, it is important that you talk to your doctor immediately after noticing the symptoms of Osteonecrosis because it is much harder to recover from once it gets to an advanced stage. Another concern is that since the jaw’s metabolism slows down while on these medications men who need to have a tooth extracted will have to stop taking medicines for a certain period of time before the tooth is removed. It is wise to prevent this possible interruption in therapy by having your teeth checked concurrent with the initiation of hormone blockade to see if there is an impending need for tooth extraction.
Don’t know your stage? Take the quiz: Visit http://www.prostatecancerstaging.org
To learn more about prostate cancer visit http://www.pcri.org
To download the free Staging Guide visit http://www.pcri.org/prostate-cancer-s...
Who we are:
The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better individualized care. Feel free to explore our website or call our free helpline at 1 (800) 641-7274 with any question that you have. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.
The information on the Prostate Cancer Research Institute's YouTube channel is provided with the understanding that the Institute is not engaged in rendering medical advice or recommendation. The information provided in these videos should not replace consultations with qualified health care professionals to meet your individual medical needs.
#ProstateCancer #Prostate #MarkScholzMD
0:21 Men with low testosterone levels from hormone blockade will experience a loss of calcium in the bones called Osteoporosis. This condition weakens the bones and without proper surveillance, it can advance without any symptoms until there is a dangerous and sometimes even fatal bone fracture or compression of the spine. Fortunately, there are ways to diagnose and treat osteoporosis, and in general, men should consider going on medications with the initiation of hormone blockade.
1:24 Physicians can check for pre-existing loss of bone density by using one of two bone density scans: The DEXA scan and the QCT scan. The DEXA scan is good for the hip but less accurate for the back. The QCT scan is accurate for the back but not as widely available. Either scan is reasonably accurate and helpful, but even if scans show normal bone density it is still wise to go on treatment to prevent the loss of bone density that comes with hormone blockade.
2:10 There a several treatments for Osteoporosis. Everyone should be taking vitamin D, perhaps 1,000-2,000 units per day. Your physician can check your blood to see if you are getting enough vitamin D. The use of around 250mg-500mg of calcium at bedtime is also advised. These supplements alone, however, will not be enough to prevent bone density loss, and so men need to be taking a pharmaceutical agent. There are two types of pharmaceutical agents to consider: Bisphosphonates and a medicine called Denosumab. Denosumab is an injectable medicine that is given monthly or once every 3-6 months. It comes in a low-dose form called Prolia and a high-dose form called Xgeva. Bisphosphonates come in an IV form called Zometa or in oral forms called Fosamax, Boniva, and Actonel. As of now, there is no evidence that any one of these pharmaceutical agents works any better than the others, so cost and convenience are reasonable considerations when deciding which to use.
3:38 These pharmaceutical agents have potential side effects that men need to be aware of. The oral bisphosphonates can irritate the stomach, so men with a history of stomach ulcers should consider injections or infusions instead of pills. Osteonecrosis, or the recession of the gums to the point that the jaw bone is exposed to infection is the main concern with all of these pharmaceutical agents. Fortunately, Osteonecrosis can be stopped with the cessation of the medicine; however, it is important that you talk to your doctor immediately after noticing the symptoms of Osteonecrosis because it is much harder to recover from once it gets to an advanced stage. Another concern is that since the jaw’s metabolism slows down while on these medications men who need to have a tooth extracted will have to stop taking medicines for a certain period of time before the tooth is removed. It is wise to prevent this possible interruption in therapy by having your teeth checked concurrent with the initiation of hormone blockade to see if there is an impending need for tooth extraction.
Don’t know your stage? Take the quiz: Visit http://www.prostatecancerstaging.org
To learn more about prostate cancer visit http://www.pcri.org
To download the free Staging Guide visit http://www.pcri.org/prostate-cancer-s...
Who we are:
The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better individualized care. Feel free to explore our website or call our free helpline at 1 (800) 641-7274 with any question that you have. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.
The information on the Prostate Cancer Research Institute's YouTube channel is provided with the understanding that the Institute is not engaged in rendering medical advice or recommendation. The information provided in these videos should not replace consultations with qualified health care professionals to meet your individual medical needs.
#ProstateCancer #Prostate #MarkScholzMD
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