Early stage breast cancer put on bisphosphonate (Zometa)

Back when I was doing letrozole, the docs weren't sure that Reclast or Zometa had that preventative effect. The main function at the time was to address the bone loss that resulted from the estrogen deprivation caused by the AI. Everyone I know is doing one or the other, unless they have some contraindication. At the time I was not given Reclast because there was a possible risk of exacerbating my afib, a concern that has since been disproven. I lost a lot of bone density as a result. Good idea to do if you can!

My oncologist said that active bone turnover during osteoporosis leaves the bone open and provides a site for cancer to grow IF there is BC metastasis. Reclast helps bind the bone and deters cancer cells. I’m not sure if/which other drugs also do that.
Because bone is a common site for metastasis- I will continue to take Reclast for as long as it is prescribed.

Wish we knew what was happening inside our bodies!
I have minor osteopenia per my first Dexa scan 6 months ago. I’m 48 at the moment. The side effects scare me but so does metastasis!

I read somewhere that if one takes bisphosphonates first, they can’t take anabolics later. Do you know anything about that?
I’m 48 right now with minor osteopenia so I’m thinking in the long run, will I affect my drug choices.

You can take anabolics afterward but effectiveness is reduced by about 1/3 (see Dr. Ben Leder's video on YouTube on Combinations and Sequencing). But still very helpful.

As I wrote before, I could not take Reclast during cancer treatment and had fractures, but I started out with pretty severe osteoporosis. You could use blood marker tests for bone turnover and growth as well as DEXA to keep track of what is happening with your bones. Two blood tests that might be useful are the CTX and P1NP (do them fasting and early). Do you have an endocrinologist?

Tymlos restored my bones to better than before cancer. So if you don't do a bisphosponate, there is that and Forteo and Evenity if you get into trouble. I don't know how bad your osteopenia is but a doctor could assess whether you can afford to do an AI without Reclast or Zometa.

ps I am 9 years out and have not yet done a bisphosphonate. I am going to start soon to lock in gains from Tymlos.

Very good question! I'm 58 yrs, thin build and within only one year of Letrozole for ILC am now in osteoporosis. My endocrinologist said should start with bisphosphates and after labs he cleared me for Fosamax. I 'm very anxious but trust my endocrinologist at MGH in Boston. Reclast infusions were a bit too harsh for me to accept with even more potential negative side effects but now it seems like many on this site start with Zometa hoping to avoid bone mets but I did read that all bisphosphates might help with this concern. Thoughts? xoxox

You're right about the prevention of metastasis to the bones. Prolia, another drug, also stops BC cells from going to the bones. My endocrinologist's wife had BC, was put on letrazole and started taking Prolia. He highly recommended Prolia and he is one of the major researchers in the U.S. on osteoporosis.

I have to admit I don’t know much about the range of options for building bone. It could be that with osteopenia you might not need a bone builder. Part of that answer is probably what is causing the osteopenia. Going into menopause you’re likely to lose more bone because of lower estrogen, but you might be able to control that with diet/exercise. Some people have a family history of osteoporosis and it seems to be some other body process that is causing it - even with a good diet and exercise the bone just loses density.

If you need a bone builder, then you’ll want to take it, but with some of those drugs you HAVE to stay on medication because when you stop the bone loss starts up again at a rather fast pace.
My sisters were able to do 4-5 years on alendronate and then stop. They are 71 and 75 yo now. I waited to take anything and dropped into osteoporosis. Fosamax caused stomach problems so I did Reclast last year. The oncology rheumatologist says I should do Reclast again this year then maybe every other year. Within 6 months of taking Reclast my spine recovered 6% of bone. But that isn’t enough for some people.

You just have to make the best decision you can based on health history, diet/exercise history (bone density drop in spite of good food/exercise?), past chemical exposures (lead, cadmium, etc), expected future hormone levels (low estrogen), and the doctor’s explanation of what is currently recommended, and what she expects in the next 20 years for keeping your bones strong.

Hi
I am 65 I had a fracture two years ago rolling over in bed in my spine at my t7 and my endocrinologist immediately put me on reclast or it's also known as zoledronic acid . I also had a lot of trepidation had a good talk with my pharmacist and I'm glad I did it because I'm on my third infusion this year and my bone density has come up a lot since starting the infusions now I've been diagnosed with dcis breast cancer and had two surgeries so I'm going to be starting radiation which terrifies me hopefully I'm ahead of the game as far as my bone density because I know my oncologist is only going to put me on 5 mg of tamoxifen because that actually helps build bone density from what I've Been Told. If I can give you a bit of advice regarding the infusions hydrate the day before with some kind of electrolyte water coconut water is a healthy option and I do two bottles the day before I take Tylenol the night before I take one bottle of electrolyte water in the morning and to Tylenol before my infusion and I have not had any side effects. Wish you well with your treatment.

Curious how long they will have you on reclast -