@bunnymoon I posted in the other thread. Most cancer docs use zoledronic acid (Reclast or Zometa) in my experience. I would not do 6 shots of Prolia due to rebound. Recently Keith McCormick, author of "Great Bones," said 2-3 Prolia shots might be okay. And yes, then Reclast.

I think it is good to have an endocrinologist. My endo won't use Prolia unless absolutely necessary due to problems getting off. See if your doc will do Reclast now or earlier, based on what my doctors have told me. Discussion with both oncologist and endocrinologist might be helpful.

The potent form of Prolia, Xgeva, is used for metastatic cancer as is Zometa, from what I have read.

I have been taking once a month Boniva for osteoporosis for a few years. Post chemo and radiation, and being on Letrozole , oncologist did not mention changing that for another bone med. I have not seen anyone else mentioning that particular medication. Has anyone else taken this post cancer treatment?

Diagnosed in 2023 at age 60, with stage 1a breast cancer, had preexisting osteoporosis and high cholesterol … unfortunately AI’s used to treat cancer tend to worsen both conditions.

AI’s are the default treatment for post menopausal women. Tamoxifen may be less effective at reducing recurrence, but it can actually help prevent bone loss and it doesn’t affect cholesterol (but it can cause blood clots and uterine cancer among other side effects).
Tam isn’t typically offered to post menopausal women, I had to specifically ask about it.
I asked my oncologist to walk me through the benefits/side effects/risk of recurrence of each med, based specifically on me … my tumor characteristics, Oncotype, family history, osteoporosis, cholesterol, etc.
My recurrence risk was very low to start with, so in conjunction with my oncologist, I was able to make an informed decision to try Tam.

Like you, I don’t like all of the medications, and I try to make informed choices, knowing that for me, quality of life is my goal.

I had a Reclast infusion in September, another this coming September, then another DEXA and will decide what future treatments are warranted.

I encourage everyone to research and advocate for themselves - ask questions - if your provider gets defensive or dismissive, it might be a sign that they are not a good match for you.

PS … keep in mind that you have time to research and make decisions - this is not an emergency situation.
I just wanted to get everything done as quickly as possible & get on with my life. Fortunately I have a good friend who helped me slow down & find the best treatment for me, which actually made things much easier in the long run!

@bunnymoon I am going to add a different thought from the other answers. Instead of saying I would not do this drug or that drug and my reasons. I would ask my doctor what the reasoning is for choosing the path prescribed. I have this most amazing Mayo doctor that prescribed exactly the same thing for me. I asked, also concerned about it.
I had finished my AI and had an accident which resulted in many fractures. I wish to keep my healthy active lifestyle and I own and ride horses. My doctor explained his reasons for the choices and I agreed.
I just had a dexa scan and my scores improved from the previous scores, I feel like my doctor has my best interests in mind and he is very thoughtful about his recommendations.
Do you feel like you trust your doctor to have your best interest in mind? Have you asked for the reasoning behind these choices?

Thank you so much. I do have a lot of trust in my oncologist. I’ve also been gathering more data specifically ASCO guidelines on this very issue (2019) and am seeing he is adhering to strong data. Bottom line is I’m just afraid and angry at my health issues. Like you, and like all of us on this string, I just want my life to be active and free of pains and mood issues and of course fractures and cancer. 🩵

Hi @bunnymoon, I merged your 2 discussions into one discussion that appears in both the Breast Cancer and the Osteoporosis group. 🙂