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Who is managing your bone health, oncologist or endocrinologist?
I’m a breast cancer patient on Letrozole for 5.5 years so far and 10 year goal. 2 years ago I had osteopenia and my oncologist wanted to put me on Zometa, but said ask your endocrinologist. My endocrinologist said no, he would do Prolia first and only when I have osteoporosis because Medicare won’t cover for osteopenia. So I haven’t been on anything. I’m reading that Medicare will cover those drugs for AI drug induced osteopenia (true?) and that oncologists choose Zometa for breast cancer as protection from cancer spreading to bones (true?). I feel like the two specialists need to talk so I get the appropriate treatment. Oncologist just told me to have my endocrinologist order DEXA that is due and manage my bone health. Endocrinologist says he can order but it won’t be covered since he has no history on that for me. I feel like a ping pong ball so I’m wondering who is managing bone health for other breast cancer/AI patients. Thanks for any input.
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@californiazebra
I take 1000 IU D and 45mcg K2. I eat salmon bone for calcium and exercise. That seems to work for me. My last Tscore went up about 9%, but my lumbar t score still went down. So now I need to do weight training. I will know next year if that’s good enough.
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1 Reaction@myoga
Thank you. I’ve only been doing DEXA every 2 years. I think someone on here said it’s covered every year if on AI. Is everyone doing the scan yearly?
@californiazebra
I don’t know if there’s protocol for yearly Dexa while taking AIs. My onco was suggesting every 2years, she said AI wouldn’t affect bone density that fast. But I requested Dexa scan a year later and it went from -1.3 to -1.7. So she gave me Dexa scan every year for three years now. My last one showed improvement on hip neck that was from -1.7 to -1.3, but my lumbar went down to -1.7. So I need to work on it. I’m trying to do lumbar spine strengthening. If you are trying something new to improve it, then you would want to know if it helps sooner rather than waiting for 2 years to find out. One thing I notice is that walking/ running is only maintaining your bone density at best. It’s not as effective to improve bone density as weight training. I heard some doctors even order zometa for osteopenia patients on AIs because it can prevent cancer metastasize to the bone. Should I ask for it? Anybody has experience with zometa and side effects?
I have been doing a DEXA every year. Just had 4th Reclast, the same drug as Zomata, but only 5 mg a year. Zomata is often multiple times a year at 3-4 mg each.
I did not have any real side effects this time, maybe a little body discomfort not aching, for 24 hours.
With the first 2 doses I had mild flu like symptoms 30 hours after the infusion lasted of couple of days. After the 3rd infusion my eyes ached for about 20 min then cleared. I set up an ophthalmologist appointment immediately following the 4th infusion in case I had eye problems. He said my eyes showed no effects.
I was at osteoporosis, now at osteopenia.
@myoga
I agree that you need to know sooner rather than later if what you’re doing is working.
I walk a lot but that’s mostly what I do. Cardio sends me into afib and neuro and other issues make weights or resistance risky. It always seems the treatment for one disorder exacerbates another. I’ll have to start slowly and hope it’s enough to help. Best of luck with your weight training. ❤️