Cases of osteoporosis correlated with Brachytherapy?

Posted by dk68 @dk68, Mar 21, 2023

My PCP assigned a DEXA for on the basis of weigh and "having been treated for Prostate Cancer." Androgen ablation (HT) is causally associated with OP. But I had no HT. I was treated with brachytherapy 11 years ago. I have femoral neck OP and severe OP in lumbar.

I've read papers that stress the need to do baseline testing before brachytherapy for breast, cervical, and rectal cancer, before drawing any firm conclusions regarding correlations.

No mention of prostate brachy, but it is certainly in the same areas of cervical/rectal cancers. Curious

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@dk68

Candy, what did the MDs say when they discovered you are in the -5s? Which area was it in? How was it discovered--the standard schedule for front line MDs is >65 for women (way too late for informed decision making!).

My GP has approached my OP as simply OP and still refuses to further tests. Most charitable explanation, she wants to leave it in the hands of more advanced specialists. I've secured a soon appt. in July (4 months out) at another endo. I'll try one more group.

At least, GP agreed that I shouldn't start Fosamax without getting the information that will "satisfy" (pacify) my anxiety.

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Good morning,
It’s in my spine and can’t remember exactly where in my spine. I’ll look it up today. I asked for the dexa a few years ago because my mom had fractures in her ribs at an early age. She ended up being fine and never got osteo but had a much larger frame than me. My primary care wanted me on prolia. I went to an endo at UC San Francisco and a few years ago he suggested hormones because I read about side effects of the meds. At the time he told me that my numbers aren’t as bad as they appear mostly because of my small thin frame. The numbers in a dexa compare you to a 35 year old average young adult and I am not average. I am tall, very small frame and slender. Anyway that’s when they were in the 3’s. i lifted weights and was active my entire life. Never sat at a desk all day.
Well my mom ended up needing help with her health and I moved her in with me and cared for her while I worked in a 60 hour a week career. I was so focused on her and ended up loosing her in a few years and never did anything about my osteo during that time and now here I am. I am anxious and not much help from docs. I finally found an endo with Stanford and she prescribed tymlos the other day. Waiting for insurance approval. She is very busy and my next follow up with her is in late sept which really bothers me to wait that long. I have more questions for her. Not the best bedside manner. She did run a 24 hour urine and pth along with comprehensive panel with no explanation as to why this happened. She is all about text book and not real life experiences from other patients. My UC San Fran doc was amazing but no longer sees patients. So I found an amazing functional med doc and working with him to try and stop further bone loss while I take tymlos.
Sorry for the long message. Happy you secured an earlier appt.

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@candy209

Good morning,
It’s in my spine and can’t remember exactly where in my spine. I’ll look it up today. I asked for the dexa a few years ago because my mom had fractures in her ribs at an early age. She ended up being fine and never got osteo but had a much larger frame than me. My primary care wanted me on prolia. I went to an endo at UC San Francisco and a few years ago he suggested hormones because I read about side effects of the meds. At the time he told me that my numbers aren’t as bad as they appear mostly because of my small thin frame. The numbers in a dexa compare you to a 35 year old average young adult and I am not average. I am tall, very small frame and slender. Anyway that’s when they were in the 3’s. i lifted weights and was active my entire life. Never sat at a desk all day.
Well my mom ended up needing help with her health and I moved her in with me and cared for her while I worked in a 60 hour a week career. I was so focused on her and ended up loosing her in a few years and never did anything about my osteo during that time and now here I am. I am anxious and not much help from docs. I finally found an endo with Stanford and she prescribed tymlos the other day. Waiting for insurance approval. She is very busy and my next follow up with her is in late sept which really bothers me to wait that long. I have more questions for her. Not the best bedside manner. She did run a 24 hour urine and pth along with comprehensive panel with no explanation as to why this happened. She is all about text book and not real life experiences from other patients. My UC San Fran doc was amazing but no longer sees patients. So I found an amazing functional med doc and working with him to try and stop further bone loss while I take tymlos.
Sorry for the long message. Happy you secured an earlier appt.

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No apologies necessary. My GP seems to agree with you that my similar Lumbar numbers aren't a big deal. Having a small frame seems to be one of the big risk factors for OP. I'm reaching the limit of my researching, but I'm going to look at the correlation between small frame folks and rate of fractures.
If we take your MD's interpretation seriously, (based primarily on your MD's clinical practice), what would justify/explain it? I'll be looking into for corrolation between larger frame (mostly male) folks and their rate of fracture and those of us with more petite/petit bearings. Assume that we are like the compact models of the automobile world--small cars likely have no greater risk of breaking down or collision. In theory, our tires wear out quicker than the big-car tires. If our bones are like tires, wee folks might have less tread to lose, but if we drive properly, safely, we're not in any more danger than the big-tire types. I need to work this out more. Something sounds like my thinking has gone off the tracks...

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@dk68

No apologies necessary. My GP seems to agree with you that my similar Lumbar numbers aren't a big deal. Having a small frame seems to be one of the big risk factors for OP. I'm reaching the limit of my researching, but I'm going to look at the correlation between small frame folks and rate of fractures.
If we take your MD's interpretation seriously, (based primarily on your MD's clinical practice), what would justify/explain it? I'll be looking into for corrolation between larger frame (mostly male) folks and their rate of fracture and those of us with more petite/petit bearings. Assume that we are like the compact models of the automobile world--small cars likely have no greater risk of breaking down or collision. In theory, our tires wear out quicker than the big-car tires. If our bones are like tires, wee folks might have less tread to lose, but if we drive properly, safely, we're not in any more danger than the big-tire types. I need to work this out more. Something sounds like my thinking has gone off the tracks...

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Well, it sounded hopeful, but I've found nothing in the research to verify the thought. Still, being lithe would seem to have some mobility advantages, outside of competitive sports. Losing a few pounds, I can scale hills and staircases with little exhaustion.

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I am a big researcher as well and will be talking the Dr. Mc Cormick about this and am trying to get into my old endo for one more quick chat and will ask him to clarify this for me as well.
Please share any details you come up with and I will do the same.

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