It is a challenge when one develops multiple health issues. It is important to see the patient's total picture.
I have osteopenia/ osteoporosis and have been on medications for some 20+ years. I have been on Prolia for 7 years.
I was diagnosed with lung cancer two years ago and had 2 VAT surgeries, and recently a radiation treatment. Radiation impacts bone density. I had a bone density recently and the local provider suggested I lock in my results and go to Fosamax from Prolia. I asked my Primary Care Provider if he thought that was a good idea and he said he did not have the knowledge and recommended I see an Endocrinologist. I therefore consulted one at Mayo. I learned something very important. He recommended I continue on Prolia for another 5 years and then I could consider changing to a different drug. Prolia has bone specific antitumor effects. That is very significant for someone with cancer who fears spread to bones!
I am also now on Prednisone which impacts bone density significantly, so it is important to consider all the related effects of treatments.