Anyone have severe bone (spine) loss with recurrence of PC?

As soon as you went on Lupron you were supposed to get a DEXA scan to see what your bone strength is and Instructions to take calcium at least twice a day, (calcium citrate preferably).

Soon after I went on Lupron, I was put on Fosamax. It’s a bone strengthening pill you take once a week. After six years of that I went on Zometa infusions, but you can also get Xgeva infusions. Either one keeps your bones, strong and prevents them from fracturing.

You should speak to your doctor about this. It’s probably time for you to do at least one of the bone strengthening drugs.

Had Prolia from start of Lupron. Taking calcium since ending Lupron. DEXA done twice. Before RALP and about 6-months after ADT stopped. I was 70% to the good side for my age, 78.
I’m worried that since sore back didn’t start till just after last PSA, 9/25, that PC has come back super fast deteriorating 3 vertebra.
But never heard PC causing bone loss. Thought it only made tumors.
Worried and confused.
Will request biopsy of bone for PC or other culprit during repair

@grandpun

One of the primary problems that Lupron causes is thinning of The bones. There was a doctor at one of the conferences about nine months ago, that specialize in bone health and said that everybody who is castrate resistant Should be on bone strengtheners. He emphasized that Lupron is really hard on the bones, And those were on it long-term should be on Strengtheners.

I forgot to mention that vitamin D is another one of the important things needed for keeping bones strong. That was another thing. My doctor mentioned I needed to take daily. I’m sure you’re doing that..

From AI

Lupron can cause bone loss (thinning of the bones) as a side effect, particularly with long-term use. This is because it can decrease sex hormones, which are important for bone density. Doctors can mitigate this risk by using "add-back" therapy with a progestin like norethindrone acetate, ensuring adequate calcium and vitamin D intake, and monitoring bone mineral density with DEXA scans.

@grandpun, you may wish to check out these related discussions:
- Did androgen deprivation therapy (ADT) cause bone loss for you?https://connect.mayoclinic.org/discussion/adt/
- Osteoporosis and Osteopenia treatment and prostate cancer?https://connect.mayoclinic.org/discussion/osteoporosis-and-osteopenia-treatment/
- Osteopenia Supplements that work? https://connect.mayoclinic.org/discussion/osteopenia-supplements-that-work/

Thank you Colleen for the good links.
My Ortho Doc said I'm a unique case. My vertebrae compression fractures were every other bone; T5, T7, T9.
And not seen on most recent DEXA scan. He elaborated, protocol (at least around here) is front/back oriented. For the vertebrae this makes the center of the bone difficult to evaluate because the dorsal (back side) extensions of the vertebrae make it almost impossible to see what's happening inside the bone.
As a result, of three DEXA scans none show spine bone loss/weakness; even the one 12/8/25 AFTER my fractures were repaired. All my arm and leg bones viewed per the protocol show my bones are in great shape.
Now I"m on good supplements (Bone Restore) to prevent more compression fractures. And those fractures do hurt like all hell fire. I thank the Good Lord and an awesome doctor for not having collateral nerve damage throughout this mess.
Good luck to all on or having used ADT. And watch your spine as best you & your doctors can.

@grandpun
I do not understand this bone supplement thing. I’ve been told to be on calcium and vitamin D since I started ADT. That’s one way to prevent bone loss.

I was specifically put on bone strengtheners that are not supplements. They are drugs that specifically are designed to prevent bone weakness and strengthen the bones.

I was on Fosamax the first six years I was on ADT.

Since then, I’ve been on Zometa and a lot of other people are on Xgeva.

Since you’ve already had bone weakness issues, why is it that your doctor isn’t having you on these bone strengtheners? I don’t recall if you are no longer on ADT, In that case, you probably don’t need it.

I understand the Dexa scan doesn’t show weakness, but if you are on ADT, it can easily become a problem.

I'm off Lupron since Jan 2023. (Side note, some hot flashes continue so there's probably some residual still in me).
When on ADT I got PRolia shots every 6 months.
The supplements are doctor's choice. Probably any good Rx or supplement is fine.
DEXA should show weakened bones by the T and Z scores. But the front to back view won't show any trouble in spine.
But today I feel like another one is fracturing so off I go.

@grandpun
It is impossible for Lupron to be in you for that long. It’s half life is only a few hours. When you get the shot, it’s one month three months four months or six months. The drug does dissolve after that amount of time and disappears since the half life is so short.

What can be going on is your testosterone is not increasing. I have not seen you mention your testosterone level? After getting Six months of Lupron, my brother was still having mild hot flashes when he was off it for one year. His testosterone still was below 150.

If you are still having fracturing in your spine, getting one of those bone strengthening drugs, I mentioned could stop this from happening.