Breast cancer patient also with osteoporosis: AI, Prolia and Reclast

bunnymoon,
there is some controversy about Prolia. I'm on the "don't ever take this drug" side. It works by supressing the cells that clean the bone of fissures to prepare it for the cells that lay new bone. So the patient that takes Prolia collects older bone while preserving a surfeit of undeveloped cells just waiting mature. When you stop Prolia, you have to take another drug to prevent those cells from destroying your bones.
I'd suggest that you look at Forteo as an alternative to Prolia. It would protect you sooner and more safely.
There is a lot of discussion on these drugs on this site. And it is easy to search the Q box. But don't think about asking the same questions as a negative. We sometimes change our minds.

I also had osteoporosis, pretty severe, and did 5 years of an aromatase inhibitor (letrozole). Most doctors I have had contact with use Reclast during treatment.

Prolia works well while you take it but there is a rebound problem. If you don't follow it with Reclast you lose whatever you gained and fracture risk goes up. If you are on Prolia for only 2-3 shots this is apparently less of a problem.

Do you have an endocrinologist or is your oncologist managing this?

With cancer treatment, it is usually not something like Forteo, Tymlos or Evenity. Reclast and Prolia both have possible preventative effects with cancer. They counteract the effects on bone density from the aromatase inhibitors. Some women with osteoporosis take Tamoxifen. I wanted the more potent effect of an aromatase inhibitor.

Zometa and Reclast are both zoledronic acid with dosing differences. In my experience, oncologists and endocrinologists tend to suggest these.

Thank you. The current recommendation from my oncologist is for 2-3 years (six shots) of Prolia followed by 2 years of Reclast.

I do not have an endocrinologist.

Hello. I’ve posted my question (concern) under osteoporosis site. Realizing might be helpful to post to Breast Cancer site. Please forgive if this topic addressed previously.
I am 58 with early stage breast cancer. I have osteoporosis also. I am to start an aromatase inhibitor (letrozole). Plan is for me to start every six months Prolia shots. For 2-3 years. Then Reclast.
I’m dreading all these medications, more fearful of osteoporisis, wanting to stay vibrant and active for my young children.
Was instructed by oncologist to take calcium supplements a “few days before and after” Prolia shot.
Am I over-fearing?

Windyshores, may I ask, did your osteoporosis improve? Stabilize? I’m wishing I’d had an involved PCM or endocrinologist pre-Cancer, while still “just” osteopenia! I’m scared of osteoporosis honestly more than the early breast cancer. Do you have any recommendations on what to do in prep for Prolia? Thanks either way.

My doctors did not give me bone meds during letrozole. After treatment I did Tymlos and regained everything and more.

I would not do 6 shots of Prolia, myself. I hope you will see an endocrinologist. Most cancer docs I am familiar with use Reclast.
(Or Zometa, same drug.) You could do 2-3 shots with less risk of rebound, according to McCormick recently.

For metastatic cancer, Zometa and the more potent form of Prolia, Xgeva, are used.

@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?