Breast cancer treatment and osteoporosis

Posted by jknows @jknows, Feb 24 8:06am

I was diagnosed with triple negative breast cancer in February 2023. I received the Keynote 522 protocol that includes chemo, surgery and immunotherapy. I just had a repeat bone density test and discovered I have moved from osteopenia to osteoporosis. Is this a common outcome from BC treatment and if so how is the osteoporosis treated?

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@semurrey

I appreciate all you offer! I have ILC and so wonder why doc didn’t mention bone builders-I’m at -2.7!
Thx again! I’m so stressed about this Fosamax as already have joint pain from Letrozole and now have a “heaviness” in legs that sometimes wakes me around 3am. I’ve been on Fosamax for about one month!

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For -2.7 a bisphosphonate is good! And it helps with preventing cancer, possibly. You can trust your docs. With -2.7 bone builders would not be covered anyway 🙂

If you cannot tolerate the Fosamax, then you can be considered to "fail" it and insurance might cover other meds. But talk to your doctor if you are experiencing such awful side effects. Some people do Prolia with cancer, but that can end up requiring a bisphosphonate when you stop! We are all between a rock and a hard place.

I could not do a bisphosphonate during my cancer treatment and lost a lot of bone. I was on an aromatase inhibitor like you, letrosole) for 5 years. Then Tymlos after the cancer meds, helped me catch up, though I fractured. If you can tolerate Fosamax it will protect you, perhaps on two counts- bones and cancer. Reclast is standard protocol, with my docs, but Fosamax is a good one if you didn't want to do that.

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@windyshores

@timely so she was not on tamoxifen, right? How bad were her scores? My bone density plunged on an AI without Reclast.

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I will ask her.

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@windyshores

For -2.7 a bisphosphonate is good! And it helps with preventing cancer, possibly. You can trust your docs. With -2.7 bone builders would not be covered anyway 🙂

If you cannot tolerate the Fosamax, then you can be considered to "fail" it and insurance might cover other meds. But talk to your doctor if you are experiencing such awful side effects. Some people do Prolia with cancer, but that can end up requiring a bisphosphonate when you stop! We are all between a rock and a hard place.

I could not do a bisphosphonate during my cancer treatment and lost a lot of bone. I was on an aromatase inhibitor like you, letrosole) for 5 years. Then Tymlos after the cancer meds, helped me catch up, though I fractured. If you can tolerate Fosamax it will protect you, perhaps on two counts- bones and cancer. Reclast is standard protocol, with my docs, but Fosamax is a good one if you didn't want to do that.

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Thanks so much for weighing in! I sure hope you're right and that maybe Fosamax can protect bones from potential spread like Zometa. I'm sure I'll be on Letrozole a long while. I'm sorry you fractured and hoping your number improve! xo

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I think it’s very individual. Not everyone sees a dip in bone density. I had my DEXA yesterday and at 24 mos on Anastrozole I have held steady with .2 here or there. Normal spine, and right hip and osteopenia now in left hip. I’m 73 and have always had an active lifestyle and genetics also plays a role. I am so grateful that good well studied meds are out there for us if ( and when) we do need it.

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@anjalima

I think it’s very individual. Not everyone sees a dip in bone density. I had my DEXA yesterday and at 24 mos on Anastrozole I have held steady with .2 here or there. Normal spine, and right hip and osteopenia now in left hip. I’m 73 and have always had an active lifestyle and genetics also plays a role. I am so grateful that good well studied meds are out there for us if ( and when) we do need it.

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@anjalima were you on a bone med during anastrazole?

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@3dogngt

does anyone get really chilly/cold about 3ish daily? I had Reclast and did horribly last November, but I still get really cold around late afternoons..

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Sending warm hugs !!

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@windyshores

@anjalima were you on a bone med during anastrazole?

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No I was/am not.

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@anjalima

No I was/am not.

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Wow, I lost so much bone density on letrozole! My doc did not want me on Reclast due to afib, a concern that has since been disproved. I hope you continue to do well!

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I'm trying to avoid additional meds. So I'm being proactive and trying to maintain or improve my osteoporosis by strength, balance, and other excercises. We'll see how that goes. I just wish doctors would let us try things on our own before pushing meds. My opinion only. I also take vitamin D and K. I stopped calcium supplements as new research has determined that that has a set of its own problems. I try yo get calcium by diet alone.

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@windyshores

Wow, I lost so much bone density on letrozole! My doc did not want me on Reclast due to afib, a concern that has since been disproved. I hope you continue to do well!

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Thank you. Hope it holds . I do not take any calcium other than food based but I do take 1000 D3 and K2. I’m a fan of k2… calcium score of arteries was 0!

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