Diagnosed with DCIS: How do I decide on treatment?

It’s all so true. I thought I was doomed to radiation and definitely chemo based on the first doctor that I was seeing. After “accidentally” seeing another doctor who seemed to have a similar opinion, once all that genomic testing came through, everyone was shocked and the entire office was calling me with the good news. Wishing you good news.

This article explains how the different medications help bones.
https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-finding-the-right-osteoporosis-medication/
After reading it, I am glad that I chose the Prolia during my treatment and not the Reclast. I just don’t know what to do when the Prolia is up in January. I mean, when my oncologist and I were discussing what to do about my bones all I did was mention the six months that I wasn’t on anything and innocently said that maybe we could do another 6 months to make up for it and he said he thought it would be a good idea. But every doctor is different and some patients also have no bone issues. You and I have both been reading posts about how some doctors are flexible and are willing to experiment and work with their patients so that they take this important medication. (and you understand the language better than I do). I try to be careful when I post and try to stick to my own experience. The only reason that I heard this from 2 doctors is because my breast surgeon told me to get my thyroid levels checked. So I did. My number was 6 and as much as my PCP was my rock through this, he told me that he starts treating at 10. My surgeon and oncologist told me that they start treatment between 3 and 4. As a result, I ended up with an endocrinologist who also knew all about bones and she also mentioned the metastasis.
I never asked why it would help, but you did. I just assumed it was just a good call because they both told me that patients who have cancer in their bones are treated with Prolia and breast cancer can go to the bones. That’s really just what happened.

Just read this and so embarassed by all the spelling mistakes!!! LOL Thats what happens when your fingers wont bend!

@lcr2017 I read your link and for me, the most important sentence was the last one: "The suggestion that estrogen deprivation with AIs can favour a ‘bone-related’ risk conditions for developing bone metastases must be considered with caution and surely needs further validations; our next multicenter confirmatory study will try to shed light on this topic."

The idea that aromatase inhibitors encourage metastasis both by creating an environment that encourages it, and by causing osteoporosis that also encourages it, is pretty darn alarming- and will affirm those who decline these meds.

I am going to ask my doctor about this. These issues are a far cry from my original question about whether Prolia and biphosphonates have preventative effects regarding metastasis, as well as having protective effects for bones.

Take it a step at a time if you can. For one thing, a lot will be learned from the surgery, the size of tumor when the surgeon is actually "in there" as my surgeon referred to it, sentinel lymph biopsy if being done and post-surgery biopsy results. If you're a candidate for genomic testing, that can also yield a lot of information. So a lot of decisions you're pondering now might not even be recommended when all the data is in. I worried about decisions that, happily, I didn't have to make. That was a huge benefit of, in my case, the OncotypeDX test.

Hi everyone. Thank you for all the helpful information. I’m really going to need it.

I got my surgery date today - October 24th. (But, honestly, I think I’m more nervous about all the decisions that go with the aftercare. 😱)

You’ll be hearing from me a lot! Thanks again.

The non-profit Pro Publica has myriad articles on financial and other incentives paid to doctors but not reported to patients. I've checked every doctor I use and not one accepts these 'incentives.' A friend nearly died from a drug his cardiologist pushed only to find out later that he was, unbeknownst to him, 'in a study' for the drug. For which his cardio received over $300,000 in undisclosed incentives. Worse, the drug failed FDA approval because some "participants" in the study died from side effects.

Caveat emptor!

DOLLARS FOR DOCTORS
How Industry Money Reaches Physicians
https://www.propublica.org/series/dollars-for-docs

Food for thought on doctors' ratings online, which I never trust.

I’m Also One of America’s “Top Doctors.”
https://www.google.com/amp/s/www.propublica.org/article/top-doctors-award-journalist/amp

Hmmm, physicians incentives wasn’t even on my radar. It would be a good question to ask. In Missouri we have Siteman Cancer which is a larger institution & ranked #10 in the country. I’m not currently going there but I may switch if for no other reason than to get a 2nd opinion regarding if I absolutely need radiation or not. Thanks!

That is encouraging. As so many others have said, seems that many Docs prescribe standard protocols, not individualized. Praying my Doc actually sees “me”, not another statistic. Tnx for your response🤗