Should you get a bone test if only on ADT for 6 months

@clevelandguy Thanks for comments. my PSA in May was .014 and I am due to get another test next week prior to 1 year Radiation Oncology follow-up. I was told that the side effects with Hormone treatment would be 10% compared to prostate removal or implants. That has not been the case...it's more like 40-50% side effect issue. The fact that after the 3rd shot, my hips started hurting was very troublesome and disabling to normal life...hard to walk. The bone density completed at mid-treatment was normal but Orthopedic Surgeon says Bursitis could be started. I am still going to request a PET scan because quick onset of severe side effects in bone and skin itching after 3rd shot is troubling. I was told prior to being diagnosed for Prostate Cancer that the increased PSA score after 70 years old is natural....then I was diagnosed with an aggressive Aden Carcinoma Cancer. I question everything.

@jeffmarc Thanks Jeff for your comments. I had a bone scan...it was normal. As I discussed with "clevelandguy", the side effects after shot 3 came on strong and disabling. I have done some research and there is a possibility that cancer cells become immune to hormone meds and seek other sources to survive. Per my Urologist, my cancer was very aggressive and climbed very fast until my first hormone shot. I am going to continue to look at all testing options available. Had my PCP intervened two years prior when PSA started climbing, the last 18 months of discomfort and doubt could have been avoided or less intrusive.

My experiences while on Firmagon, which doc initially said would be 6-12 months.

No offer for a DEXA was made by my COE care team. After first one month shot of Firmagon I was watching a PCRI 8 hour long video for their September 2025 conference in Los Angeles. Within the video one oncologist said that ANYONE that will be starting on a course of ADT should have a DEXA. So I asked the oncologist taking care of me about that. His reply paraphrased was since I asked they would do it. But that Medicare may not pay the test cost. Told him I didn’t care and wanted a scan. It came back showing that I ALREADY HAD osteoporosis. Visited and Endocrinologist and she did a zoledronic acid infusion. Also taking vit D and Calcium. And three hours a week doing resistance weight exercises.

Point is that you will need to advocate and press the care team to have this test done. Things could have turned out really bad for me, and it was just luck to a degree that helped.

I pulled the plug on Firmagon after five injections. Last one was mid February. Mid June checkup had me at undetectable levels of both psa and testosterone. So my five months of Firmagon (started October 2025) has at this point turned into 10 months and counting. So glad I stopped when I did.

Gleason 9 diagnosed in August 2024. I was on Orgovyx for 20 months, ending in April 2026. Twenty-five sessions of IMRT. PSA presently less than 0.04. 74 years old. Presently taking Centrum 50 Plus multivitamins and Omega 3 fish oil daily. I'm debating whether or not to take Calcium Citrate supplements because I had a kidney stone removed four months ago and still have a non-obtrusive small stone in the other kidney.

@climateguy

I know of no one who had the tests you listed. Everyone I know got radiation or surgery with only a biopsy and PET scan. All also got ADT for 18 or more months.

@johnny8924
Since you had kidney stones you should be very careful with Ca supplementation.

If I were you I would ask my doctor about that since Ca and D supplementation actually was never proven to help preventing bone loss.

There were no studies conducted comparing man on ADT who took Ca + D and those that did not and what is even more troubling there are some studies that show that Ca supplementation can increase coronary disease risk, kidney stones and even can have "positive" effect on PC progression.

I found about all that yesterday while doing some reading about recommended daily levels of Ca in diet and was shocked : (.

Here are some links :
https://www.theoncologynurse.com/articles/ton-3879
https://pmc.ncbi.nlm.nih.gov/articles/PMC3448410/
Hope this was of some help and wishing very fast healing of your kidney. It can be extremely painful condition : ((

@oldgreenpaint
Fortunately my oncologist ordered a Dexa at the start of my 18 month regime of Orgocyx, which showed mild osteopenia. He has me on Prolia, and I am doing daily impact loading exercises.

@jeffmark do you know if medicare covers yearly Dexa scans for individuals on ADT? My wife is only allowed one every 2 years and she is on a yearly Reclast infusion.