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Who is managing your bone health, oncologist or endocrinologist?
I’m a breast cancer patient on Letrozole for 5.5 years so far and 10 year goal. 2 years ago I had osteopenia and my oncologist wanted to put me on Zometa, but said ask your endocrinologist. My endocrinologist said no, he would do Prolia first and only when I have osteoporosis because Medicare won’t cover for osteopenia. So I haven’t been on anything. I’m reading that Medicare will cover those drugs for AI drug induced osteopenia (true?) and that oncologists choose Zometa for breast cancer as protection from cancer spreading to bones (true?). I feel like the two specialists need to talk so I get the appropriate treatment. Oncologist just told me to have my endocrinologist order DEXA that is due and manage my bone health. Endocrinologist says he can order but it won’t be covered since he has no history on that for me. I feel like a ping pong ball so I’m wondering who is managing bone health for other breast cancer/AI patients. Thanks for any input.
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@marceen
My doctors are aging right along with me. I think doctors, like every other profession, start to burn out over time. Some just want to scale back to easy by the book cases. The trick is to build a medical team that likes a challenge. 😊
@californiazebrI
I take 2,000 of D3 also............and my potassium is also a combo gummy with magnesium.
Number 1 on my list - always is the PTH blood test..........otherwise calcium is sucked up and out in the blood.
@marceen
I’ll look into that. I have quite an array of medical conditions so I’m already overwhelmed by the onslaught of appointments and research. I’ll add that to my list to look into before my DEXA follow-ups though. I try to squeeze in a little fun here and there between medical stuff. 🥰
x
Hey there!
My rheumatologist with a cc to my oncologist manages my bone health .
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1 Reaction@kensiejames
Good to know. Thanks for your reply.
Hey there!
Medicare will cover test ordered by your oncologist. At this point your bone health is at risk from the cancer so there should be no issue with approval from Medicare .
“Zometa can help reduce the risk of early-stage breast cancer returning or spreading to the bones. It changes the bone environment to make it harder for stray cancer cells to survive and grow there, particularly in postmenopausal women or premenopausal women whose ovaries are suppressed”.
All the best🙏🏻
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1 Reaction@kensiejames I appreciate your post about the benefits of Zometa for early-stage breast cancer. Even though that's not a ton of information, it's more information than any of my doctors have offered! So far, when pressed by me as to whether the Zometa is primarily for bone health (preventing fractures) or to offer protection against possible cancer spreading to the bones, they have emphasized that it's to prevent fracture more than to prevent cancer spread. Had I declined Zometa, though, perhaps they would have emphasized the cancer spread prevention.
Your information prompted me to look a bit further. Google AI's main statement echoes your statement. There is mention of Zometa altering the bone microenvironment which makes the growth of cancer cells less likely.
Google AI also states that ideally one would start it within 3 months after surgery, which I did not do. But it also goes on to add "However, studies indicate that it does not improve survival rates more than 2 years of treatment compared to longer durations." The sources for this statement are the National Cancer Institute and breastcancer.org. The statement is somewhat vague and one would need to track down the original studies to really understand their findings.
These same sources are referred to behind this:
The long-term implications of using Zometa (zoledronic acid) in breast cancer patients include a reduced risk of breast cancer recurrence in the bone and improved survival rates among postmenopausal women. However, there are potential side effects, such as osteonecrosis of the jaw and kidney toxicity, that patients should be aware of.
@kensiejames
Thank you for your response.
@prarysky
Good info. Thank you for your response. Meds always sound like a miracle until you get to that fine print with the scary side effects. Jaw osteonecrosis is pretty darn scary! I’ll wait for my upcoming DEXA results and go from there.