Bisphosphonates for Breast Cancer Bone Health: All You Need to Know
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- เผยแพร่เมื่อ 29 มิ.ย. 2024
- How does breast cancer treatment impact bone health? In this video, Dr. Jennifer Griggs explains everything you need to know about how bisphosphonates work, their benefits for breast cancer, and what you need to know about managing your bone health during and after treatment.
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Disclaimer: Yerbba TH-cam videos are for informational purposes only, do not constitute medical advice, and are not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your medical team, mental health professional, or other qualified health provider with any questions you may have regarding your medical condition.
Your last few videos have been very on-point in relation to my breast cancer journey (I hate that word, but it's apt). I would very much like a follow-up video on the side-effects of bisphosphonates, as they seem kind of concerning (lower calcium, GERD, kidney issues) and self-defeating (i.e. joint pain??).
Thank you for your feedback and for sharing your concerns about bisphosphonates. We will be making a video on the side effects of bisphosphonates. We just ran out of time on this video. Thank you for being part of the Yerbba community!
I have very mild Osteopenia and am on Anastrozole - my Medical Oncologist reviewed the DXA scan and said that I did not need a bisphosphonate at this time but would continue to monitor my bone density (I'm 70). I have read about some very horrific side effects of bisphosphonates (osteonecrosis of the jaw being a major one for me) and have made the decision to try to build up my bone density through weight bearing exercises, weight moderation and prunes 😊. I would very much like to see your input on the side effects of bisphophonates and alternatives.
It’s great that you’re being proactive about your bone health with weight-bearing exercises and a healthy diet. Monitoring bone density is crucial, especially with mild osteopenia. We will be putting out a video about the side effects of bisphosphonates. Thank you for sharing your experience and being part of the Yerbba community!
Hi Dr Griggs, thank you for your informative videos .I am on Anastrozole and have beginning osteoporosis, my Oncologist prescribed me Zometa I.V every three months (for now..) He prepared me for the side effects,(flu like symptoms ect.)Nothing to be scared of but nice to know that the first time it might give you two or three days of not feeling so great..my Oncologist informed me very well about everything that is happening but it is still nice to hear this from a second specialist,..Thank you once again and greetings from Croatia ..😃👋
Greetings to you in Croatia! It’s great to hear that your oncologist has prepared you well for Zometa infusions. It’s always reassuring to hear information from multiple sources. Thank you for your kind words, and we hope our videos continue to provide you with support and information. Most people find that the side effects get much better after the first one to two treatments.
Thank you, Dr. Griggs, for your continuous support for breast cancer (health) patients.
Thank you for being part of the Yerbba community!
Thank you for this. I've just completed chemo and radiotherapy for TNBC. I was due to start bisphosphanates but nobody could explain why. You've made it all clear. Please talk about the side effects. I'm nervous about the jaw bone necrosis. Thank you.
Thanks for responding to my request and making this video about Zometa ❤
Your feedback is always appreciated! Thank you for suggesting this topic and being part of our Yerbba community!
Very insightful. Thank you!
Thanks for the positive feedback and for watching!
Thank you Dr. Griggs for another very helpful video. Please do a follow up video on the side effects of the bisphosphonates, especially Zometa. Also if you could do a video on the pros/cons of the various AI medicines. If a person is having problems on one, how do they decide which one to try next? Thanks again!
Thank you for your feedback and suggestions. We are planning on making a video of the bisphosphonates side effects. We just ran out of time with this video! Discussing the pros and cons of various AI medicines is also a great idea. Thank you for being part of our community.
From recurrence surgery I ve gone radiation 3yrs ago and on Anastrozole.. I ve started my Zoledronic infusion every 6 months and will be on 3rd time by August until finish my 6x as per my oncologist advised.. I would be happy to hear about this treatment as additional understanding on my part.. I was on grade 2 recurrence and first undergone mastectomy with no cancer 11 yrs before recurrence on 2021 surgery and now on anastrozle and colacefarol vit 3 tablets taking once a month and zoledronic infusion every 6 months for 3 yrs as advised.. I want to know more about this treatment and I ve found yr video
Thanks
We're happy that this video was helpful. Thank you for sharing your experience.
After my cancer treatment I was diagnosed with Osteoporosis in the back and Osteopenia in my hips. Scared of the side effects I only started taking bisphosphonates six months ago. I had my Dexa scan last month and the bone density in my back as slightly decreased. How long do bisphosphonates take before there is signs of improvement.
Could you please make a video on changes to look out For on the blood work? I noticed very high ferritin along lower iron and hemoglobin and rbc. Thank you for all your great information sharing 🙏
Thanks for the suggestion. We do recommend that each person review their bloodwork with their own team. It would be difficult to make a blanket recommendation for each type of blood test that we do. In your case, very high ferritin along lower iron and hemoglobin and RBC represents a complicated situation that only you and your doctor can work through. Thank you for your comment.
Could you do video about the Oncotype DX test? I have been recommended this test, but it is just so expensive, here in Germany €4000.
Thank you! Very helpful. I’m going to ask for a bone density test so I have an idea of where I started out versus after chemo, etc.
Depending on your age, a baseline bone density test may be useful. In people who are young, bone density tests are usually not useful. Rather, checking the bone density after being on a bisphosphonate or an aromatase inhibitor (or both) is more helpful in guiding treatment.
Thank you for all these videos
So helpful ❤
I am trying to find out the latest data on taking Anastrazole
The side effects are harsh and my concern is that it’s standard protocol but how effective is it
I can only find old information on this subject
Thanks
Thanks for taking the time to write. The side effects of anastrozole were identified in large randomized trials with thousands of people. Those studies have since been completed, and the profession believes that we know the full range of side effects. Of course, everyone is different, and unexpected side effects can occur with any drug. The existing data are, however, extensive. Is there a particular side effect you'd like to know more about?
Gosh, I’m so grateful that in Australia it’s not legal to advertise prescription drugs. I feel like I’m caught between a rock & a hard place. I know I need bone support but I’m just to concerned being at stage 4 ILC to have these drugs & experience the pain, nausea & potential weight loss caused by side effects. I know not everyone has these problems but in my family it has occurred & if my life is full of constant side effects I’m not sure I can take the risk. Also the only reason it appears to improve bone density is because the osteoclasts are virtually turned off therefore not mopping up old bone tissue. In time bone remodeling decreases potentially leading to spontaneous fractures. It just doesn’t feel like a good drug model. “Bisphosphonates inhibit osteoclasts and decrease bone remodelling that may lead to accumulation of microdamage and stress fracture in the femoral shaft “
You are correct that there are some downsides of the bisphosphonates, in particular, a type of fracture called a "fragility" fracture. While the benefits of the bisphosphonates outweigh the risks for most people, it's important to remember that all drugs, even placebos, can have downsides. Thanks for sharing your perspective.
Thanks for the informative video. May I ask about the drug "Raloxifene" - is it a good choice if you can't tolerate Tamoxifen? Is Raloxifene just as effective (have any studies been done to compare?) tia
What is the significance of a pathological complete response in er positive breast cancer?. My wife’s tumors are gone from the mri and the cancerous node is now appearing normal. I know the pathological report will tell the story and endocrine therapy rules the day but I always hear and see information on the significance in triple negative but I can’t find ANYTHING on what this means in er/pr + her 2- cancer. Any info would really help . She’s 37
Thank you Dr. Griggs..it was so very informative..have been dx with higher risk of hip fx. My PCP is referring me to an Endocrinologist.. she feels i would benefit more by having the medication administered by injection or infusion, due to my gastrointestinal issues with taking certain medications..if so, would it also reduce some of the other side effects of taking medication to strengthen bones as well? Note..though i had quite a struggle with my breast surgery, chemo,.radiation, etc., Armidex did not reduce my bone density significantly as you shared!!
Thanks for the questions. The bisphosphonates are not absorbed very well by the body. That's why we have to take them first thing in the morning on an empty stomach and have to avoid eating for a while after taking them. When they are given by IV, they do not cause the GI problems and can be taken even if you've eaten. In people who do not get enough benefit from the oral bisphosphonates, switching to IV is a terrific strategy.
Thank you Dr Griggs for this very informative video. Do calcium & glucosamine chondroitin supplements help with bone health for patients taking AI?
It's Dr. Jennifer Griggs
These supplements were used primarily to help with arthritis, problems in the joints, rather than problems in the bones. Research results are mixed, however, with many studies showing no significant benefit over placebo (a "sugar pill") The American College of Rheumatology and the Arthritis Foundation discourage the use of these supplements due to lack of strong evidence and potential bias in available studies. And get this, a 2016 study found that some patients taking glucosamine and chondroitin actually reported worse symptoms than those taking a placebo.
could you please talk about shortness of breath during chemo 😢
Thank you Dr Griggs for the very insightful video. What’s your opinion about vibration plate to improve bone health for this community?
Dr. Griggs.. is wonderful
@@EC-yd9yv Thank you!
Vibration plate therapy shows promise for osteoporosis management, particularly in improving balance and potentially slowing bone loss. More research is needed to fully understand its long-term effects and optimal use. It's crucial to consult with a healthcare provider before starting any vibration therapy regimen, especially if you have osteoporosis or are at risk for fractures. Thank you for watching.
@@yerbba Thank you❤️
Im getting zometa infusions once every six months with steroids and i have pretty bad pain for almost a week after. Ive learned to schedule time off work for it. It's worse than i expected it to be. I also had bad leg pain after each infusion of paclitaxol so maybe its just how i react. Even taking calcium and vitamin d and zometa, i saw a slight decrease on my dexa.
It’s tough dealing with the pain from Zometa infusions, but it sounds like you’re handling it as best as you can. Scheduling time off work to manage the side effects is a smart strategy. The steroids are likely to decrease your bone mineral density. It would be worth asking if the steroid dose can be gradually reduced if that hasn't been tried already. Everyone reacts differently, and it's important to take care of yourself during this time. Wishing you relief and strength.
Last month my doctor told me stop the aromatese inhibitor letrozole for 8 days to check if the bone pain was due to medications,
Is it safe to stop letrozole for 8 days in a row ??
My doctor said he will put me on letrozole for 5 years,
So in 5 years how many times can I stop the medications for 8 days in row ?
Plz let me know .
Mam is T3 N1a M0 tnbc cureable?
Doctor Griggs,what the difference between prolia denosumab injection and zometa?
I’d love to see a video on denosumab
Denosumab is a RANK ligand inhibitor and works differently from the bisphosophonates. Denosumab appears to increase bone mineral density more than bisphosphonates, but the thing that we really care about is fracture risk, which does not differ between denosumab and the bisphosphonates. Denosumab is extremely expensive compared to the bisphosphonates, so it is often reserved for people with kidney problems or for people who have no iv access. It is sometimes also used if someone continues to have loss of bone mineral density while on a bisphosphonate. Thank you for watching.
@@yerbba Thank you for this answer. Could you also speak more to long term dosing on Denosumab & the Bisphosphonates. I recently saw a TH-cam video that said after a year you may be able to extend the dosing to every 3 months instead of every month. The other thing that was mentioned was the dosing of Zometa is more flexible than Xgeva. That Xgeva has to be given on an exact schedule otherwise you can have rebound bone breakdown. Finally, could a baseline BMD help with getting Xgeva covered by insurance. My doctor tried to start me on this, but it was denied by my insurance. We are going to use Zometa instead. There are definite pros and cons- such as the injection versus the infusion. However, if there is more flexibility, I would rather have the infusion.
I am on Anastrozole for 14 months.The joint pain, mainly in my hip, is getting progressively stronger.My oncologist wants to add Timoxifen additionaly to Anastrozole.He told me that Timoxifen helps me with pain.My Dexa scan result is-1.2I refused to take any bisphosphonate.Not sure what to do.Any suggestion would be welcome.
In general, it is not recommended to take an aromatase inhibitor and tamoxifen together. If your hip pain is getting worse, ruling out something other than pain from the aromatase inhibitor would be a good first step. If the pain is definitely consistent with pain from an aromatase inhibitor, stopping the aromatase inhibitor and changing to tamoxifen would be an option.
Many thanks Dr Griggs for your reply and your opinion.Tomorrow I will see an orthopaedic surgeon and hopefully he can either exclude or confirm that my hip pain is not related to Anastrozole.
Do you mean that Bisphosphonate prescribe only in case of bone problem? And this usually occure from AI drugs and not Tamoxifen?
Bisphosphonates are used to decrease loss of bone mineral density, which does not cause any symptoms unless someone has a fracture. That is they are not used to treat pain from any source. Rather, they can help bones be stronger. Thank you for watching.
I have a question. After all my treatments were done for my breast cancer, I asked to get another bone scan. My doctor said no, that they are only done every 2 years. Why is that??
Same here…it takes time to be able to see a significant change. 😊
Been watching all your videos since i was diagnosed with stage 2 idc 2 months ago. I would like to know if i will not be doing any treatment after the surgery how many years will i still leave?
Do you have any idea what will happen??
Talk to your medical team for guidance. Each patient diagnosis is not the same and have different outcomes. 🙏
It sounds as if you're asking what your survival will be if you don't receive any additional therapy after surgery. It is not possible for us to estimate your survival with and without treatment since we do not have all of the details about your cancer. Your medical team will help you figure that out as long as they know you really want to know.
My doctor told me I must see dentist before starting Zometa. Why dental work must be done prior to Zometa infusions?
To ensure that you don’t need extensive dental work as bisfosfonates cary a slight risk of jawbone necrosis.
Great question. Seeing a dentist before starting Zometa is crucial to prevent complications like osteonecrosis of the jaw. It’s important to address any dental issues before beginning treatment. Thank you for watching!
BRCA anti neoplastic drugs meds side effects 😏🙏🌎💖
Dealing with the side effects of BRCA-targeted anti-neoplastic drugs, specifically the PARP inhibitors, can be challenging.
The most common side effect is fatigue, marked by tiredness and lack of energy. Gastrointestinal issues like nausea, vomiting, diarrhea, and decreased appetite are frequent. Hematological toxicities include anemia (low red blood cell count), neutropenia (low white blood cell count), and thrombocytopenia (low platelet count), increasing the risk of infection, bleeding, and fatigue. Headaches and dizziness are common symptoms. Respiratory symptoms like shortness of breath or cough are generally mild. Insomnia is reported as a side effect, and some patients experience joint or muscle pain. Skin reactions, such as rashes, may develop. Possible laboratory abnormalities include elevated liver enzymes (ALT, AST) and creatinine levels, especially with rucaparib. Hypertension is more frequently noted with niraparib compared to other PARP inhibitors.
While these side effects are common with all PARP inhibitors, each drug has its own profile. For instance, rucaparib is linked to more lab abnormalities, while niraparib often causes thrombocytopenia and hypertension. Most side effects are manageable and often improve after a few months. Some individuals may need dose adjustments or, in rare cases, to stop the drug. It's crucial to stay in close contact with your healthcare provider to manage these side effects effectively.