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Medical Forum / Diseases and Disorders / Prostate Cancer / November 2007GP overrules Professor on BMDT
You may have picked up in my post in a thread from Mike HIFU, that my Rad Onc Registrar referred to the Consultant (a Professor) and then sent me home with a 20% compression area in my spine. I casually mentioned this to my GP (pcp) whilst picking up a truckload of prescription meds. He immediately got excited and has now scheduled me, at last, for a Bone Mineral Density Test! This test was initially up-front on the Clinical Trial schedule in 2004 & it was later omitted "because of too many participants clogging up the equipment, plus causing cost blow-outs". The Professor (who initiated the trial by TROG), then said he could make the necessary judgment by looking at all the X-Rays done on the participants pre-qualification testing criteria. So soon we'll see what transpires. I'm loath to make a noise as my PCa is well in remission, (but my QOL is that of a zombie.) -Please reply to group as my email addr is fake! -Regards CC > You may have picked up in my post in a thread from Mike HIFU, that my > Rad Onc Registrar referred to the Consultant (a Professor) and then [quoted text clipped - 3 lines] > of prescription meds. He immediately got excited and has now scheduled > me, at last, for a Bone Mineral Density Test! I was scheduled for a bone density test when I went on ADT just to get a baseline. He also put me on Fozomax. Haven't had cause to get another density test. My GP has even asked me to back off on my Calcium as my numbers are high. On Nov 8, 3:56 pm, "Steve Kramer" <skra...@cinci.rr.com> wrote...snip... >My GP has even asked me to back off on my Calcium as my numbers are high. Hi Steve...Of course the other side of the coin would be that your calcium intake is at the right level, but it's just not being processed as desired. Have you had your 25(OH)D3 measured?..Best wishes and good health, ron > On Nov 8, 3:56 pm, "Steve Kramer" <skra...@cinci.rr.com> > wrote...snip... [quoted text clipped - 5 lines] > processed as desired. Have you had your 25(OH)D3 measured?..Best > wishes and good health, ron Dammit!! That was nagging at me when I had my last blood test. I knew I wanted two things tested, but all I could remember was testosterone. Okay, sending this to my dr's appointment on my Palm. Thanks. On November 8, Steve Kramer replied to CC: > I was scheduled for a bone density test when I went on ADT just to get a > baseline. He also put me on Fozomax. Haven't had cause to get another > density test. My GP has even asked me to back off on my Calcium as my > numbers are high. It's Fosamax. I wonder how Steve K would know whether he has "cause" to have another BMD test. What is "cause?" I don't ask just to harass Señor K, but because there is no way to know one's BMD unless one tests it. Of course, another clue would be collapsed vertebrae or other idiopathic fractures. If Steve continued on ADT over time, his BMD would be at risk unless he was taking a bisphosphonate (BP). Fosamax is an oral BP. Sometimes oral BPs correct/prevent loss of BMD, sometimes they don't. In the latter case, use of an intravenous BP such as Zometa or Aredia should be helpful. The only way to be certain of BMD status would be to have periodic tests such as DEXA or QCT scans, as well as a Pyrilinks-D (deoxypyridinoline) urine test, which measures bone turnover. It's necessary to monitor blood calcium and titrate any calcium supplements in order to maintain recommended level. It is *vital* to monitor renal function. Steve might not need any of this if he's no longer on ADT, though if such be the case, I recommend another BMD test to check on status. Well, I didn't intend to go into lecture mode. Regards, Steve J PS: If anyone wishes to see pix of our sorely-missed Hugh Kearnley, let me know via e-mail. I don't think we can post jpgs here. What a life! As always, Senor J (don't know how to get the tilde over the "n"), you are a font of knowledge. I will discuss this with both my doctors. > On November 8, Steve Kramer replied to CC: > [quoted text clipped - 39 lines] > PS: If anyone wishes to see pix of our sorely-missed Hugh Kearnley, let me > know via e-mail. I don't think we can post jpgs here. What a life! On November 9, Steve Kramer replied to me: > As always, Senor J (don't know how to get the tilde over the "n"), you are a > font of knowledge. I will discuss this with both my doctors. Thanks for the compliment. Regarding checking the renal function, what's being tested is whether the pt's renal function is normal. Not to imply that a BP would cause such a problem. FWIW, I do extensive tests a week before each (90-day) infusion of Zometa. This is recommended in the literature on Zometa, and appears to be somewhat different in the case of an oral BP such as Fosamax. "No dosage adjustment is necessary for the elderly or for patients with mild-to-moderate renal insufficiency (creatinine clearance 35 to 60 mL/min). FOSAMAX is not recommended for patients with more severe renal insufficiency (creatinine clearance <35 mL/min) due to lack of experience." See http://www.rxlist.com/cgi/generic/alendron_ids.htm#D As for the tilde, I press "option" then "n" to get ñ. But I'm on a Mac. I can switch to a Spanish keyboard, which I do from time to time when on a PCa chat with folks in Spain. So much for bragging :-) Regards, Steve J On November 9, Steve Kramer replied to me: > As always, Senor J (don't know how to get the tilde over the "n"), you are a > font of knowledge. I will discuss this with both my doctors. Thanks for the compliment. Regarding checking the renal function, what's being tested is whether the pt's renal function is normal. Not to imply that a BP would cause such a problem. FWIW, I do extensive tests a week before each (90-day) infusion of Zometa. This is recommended in the literature on Zometa, and appears to be somewhat different in the case of an oral BP such as Fosamax. "No dosage adjustment is necessary for the elderly or for patients with mild-to-moderate renal insufficiency (creatinine clearance 35 to 60 mL/min). FOSAMAX is not recommended for patients with more severe renal insufficiency (creatinine clearance <35 mL/min) due to lack of experience." See http://www.rxlist.com/cgi/generic/alendron_ids.htm#D As for the tilde, I press "option" then "n" to get ñ. But I'm on a Mac. I can switch to a Spanish keyboard, which I do from time to time when on a PCa chat with folks in Spain. End bragging :-) Regards, Steve J > On November 9, Steve Kramer replied to me: > [quoted text clipped - 7 lines] > Mac. I can switch to a Spanish keyboard, which I do from time to time > when on a PCa chat with folks in Spain. End bragging :-) Hola Esteban.....does your spanish keyboard have the @ sign as a 3rd level character?? Drove me nuts in Spain and Portugal when using the hotel computers!! Esteban K......go to the Character Map and after a frustrating search you will find it and the corresponding "Alt Plus" code to put it in your text. I found it to be Alt + 0241, but my Canadian keyboard is not co-operating at the moment. It tends to favour french, naturally. (VBG) Cheers....Heather (with a new $5,000 bridge that is going to take some getting used to. But at least I can now stop eating pooched eggs!!) > Hola Esteban.....does your spanish keyboard have the @ sign as a 3rd > level character?? Drove me nuts in Spain and Portugal when using > the hotel computers!! On my Spanish keyboard, @ is, er, @ "option, g." > Cheers....Heather (with a new $5,000 bridge that is going to take > some getting used to. But at least I can now stop eating pooched > eggs!!) "Pooched?" What do dogs have to do with it? Eh? Hee hee. Hope popcorn, apples and such are now back on the menu. Pls visit us @ the pcainaz bulletin board and chats. Just had the first Snowbird register. Now, that's progress, eh. (I'm practicing) ;-) Regards, Esteban J >> Hola Esteban..... >> Cheers....Heather (with a new $5,000 bridge that is going to take >> some getting used to. But at least I can now stop eating pooched >> eggs!!) > > "Pooched?" What do dogs have to do with it? Eh? Hee hee. LOL!! I deliberately misspelled that because when we were in England, where we stayed in Brighton had all spanish lasses for waitresses, so Ron found it easier to order in that language. And it turns out, there is NO word in espanol for "poached" eggs....he practically had to go to the kitchen to show them how to make them. > Hope popcorn, apples and such are now back on the menu. Nah.....not quite ready for that yet. But had shrimp and chips for dinner and that was my first meal on the new diamond-encrusted bridge. (should be, for the money, grin) > Pls visit us @ the pcainaz bulletin board and chats. Just had the > first Snowbird register. Now, that's progress, eh. (I'm practicing) > ;-) Muy bueno, Esteban. I will have to find that. A Snowbird, eh? Ann Murray by any chance?? Cheers.....Sra. Heather PS......Good thing I looked up that Latin in the other post.....darn near gave you a *virtual slap*, lol. All of these years and I wonder if my sly Dad was truly thinking of those words, grin. He did get a kick out of my rather salty language at times tho. >> On November 9, Steve Kramer replied to me: > Esteban K......go to the Character Map and after a frustrating search you > will find it and the corresponding "Alt Plus" code to put it in your text. > I found it to be Alt + 0241, Gracias, Señora. On November 9, Steve Kramer replied to Calluna vulgaris: [I'm showing off] > Gracias, Señora. Of course, we Mac users have no such problems.... Well, not much. Frex, we don't have to spend mucho $ to defend ourselves against viruses (or virii, sorry Heather) and them equine animals from Troy, like Windoze folks. Lately, becuz the Mac has been discovered to be the best and selling well, scumbags are trying to find ways to attack Macs in the same manner as they have so successfully profited from attacking the competition. It won't work. Regards, Steve J > > You may have picked up in my post in a thread from Mike HIFU, that my > > Rad Onc Registrar referred to the Consultant (a Professor) and then [quoted text clipped - 8 lines] > density test. My GP has even asked me to back off on my Calcium as my > numbers are high. I posted the following on Oct. 31, but will repeat it here: A recent study says that bone density loss can be very dramatic for men on hormone therapy - 4 to 13 percent per year. Regular walking prevents it. See: http://www.sciencedaily.com/releases/2007/10/071028135820.htm Here's a bottom line conclusion from the article: "The study shows that prostate cancer patients undergoing hormone therapy that walked about five times a week for 30 minutes at a moderate pace maintained or gained bone density, while those who didn't exercise lost more than two percent of their bone density in eight to nine weeks." Alan ,, snip ,, > I posted the following on Oct. 31, but will repeat it here: > [quoted text clipped - 13 lines] > > Alan I remember you original post of this Alan. Obviously, being on ADT now for 4¼ years, such things are becoming a considerable concern for me. By CC >> > You may have picked up in my post in a thread from Mike HIFU, that my >> > Rad Onc Registrar referred to the Consultant (a Professor) and then [quoted text clipped - 3 lines] >> > of prescription meds. He immediately got excited and has now scheduled >> > me, at last, for a Bone Mineral Density Test! By SK >> I was scheduled for a bone density test when I went on ADT just to get a >> baseline. He also put me on Fozomax. Haven't had cause to get another >> density test. My GP has even asked me to back off on my Calcium as my >> numbers are high. By AM >I posted the following on Oct. 31, but will repeat it here: > [quoted text clipped - 13 lines] > > Alan By CC Unfortunately, I don't walk across the hall unaided and need painkillers to stand in the bathroom for a shower & shave ~20mins. So I'm up for a total R knee replacement TBA, plus cartilage damage to the L Knee, plus extreme pain in both feet & ankles. Also intermittent Sciatica, dependent on my sleeping position. Add to this loss of mobility for about 2 yrs. So I really need to get my 1st BMD test before proceeding with the knee surgery. Hope you all had a good ride on my thread *s* -Please reply to group as my email addr is fake! -Regards CC > By CC > Unfortunately, I don't walk across the hall unaided and need [quoted text clipped - 5 lines] > So I really need to get my 1st BMD test before proceeding with the > knee surgery. That's a major bummer CC. I don't know what your options are where you live but, if there's a swimming pool within reach, swimming is a great way to get exercise with low impact on joints. I know that many people with severe arthritis have been able to keep it under control with swimming. An exercise bike can also work well. You set the tension to be very low so it's not putting much pressure on anything. The motion of the knees and ankles with low tension can help keep the joints flexible. Both swimming and an exercise bike are actually easier than walking. The water, or the bike seat, is holding all your weight. So you get some motion in the joints without putting pressure on them. If you try any of these things, start easy. Don't over do it. Then gradually build up, little by little. Good luck. Alan >I don't know what your options are where you live but, >if there's a swimming pool within reach, swimming is a >great way to get exercise with low impact on joints. >I know that many people with severe arthritis have been >able to keep it under control with swimming. <snip> My missus can't get up enough speed on the runup with the wheelchair before she tips me in! -Please reply to group as my email addr is fake! -Regards CC > >I don't know what your options are where you live but, > >if there's a swimming pool within reach, swimming is a [quoted text clipped - 6 lines] > My missus can't get up enough speed on the runup with the wheelchair > before she tips me in! Well, at least your sense of humor is unimpaired, though maybe in need of a soaking. Alan > By CC > Unfortunately, I don't walk across the hall unaided and need [quoted text clipped - 7 lines] > ....> > -Regards CC Hi CC I am surprised that you will be getting your BMD only now. My experiences with ADT (bPSA+=34, GS=3+4) and bone density and joint aches over the last 8 eight years may give you some ideas. After a few months on ADT I had my first BMD which came back with osteopenia (T= -1.7) and for the previous several years, I had pain in my big toes, and right hip. After a year on Fosamax, these pains have disappeared. After being on Fosamax for 4.5 years I was staring to get acid reflux so I switched to Zometa at 3 month intervals for 3 shots. I have had a BMD test done at a yearly basis (approx. same results each year - no more loss) and bone markers BSAP (bone specific alkaline phosphatase and cTX (C-Telopeptide cross laps). After 3 years off bisphosphonates and being on estradiol patches most of this time, my BMD has remained constant but my bone markers have gone up and my bone pains are starting to come back - probably time to got for treatment. My personal theory is that the cancer cells send out solvents to soften up the bones so that they can more easily establish in the bone and I believe that this affects are joints as well - this is my impression only from my experiences and I have not researched it any further. Good luck in your battle. Lud |
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