DEXA scans, Fosomax, other meds for bone loss?
Meet the Experts
Jennifer Griggs, M.D., M.P.H. is a medical oncologist specializing in the treatment of breast cancer, dedicated to developing programs that improve the well-being of women treated for breast cancer.
Question from Julie W.: There seems to be a lot of new info about treating bone loss in breast cancer survivors. I'm on Fosamax. In order to monitor how well it's working, should I be getting a DEXA scan annually? Should I be asking my oncologist about medications other than Fosamax?
- Answer —Jennifer Griggs, M.D., M.P.H.:
DEXA scans are used to measure bone mineral density and should be done more frequently in women on aromatase inhibitors than in women not on aromatase inhibitors to help decide if and when drugs such as Fosamax (chemical name: alendronate sodium) should be started. Once women are on Fosamax, close follow-up is warranted but it's not entirely clear if more frequent DEXA scans are helpful. The reason for this is there's a lot of "noise" with the test. What I mean by that is a test done even 2 days later can show changes from the first one. The tests have a certain amount of wiggle room in their interpretation. If a patient is able to take her Fosamax regularly, is taking Vitamin D and calcium, and is participating in weight bearing exercise, we would expect to see stabilization of her bone health. In a woman with very severe osteoporosis more frequent follow-up is probably warranted. There are other drugs that can be added to Fosamax, such as the inhaled Miacalcin (chemical name: nasal calcitonin), but the added benefit of this drug over Fosamax is difficult to estimate.
In summary, talking with your doctor about the best frequency of DEXA scanning in your case makes sense because the recommendations will vary depending on how severe your osteopenia or osteoporosis is. New guidelines for monitoring and treating the bones are being developed now by the American Society of Clinical Oncology (ASCO). When these come out, we may have some more clarity around optimal monitoring of bone health.
On December 19, 2007, our Ask-the-Expert Online Conference was called Updates from San Antonio 2007. Jennifer Griggs, M.D., M.P.H. answered your questions and shared the newest research presented at this year's San Antonio Breast Cancer Symposium.
The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
A production of LiveWorld, Inc.
Copyright 2008. All rights reserved.