Prostate Cancer Related Bone Complications
Prostate cancer has a propensity for spread to the bone. This occurs only with advanced disease. Bone related complications include:
Pain
Fractures
Nerve compression
Osteoporosis is a commonly recognized side effect of treatment but is not secondary to the cancer itself.
Complications from Bone Targeted agents.
Osteonecrosis of the Jaw
These medications are generally well tolerated, but there are potential serious side-effects to be aware of.
Osteonecrosis of the jaw is a weakening of the bone. This typically presents with jaw pain or loose teeth. The risk factors were prior tooth extractions, history of inflammatory dental disease (e.g. gingivitis) and implants. For Denosumab (Xgeva) the rate was about 2.2% and for Zoledronic acid (Zometa) it was 1.6% which was not found to be statistically different. The medication should be stopped immediately if this occurs.
Denosumab (Xgeva)
Coverage is not currently available in British Columbia via Pharmacare or Palliative Care Benefits (as of November 2012). Coverage is available in many provinces including Saskatchewan, Manitoba, Quebec, Ontaria and Nova Scotia. Most extended health will cover the medication.Cost is approximately $550 per dose (monthly).
It is easy to administer - subcutaneously every month. The medication does need to be refrigerated.
If your urologist or medical oncologist feels this would be a good treatment for you, assistance is available to obtain coverage from your third party insurance. Once you have a prescription, simply complete the physician information, your name and number and check the prescribed treatment box. We can fax the form if necessary.
Routine montoring includes:
1. Taking vitamin D and Calcium (about 1000 units or mg per day)
2. Monthly calcium measurements to check for low calcium.
On the Web
General Prostate Cancer Web-Resources
Prostate Cancer Canada Resources
Prostate Cancer Basics: Screening and Diagnosis
Prostate Cancer Treatment Options
Prostate Cancer Post-Treatment Recovery and Side Effects
Memorial Sloan-Kettering Cancer Center in New York is an excellent resource for information on prostate cancer. Balanced, unbiased discussions of the disease, including discussion regarding some of the controversies in prostate cancer.
General Information on Cancer
BC Cancer Agency: Good general website from the British Columbia Cancer Agency. Has contact information on locations.
National Cancer Institute: Excellent source of understandable and mainly unbiased information. Several very good brochures on every stage of prostate cancer.
National Comprehensive Cancer Network: peer-reviewed expert content/prostate cancer guidance on evidence-based cancer diagnosis and management. Best for Prostate and Kidney Cancer. The most in-depth information is located in the physician section and requires registration.