Osteoporosis risk

Hi, I’ve been on Alendronic acid for about 8 years. Yes my dentist did a sharp intake of breath when I told her, but (fingers firmly crossed) I’ve not had any dental problems with that in mind so far. It’s important to ensure you’ve a decent level of vitamin D3 (plus K to help). I think Adcal is a VERY cheap drug for the NHS to prescribe but doesn’t help everyone. GP. has helped with the reflux problems that Alendronic Acid causes, prescribing Famotidine. He did try me on Lansoprazole but that apparently negates the absorption of Alendronic Acid, so I took myself off it and talked to him again. Might be worth asking for a blood test to check D3 levels? 

incidentally I asked for a Dexa scan way before my bc diagnosis as I’d lost height and knew my mother had osteoporosis. 

Hope that helps? Oh and it’s always useful to continue with good weight bearing exercise (I walk loads!) 

hugs xxx

Hi Jennand, Like you I am a retired nurse and research everything. I was given my first prescription for Letrozole and after reading the leaflet I felt overwhelmed by the potential risks and side-effects. I too am 71 and was diagnosed with  lobular cancer in January. I have had a lumpectomy and awaiting appointment with oncologist for follow-up radiotherapy. I think I need to know by what percentage the letrozole is going to help, as  I am afraid that each  treatment has the potential to cause other problems. I researched the bisphosphonates and as I have a complicated dental picture I would have to consider it very carefully. That's the problem isn't it?  I am being faced with choices that I would prefer not to make. I send you my love and best wishes xx 

Hi Dulcibella, you are correct in that each treatment may cause other problems, but eventually you have to work out which is the more important. I had oestrogen receptive BC so I HAVE to take the aromatase inhibitor, which has the potential to cause osteoporosis. At present, I only have osteopenia, and I think I’m leaning toward waiting until my next dexa scan to see if there has been any deterioration. Problem is, the dexas are only every 2 years, so I might have a private one done next year. I have increased my walking, and will take Adcal, supplemented with extra VitD, K2. 

I was also prescribed high fluoride toothpaste by my dentist.  Been on it for 18 mths, I wish they could target the area.  Maybe one day they will.

Hi Jennand, I too am strongly ER PR positive. Scoring 8 for both. I'm node negative and no lympho-vascular invasion. With the surgery and the radiotherapy I'm yet to learn exactly what percentage gain will be achieved with the addition of Letrozole. I know of two other ladies with similar pictures. For one the gain was 1% the other was 3% (over certain time frames). To be honest I'm finding this all rather confusing and have a long list of questions for the oncologist (when I get the appointment). I am also puzzled by the fact that I was offered oncotyping when it appears that others with similar pictures were not. 

You can put all your stats into PREDICT to tell you yoir % gain for AI. 
I was told no oncotype if you are classed as low risk . But some NHS trusts will do it anyway .

You can have a private DEXA but you need a signed referral letter from a medic . 

Thanks for that KLF. PREDICT tells me 1.5% gain (taking me from 88% with surgery alone, to 89% with AIs). Doesn't have radiotherapy as a treatment option though, so presumably with radiotherapy that percentage is increased.

No it doesn’t and I’m going to ask my onco about that this week. I’ll let you know . 

Thank you so much. That will be really helpful. In view of my age, I will have to be convinced that a 1.5% gain is worth the risks of the side effects. I'm going ahead with the radiotherapy so I will be interested to hear what your oncologist says.