Treatments to manage your osteoporosis

Treatments that you may have received for your breast cancer—including removal of ovaries, chemotherapy or hormonal therapy with tamoxifen before menopause, or treatment with aromatase inhibitors after menopause—decrease estrogen levels in your body. Goal of treatment for osteoporosis is to prevent further bone loss and potential fractures. However, there is no cure for osteoporosis once it occurs. This makes prevention and healthy habits very important.

Once you have been diagnosed with osteoporosis, exercises, nutrition and supplements may not be enough to reduce your risk of fractures. Medicines such as bisphosphonates and denosumab can help to increase bone density.

Not all medicines may be appropriate for your individual medical situation; consult with your doctor.

Drug treatments

(For steps to be taken other than receiving medications, refer to the healthy habits section.)

Bisphosphonates and denosumab are two classes of drugs approved for the treatment of osteoporosis and for management of bone metastasis and skeletal events associated with solid tumors; however, denosumab is not approved for use in patients with bone metastasis from multiple myeloma. Although hormone replacement therapy is helpful in osteoporosis, it may not be given in patients with history of cancer.

Charlotte: So, why do I need to know all that? Won’t the doctor just give me a prescription for the best one?

Jane: Well, you’d think so, but it sounds like there are quite a few things that might go into the decision for any one person...

Charlotte: Yes, well I do wonder why some of them are pills and some are shots…and... I've noticed there is a lot of difference in the prescription prices too.

Jane: So those are questions you better ask… and I always wonder about side effects…maybe some are easier than others in that regard…

Charlotte:  True…I wonder too how long I’ll need to take these medicines…

Jane: A lot of questions… sounds like you better make a list….

Narrator: Remember ...there are several types of medications for osteoporosis. They differ in the way they are taken… how often they need to be taken… in the way they act…the kinds of side effects they have…and how much they cost.

No treatment can cure osteoporosis but the drugs discussed in this program can slow down the diseases and help prevent you from getting a fracture or broken bone. Osteoporosis is a serious condition. It requires treatment and monitoring by a doctor to prevent additional problems.

Jane: Well we made it! So how was your first session?

Charlotte: Oh, it was fine…and I’m so glad we decided to do this together…it makes it a lot more fun.

Jane: That’s for sure… we can gossip (grins)…but first you can educate me about this bone thing… did you read all that info your doc gave you?

Charlotte: You know …a lot of it’s about the different drugs they use to treat this…and there’s a lot to digest…but it looks like at this point, just taking calcium won’t be enough…

Narrator: There are several types of medicines for treating osteoporosis: one class of drugs is called bisphosphonates. Denosumab is another class of osteoporosis medicine. Bisphosphonates are drugs you may have heard of by their various brand names…names like Boniva, Fosamax, Actonel and Reclast. These drugs all act by slowing down the loss of bone cells

None of these drugs cures osteoporosis, but all 3 of these drug classes have been shown to help prevent fractures in the spine. Most of them have also been shown to reduce fractures in the hip and other bones as well, but research on some individual drugs is not yet complete. 

Each of the drug categories has a different way of acting, and therefore they have different side effects and risks…and you will want to know more about those in order to work with your doctor to find the best one for you.


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