Posted 5/31/2017 1:08 AM (GMT -7)
As you may know, Prolia and Xgeva are brand names for the same drug Denosumab. It has a long history in breast cancer patients with bone mets, and, more recently, in post-menopausal women with osteoporosis, women with breast cancer being treated with aromatase inhibitors, men with advanced prostate cancer with bone mets, etc.
There is another line of drugs called bisphosphonates, where Zometa is one of the several global brand names for the drug Zoledronic Acid.
There has been a kind of hierarchy of these agents getting FDA approved and actually prescribed over the years.
Women and men with advanced cancers and many newly diagnosed bone mets often get either Xgeva or Zometa every month. Xgeva is a simpler injection, and Zometa is a supervised IV infusion. Different places and different Oncologist might prefer one over the other in their day-to-day practices. Many patients with many bone mets (including myself) have received these agents for 24 or more consecutive months, or more, with few or no significant side effects. Some small percentage of men have, though, experienced things like ONJ, following invasive dental work or infections, but it is rare.
Women who are on aromatase inhibitors after breast cancer surgeries can take the same agents, only less frequently, to help prevent or reverse osteoporosis and reduce their risks of fractures , e.g. with Prolia or Zometa, taken less frequently each year.
In the larger picture, your husband being started on Prolia could be quite conservative compared to some other men with more advanced disease and many bone mets. Many men do quite well on either of this type of drug, taken 3-6 times more frequently.
Just my opinion, .... some "bone juice" that might make bones less hospitable for "mets" to grow, or help prevent or perhaps delay a broken bone, or slow osteoporosis, and maybe keep me out of a wheelchair for a while longer, might be worth it, at the margins.
In my personal case, my local oncologist thought that Zometa was the best thing since ice cream. I got it 29 months in a row. Since I started with a PSA of 5,006 and a ton of bone mets, I was not quick to disagree. Of course, he billed insurance for it each time, too. There is little science for anyone taking it beyond 24 months. More recently, I talked him down to my getting it only every 90 days, instead. I probably have enough zoledronic acid in my bones to last for years. And, I'm now getting only 1/3 of the needle "sticks" that I used to get to my veins each year, compared to before.
Dx Nov 2013 Metastatic Prostate Cancer at Age 65
Numerous Bone Mets and Lymph Nodes, PSA 5,006
ADT Lupron + Zometa, PSA Nadir 1.0
Resistance after two years.
Short rechallenge Casodex.
Oct 2016 Provenge
Dec 2016 Start Xtandi, PSA 95
May 2017 PSA 3.4