What are Bisphosphonates and how do they work?
Bisphosphonates are drugs that strengthen bones weakened by advanced prostate cancer or hormone therapy. They work by preventing bone breakdown by osteoclasts (cells that break down bone tissue) and promoting bone building by osteoblasts (cells that form new bone tissue). This helps maintain bone strength, reduces the risk of fractures, and can alleviate bone pain.
Who is suitable for Bisphosphonates?
You may be offered bisphosphonates if you have:
- Osteoporosis (bone thinning) caused by hormone therapy.
- Bone weakness due to prostate cancer spreading to the bones.
- Bone pain that other pain-relieving treatments cannot manage.
- Hypercalcaemia, a rare condition in advanced prostate cancer, characterized by high calcium levels in the blood.
How do Bisphosphonates treat bone thinning from hormone therapy?
Hormone therapy for prostate cancer can weaken bones, leading to osteoporosis and increased fracture risk. Bisphosphonates help strengthen bones and prevent further thinning.
How do Bisphosphonates treat bone weakness caused by cancer spread?
When prostate cancer spreads to bones, it can damage them, causing pain and increasing fracture risk. Bisphosphonates slow this damage, strengthen bones, and reduce the need for radiotherapy.
Can Bisphosphonates relieve bone pain?
Yes, they can help relieve bone pain, especially when other painkillers are ineffective. They are sometimes used alongside painkillers.
How do Bisphosphonates help with hypercalcaemia?
Bisphosphonates can treat hypercalcaemia by reducing high calcium levels in the blood, a rare but serious condition in advanced prostate cancer.
What other factors might affect whether I can have bisphosphonates?
Your overall health, existing kidney problems, and current medications can influence bisphosphonate treatment.
How do Bisphosphonates strengthen bones?
In healthy bones, a balance exists between bone breakdown by osteoclasts and bone formation by osteoblasts. Prostate cancer can disrupt this balance, leading to weaker or abnormal bone tissue. Bisphosphonates help restore this balance by inhibiting osteoclasts and promoting osteoblast activity.
What are the advantages of using Bisphosphonates in advanced prostate cancer?
- Strengthen bones and reduce fracture risk.
- Delay the need for other bone treatments like radiotherapy or surgery.
- Relieve bone pain and improve mobility.
- Allow continuation of normal activities, such as driving.
- Lower high calcium levels in the blood (hypercalcaemia).
What are the disadvantages of using Bisphosphonates?
- Potential side effects.
- Regular hospital visits for intravenous treatments like zoledronic acid.
- Need for correct administration of bisphosphonate tablets.
- Delayed pain relief, taking up to three months.
- Regular dental check-ups and blood tests are required.
What is required before you start on Bisphosphonate treatment?
You will have tests to check kidney function and scans to identify bone spread or weakness.
A dental check-up is also necessary to prevent jaw problems. One rare but serious side effect of bisphosphonates is osteonecrosis of the jaw (ONJ), where healthy jawbone tissue becomes damaged and dies. This condition is more likely to occur in individuals undergoing invasive dental procedures, those with gum disease, or those using dentures. Symptoms of ONJ include pain, swelling, infections, loose teeth, and exposed bone. To reduce the risk, it is essential to maintain good oral hygiene, have regular dental check-ups,
What does Bisphosphonate Treatment Involve?
Bisphosphonates are administered either as tablets, intravenously or subcutaneously.
How long will I need bisphosphonates?
The duration depends on your condition. Treatment for osteoporosis or bone pain continues as long as it’s effective. For hypercalcaemia, treatment stops once calcium levels normalise.
What are the common side effects of Bisphosphonates?
- Flu-like symptoms: Fever, headache, chills, and muscle/joint pain.
- Nausea and vomiting: Usually temporary.
- Loss of appetite: Improves in a few days.
- Increased pain: Temporary joint, muscle, or bone pain.
- Kidney problems: Monitored with regular blood tests.
- Stomach issues: Diarrhoea or constipation, especially with oral bisphosphonates.
Less common side effects of bisphosphonates include;
- Rash or itching: Temporary skin reactions.
- Red or sore eyes: Managed with eye drops.
- Heart problems and stroke: Slightly increased risk.
- Jaw bone problems (osteonecrosis): Rare, but requires dental vigilance.
How can I keep my bones healthy while on Bisphosphonates?
Maintain a healthy lifestyle with a balanced diet and regular physical activity, including gentle resistance exercises. Avoid smoking and limit alcohol consumption to reduce the risk of bone thinning.
