Podcasts about prolia

Johnson & Johnson’s Stelara, Regeneron’s Eylea and Amgen’s Prolia are just some of the drugs facing off against new biosimilars or generics in 2025, as featured in the latest edition of Fierce Pharma’s annual special report documenting the 10 biggest losses of U.S. exclusivity expected throughout the year. In this week’s episode of The Top Line, we dig into the report, which details the stories behind 10 key medicines that are set to face off against new generic or biosimilar competitors this year as their patents expire. Fierce’s Eric Sagonowsky and Angus Liu recap the report, sharing their perspectives on several of the drugs and discussing the industry effects of 2025’s sizable patent cliff. To learn more about the topics in this episode: The top 10 drugs losing US exclusivity in 2025 After patent settlement, Amgen scores FDA nod for its biosimilar version of J&J's Stelara Amgen grabs FDA thumbs-up for Soliris biosim, eyes 2025 launch Novartis wins 11th-hour bid to block generic version of blockbuster heart med Entresto Amgen settles Prolia patent suit with Celltrion, teeing up potential biosimilar launch in June See omnystudio.com/listener for privacy information.

“Dead butt syndrome”—you probably already have it; Over half of Americans with uncontrolled hypertension are unaware of their condition; Is a smartwatch app for continuous blood pressure monitoring ready for primetime? What are frequent causes of errors in blood pressure measurement? How long can you continue to take Prolia? What's the likelihood of a colon adenoma turning cancerous? Metformin scores cognitive and anti-aging benefits in monkeys—human trials underway. 

I've been taking Nexium for the last 20 years. Is this contributing to lower bone mineral density?Should my 83-year-old wife take more calcium for her osteopenia?What is your knowledge of Prolia? What are the side effects?I have mitral annular disjunction (MAD). Can you advise me?What can I take for my post nasal drip?Are there other blood thinners I can take where I don't need to check my INR?

在今集【開心星期三 －醫家等你call】 -鄺美玲請來老人專科醫生譚顯祥和大家談談最近有報道指一隻廣受歡迎的骨質疏鬆藥Prolia可能會導致非典型股骨骨折這個副作用。究竟情況是否如此？

Dr. Doug reviews various bone health drugs, their mechanisms, benefits, and potential risks. He emphasizes the importance of a comprehensive approach to bone health, considering both pharmaceutical and non-pharmaceutical strategies. This video covers different classes of drugs, including bisphosphonates, Prolia, anabolic drugs, Evenity, selective estrogen receptor modulators, and calcitonin, highlighting their effects on bone density and overall health.

“Dead butt syndrome”—you probably already have it; Over half of Americans with uncontrolled hypertension are unaware of their condition; Is a smartwatch app for continuous blood pressure monitoring ready for primetime? What are frequent causes of errors in blood pressure measurement? How long can you continue to take Prolia? What's the likelihood of a colon adenoma turning cancerous? Metformin scores cognitive and anti-aging benefits in monkeys—human trials underway.

Welcome back to another enlightening episode of The Hormone Prescription Podcast! This week, we dive deep into a topic that resonates with so many of us: bone health. We often think we're doing enough by following generic health programs, but what if those programs fall short when it comes to bone health? What if there's a better way to ensure stronger, healthier bones?

“Sitting is the new smoking”—how best to use short bouts of exercise to reduce hazards of prolonged inactivity; Should we be concerned about the chemicals used to make decaf coffee? Can tinnitus damage the brain? Berberine combats insulin resistance; A healthy diet can't overcome the adverse effects of sleep deprivation on blood sugar control; How long should a person take Prolia for osteoporosis? Can adequate sleep fend off bone loss? Olive oil vs. dementia.

I drink carbonated water with 'natural flavor'. Is this something to worry about?; Which blood pressure device is more accurate--wrist or arm cuff?; What do you think of wearing weighted vests for building or preserving bone health? Any downside?; What protocols do you recommend for healing faster after rotator cuff repair surgery?; What are your thoughts on Prolia shots for osteoporosis?

In this episode, Dr. Doug discusses the popular drug Prolia (Denosumab) used for the treatment of osteoporosis. He focuses on the risk of fracture after stopping the drug and addresses the fear surrounding it. Dr. Doug presents research from the FREEDOM trial, which showed a reduction in vertebral fractures with Prolia but also a reduction in bone building. He then discusses the 10-year data from the trial, which showed an increased risk of vertebral fractures after discontinuing the drug. Dr. Doug reassures listeners that with a solid plan and monitoring, the risk can be managed.

This episode has been Unlocked from patreon.com/curbsiders! Hone your obesity medicine skills in primary care! We discuss overcoming barriers, patient counseling, obesity pathophysiology, motivational interviewing, tools and tips from a weight loss program, and how to discuss medications for weight loss including phentermine/topiramate, bupropion/naltrexone, orlistat, oral superabsorbent hydrogel, and GLP1 agonists. We're joined by obesity medicine expert, Dr. Kimberly Anne Gudzune of @HopkinsMedicine, recorded @SocietyGIM#SGIM23 in Denver, Colorado This audio episode is only available on Patreon!  Below are links to the original interview & show notes. #405 Obesity Medicine, GLP1 agonists, Weight Loss Management Tools and Tips Picks of the week: Paul recommends: Blue Eye Samurai (Netflix) Matt recommends:  Live, Die, Repeat aka Edge of Tomorrow (film) Show Segments 00:00 Introduction and Happy New Year 02:22 Overview of Obesity Medicine 04:13 Challenges in Weight Maintenance 06:07 Prevention of Obesity 08:04 Barriers to Obesity Care 09:29 Setting Realistic Weight Loss Goals 10:24 Counseling Patients on Weight Loss 11:45 Measuring Waist Circumference 12:44 Telemedicine and Tracking Apps 13:41 Psychological Considerations in Obesity Medicine 15:05 Low-Carb Diets 21:04 Managing Side Effects of GLP-1 Agonists 23:54 New Medication for Obesity 24:52 Prolia and Forteo for Osteoporosis 26:18 Statins and Lab Testing 29:30 Annual Labs and Urine Testing 32:37 Picks of the Week 35:02 Outro Join our Patreon today and save 16% on an annual membership at patreon.com/curbsiders. Kashlak Admitting Privileges comes with ad-free episodes, access to the Kashlak Vault, which contains PDF files and graphics from over 400 Curbsiders shows, access to our private Discord group, plus twice monthly bonus episodes like this one!

Here is information on the latest US FDA approvals, the week of March 4 – March 8, 2024 ·         ChatGPT4 in medical writing and editing—visit learnAMAstyle.com ·       Nascentmc.com for medical writing assistance for your company. Visit nascentmc.com/podcast for full show notes   - **OTC Glucose Monitor**: The FDA has approved the Dexcom Stelo Glucose Biosensor System for over-the-counter sale, a first for a continuous glucose monitor. Designed for people aged 18 and older not using insulin, it helps manage diabetes with oral medications or monitors the impact of diet and exercise on blood sugar levels. Scheduled for release in Summer 2024, the system offers a 15-day sensor wear time and does not alert users to low blood sugar episodes.   - **Semaglutide in CVD Risk**: The FDA has approved semaglutide (Wegovy) for reducing cardiovascular risk in adults with known heart disease who are overweight or obese, specifically targeting the reduction of major adverse cardiovascular events. This approval makes semaglutide the first weight-loss medication also indicated for preventing life-threatening cardiovascular events in patients with established cardiovascular disease and obesity or overweight.   - **Juvederm Additional Indication**: JUVÉDERM® VOLUMA® XC, a hyaluronic acid dermal filler, has received FDA approval for treating moderate to severe temple hollowing in adults over 21, marking it as the first HA filler for this purpose. With effects lasting up to 13 months, clinical studies show significant improvement and patient satisfaction with facial symmetry post-treatment. This approval highlights Allergan Aesthetics' commitment to innovation in aesthetic treatments.   - **Nivolumab in mUC**: The FDA approved nivolumab in combination with cisplatin and gemcitabine for first-line treatment of metastatic urothelial carcinoma, based on significant improvements in survival outcomes from the CHECKMATE-901 trial. This expands nivolumab's indications, which include treatments for melanoma and lung cancer, among others, demonstrating its broad applicability in cancer treatment.   - **Zanubrutinib in FL**: The FDA has granted accelerated approval to zanubrutinib and obinutuzumab for relapsed or refractory follicular lymphoma patients after two or more systemic therapies. This combination targets key pathways in B cell survival, offering a new treatment option for patients. Approval was based on the ROSEWOOD trial, highlighting significant patient outcome improvements.   - **Donanemab and Alzheimer's**: The FDA has postponed the decision on the approval of Eli Lilly's donanemab for Alzheimer's treatment to convene an advisory meeting for further examination of safety and efficacy data, indicating a significant delay. This reflects the complex nature of Alzheimer's drug approval and Eli Lilly's confidence in donanemab's potential benefits.   - **Tocilizumab Biosimilar**: Tyenne® (tocilizumab-aazg), the first FDA-approved biosimilar to Actemra® for various inflammatory diseases, is now available in both IV and subcutaneous formulations. This approval introduces a new treatment option for patients with conditions like rheumatoid arthritis and juvenile idiopathic arthritis, emphasizing advancements in biosimilar medications.   - **Denosumab Biosimilars**: The FDA approved Jubbonti and Wyost as interchangeable biosimilars to Prolia and Xgeva, respectively, marking a first for biosimilars targeting the RANKL inhibitor used in osteoporosis and cancer-related bone conditions. These approvals offer new treatment options for managing bone health, underlining the importance of biosimilar development in expanding patient care.   - **Clobetasol Propionate Eye Drops**: The FDA's approval of clobetasol propionate 0.05% eye drops for post-operative eye inflammation and pain introduces the first ophthalmic formulation of this corticosteroid and the first new steroid in ophthalmology in over 15 years. Developed using proprietary nanoparticle technology for twice-daily dosing, this approval offers a new option for effective pain and inflammation management post-eye surgery.

Over-the-counter birth control pill to be available in the coming weeks; first over-the-counter continuous glucose monitor to be available starting this summer; the 2024-2025 US influenza season vaccine will be trivalent; LSD granted Breakthrough Therapy for treatment of generalized anxiety disorder; interchangeable biosimilars to Prolia and Xgeva approved. 

Listen to FDA Drug Safety Podcast titled, FDA adds Boxed Warning for increased risk of severe hypocalcemia in patients with advanced chronic kidney disease taking osteoporosis medicine Prolia (denosumab).

On this week's Biotech Hangout, hosts Brad Loncar, Tim Opler, Luba Greenwood and Brian Skorney discuss the latest industry news including 2 biotech IPOs from ArriVent Bio ($175M) and CG Oncology ($380M). They also discuss Sanofi buying Inhibrx ($2.2B), Kura Oncology's private placement ($150M) and Gilead's failed phase 3 study. The hosts cover class-wide black box warnings from the FDA, including Amgen's Prolia, plus Eli Lilly's investigational gene therapy for hearing loss data, HPV vaccine study in Scotland and The House Ways and Means Committee approves restoration of R&D tax credit. *This episode aired on January 26, 2024

When discussing Osteoporosis treatment, your physician will most likely prescribe some medications. With the different drugs out there, how do you know which one to take? Is it safe if you have other medical conditions? What are the long-term side effects? Which is a better brand? And the list goes on.   Today, I have someone who will answer your questions about Osteoporosis medications to put your mind at ease.   Dr. R. Keith McCormick is a chiropractic physician specializing in the management of patients with osteoporosis. He is the author of the recently released book Great Bones: Taking Control of Your Osteoporosis and The Whole Body Approach to Osteoporosis.    Sports have always played a vital part in Dr. McCormick's life. He is the former U.S. record holder for the most points scored in a pentathlon competition. Dr. McCormick continues to compete in triathlons of all distances and has completed six Ironman competitions, five of them after recovering from multiple osteoporosis-related fractures.   So, if you have questions about Osteoporosis medications, listen to this informative episode of the Happy Bones, Happy Life podcast!    “I always talk about medications as being a short-term solution to a long-term issue. And that is, when you're taking the medications, all that time you're (also) doing things to improve your overall bone health—your diet and supplements, all that.” - Dr. R. Keith McCormick   In this episode: - [02:10] - How long can you stay on Prolia? - [05:31] - How can I prevent the rebound effect from quitting Prolia? - [10:47] - Should I continue using Prolia?  - [12:08] - How long do most people use Prolia? - [13:56] - How to achieve long-term success in your battle with Osteoporosis  - [17:52] - What can I do to prevent the adverse effects of taking teriparatide? - [19:55] - Forteo vs. Tymlos - [21:59] - What are the effects of MGUS, and is there anything we can do about it? - [24:43] - Can I safely quit taking Prolia with my current medical condition? - [26:57] - Will mast cell activation affect your bone health? - [27:36] - I have Osteoporosis and breast cancer. My oncologist prescribed Raloxifene. I'm not sure about taking it. Who do I see for testing and the meds? - [33:42] - I used to take Forteo, then stopped. If I use it again, will it have the same effect as building bone density the first year? - [37:32] - It's important to do these things before taking tests and medications - [42:21] - I'm 74 and have scoliosis. My doctor has recommended I take either Forteo or Prolia. Which drug should I take? - [44:15] - How important is Vitamin K2 to your bone health?   Resources mentioned - The Happy Bones Club - https://www.happyboneshappylife.com/bones-club - Great Bones: Taking Control of Your Osteoporosis - R. Keith McCormick, DC - https://www.osteonaturals.com/product-page/great-bones-taking-control-of-your-osteoporosis - Consult with Dr. McCormick - https://www.osteonaturals.com/consult-osteonaturals   More about Margie - Website - https://margiebissinger.com/  - Facebook - https://www.facebook.com/p/Margie-Bissinger-MS-PT-CHC-100063542905332/  - Instagram - https://www.instagram.com/margiebissinger/?hl=en    DISCLAIMER – The information presented on this podcast should not be construed as medical advice. It is not intended to replace consultation with your physician or healthcare provider. The ideas shared on this podcast are the expressed opinions of the guests and do not always reflect those of Margie Bissinger and Happy Bones, Happy Life Podcast. *In compliance with the FTC guidelines, please assume the following about links on this site: Some of the links going to products are affiliate links of which I receive a small commission from sales of certain items, but the price is the same for you (sometimes, I even get to share a unique discount with you). If I post an affiliate link to a product, it is something that I personally use, support, and would recommend. I personally vet each and every product. My first priority is providing valuable information and resources to help you create positive changes in your health and bring more happiness into your life. I will only ever link to products or resources (affiliate or otherwise) that fit within this purpose.  

T-cell malignancies prompt label changes for certain T-cell immunotherapies; Novel opioid provides in-built protection against overdose; Hypocalcemia risk with Prolia; At-Home semen insemination kit cleared; New asthma rescued medicine approved

October 13, 2023 Ray, Mark, and Scott discuss questions from the Urology Coding and Reimbursement Group.Are injections like Lupron and Prolia and the administration given by an advanced practice provider subject to the 85% reimbursement or are these reimbursed at 100% even if given by a nurse practitioner?Are 11006 and 97606 appropriate here for wound vac?OPERATION: Debridement of Fournier's gangrene.DRAINS: Wound VAC, 16-French Foley catheter.OPERATIVE TECHNIQUE: The patient was brought into the operating room, placed in supine position on the operating room table. After administration of IV antibiotics and anesthesia, the patient was repositioned in dorsal lithotomy position, prepped and draped in the usual sterile fashion. The wound measured approximately 30 cm x 14 cm and went from the left inguinal region through the left perineum and to the posterior left buttocks. Using a curettage, we proceeded with additional debridement of all the raw surfaces. Spot electrocautery was used as needed for hemostasis and the wound was irrigated copiously with antibiotic irrigation. The sharp debridement was done to the level of the dartos fascia and Colles fascia. Once we had finished the sharp debridement, we went ahead and decided to place a wound VAC. A black sponge was placed into the wound and then carefully placed using the sticky plastic and put it to suction. Given the location, it was a bit challenging but we were able to place the wound VAC to suction. Given that the wound extended near the posterior buttocks, it was near the anus which would likely be an issue for maintaining suction if the patient had a bowel movement. The patient tolerated the procedure well.Mark Painter and PRS ConsultingSchedule a call with Mark Painter / PRS ConsultingUrology Documentation, Coding, and Billing CertificationFor Urologists and APPs (Click Here for Pricing, More Information, and Registration)Documentation, Coding, and Billing Fellowship - Urology (DCB-FS) For Coders, Billers, and Admins (Click Here for Pricing, More Information, and Registration)Documentation, Coding, and Billing Specialist Certification (DCB-SC)Documentation, Coding, and Billing Master Certification (DCB-MC)Urology Advanced Coding and Reimbursement Seminar(Click Here for More information and Registration) Las Vegas, December 1 & 2, 20238 am - 4:30 pm Friday, 8 am - 3:30 pm SaturdayNew Orleans, January 26 & 27, 20248 am - 4:30 pm Friday, 8 am - 3:30 pm SaturdayReserve your spot and save!As a Urology Coding and Reimbursement Podcast listener, you get access to a discount (expires 8/31/23).Use code: 24UACRS733Get signed up today and get peace of mind knowing you will be prepared for all the upcoming changes.The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ Join the discussion:Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom.Click Here to Start Your Free Trial of AUACoding

Dr. R. Keith McCormick is a chiropractic physician specializing in the management of patients with osteoporosis. He is the author of the whole body approach to osteoporosis and his recently released book – Great Bones: Taking Control of Your Osteoporosis. Sports have always played a vital part in Dr. McCormick's life. He is the former U.S. record holder for the most points scored in a pentathlon competition. Dr. McCormick continues to compete in triathlons of all distances and has completed six Ironman competitions, five of them after recovering from multiple osteoporosis-related fractures. In this interview, Dr. McCormick discusses the current osteoporosis medications in terms of safety and indications for use as part of a comprehensive treatment plan.   Links Dr. McCormick's website, where you can purchase his new book - https://www.osteonaturals.com More Natural Approaches to Osteoporosis and Bone Health Summit 2.0 - https://morebonehealth.byhealthmeans.com/?idev_id=22547   Timestamps [03:34] Where to get his book [07:46] Mediations and Classifications [12:52] Who Is or Isn't a Candidate - The Risk Factors [18:49] Bisphosphonates and Fracture Reduction [24:01] How to Balance Which Way You Should Go [35:19] The Problems with Prolia [42:32] Anabolic [52:54] Dr. McCormick's Story   DISCLAIMER – The information presented on this podcast should not be construed as medical advice. It is not intended to replace consultation with your physician or healthcare provider. The ideas shared on this podcast are the expressed opinions of the guests and do not always reflect those of Margie Bissinger and Happy Bones, Happy Life Podcast.

What does the body of evidence say on the topic of osteoporosis? Plus: we look at a genuinely breakthrough therapy for metastatic melanoma, and Chris lets you in on a troubling “secret” when it comes to travel health insurance! You will also learn what a “dowager's hump” is and hear Chris sing, and for that we formally apologize.   Block 1: (2:01) Osteoporosis: what it is; bone cells and how they are assessed   Block 2: (9:02) Osteoporosis: bone mineral density, T-score and Z-score; can doctors see signs of osteoporosis in the clinic; causes of osteoporosis; treating it: lifestyle changes, supplements, bisphosphonates, and Prolia; screening guidelines   Block 3: (32:04) Breakthrough therapy for metastatic melanoma: TILs (vs. ipilimumab)   Block 4: (47:53) Travel insurance caveat     * Theme music: “Fall of the Ocean Queen“ by Joseph Hackl. * Assistant researcher: Nicholas Koziris   To contribute to The Body of Evidence, go to our Patreon page at: http://www.patreon.com/thebodyofevidence/.   To make a one-time donation to our show, you can now use PayPal! https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE   Patrons get a bonus show on Patreon called “Digressions”! Check it out!     References:   1) Estrogen does reduce the risk of hip fracture from osteoporosis: https://doi.org/10.1001/jama.288.3.321   2) Exercise increases bone mineral density in post-menopausal women: https://doi.org/10.7326/0003-4819-108-6-824 & https://doi.org/10.1001/jama.288.18.2300   3) Calcium and vitamin D supplementation and the risk of fractures: https://doi.org/10.1001/jama.2017.19344   4) Medications can reduce the risk of osteoporotic fractures: https://jamanetwork.com/journals/jama/fullarticle/2685995   5) Screening guidelines from the US Preventive Services Task Force: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/osteoporosis-screening   6) Results from the phase III clinical trial comparing TILs to ipilumumab in advanced melanoma: https://www.nejm.org/doi/full/10.1056/NEJMoa2210233     It's Not Twitter, But It'll Do:   1) Jonathan on the Martial Culture Podcast: https://www.stitcher.com/show/the-martial-culture-podcast/episode/combating-pseudoscience-unscientific-thinkings-in-martial-arts-w-jonathan-jarry-209989826   2) Jonathan's article on the Healy: https://www.mcgill.ca/oss/article/critical-thinking-pseudoscience/healy-old-woo-new-clothes   3) The Hard Fork Podcast: https://www.nytimes.com/2022/10/04/podcasts/hard-fork-technology.html   4) The CTV Montreal News website: https://montreal.ctvnews.ca/video?binId=1.1332485   5) The CBC Player: https://www.cbc.ca/player/news   6) The CJAD website: https://www.iheartradio.ca/cjad   7) Odyssey TV: http://odysseytv.ca/   8) Chris on the CBC, interviewed about mpox: https://www.cbc.ca/news/politics/mpox-outbreak-canada-plateau-1.6696842     Time Machine:   1) Our episode on childbirth: https://bodyofevidence.ca/042-childbirth-and-crowdfunding-quackery   2) Our interview on conspirituality: https://bodyofevidence.ca/interview-matthew-remski-on-conspirituality     Music Credits:   The following music was used for this media project: Music: 3am Glowsticks by Tim Kulig Free download: https://filmmusic.io/song/9166-3am-glowsticks License (CC BY 4.0): https://filmmusic.io/standard-license    

FDA investigating risk of severe hypocalcemia in patients on dialysis receiving osteoporosis medicine Prolia (denosumab)

ASCO: You're listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the voice of the world's oncology professionals. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guests' statements on this podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Cancer research discussed in this podcast is ongoing, so data described here may change as research progresses. In the Research Round Up series, ASCO experts and members of the Cancer.Net Editorial Board discuss the most exciting and practice-changing research in their field and explain what it means for people with cancer. In today's episode, our guests will discuss new research in multiple myeloma, breast cancer, and cancer in adults 60 and over that was presented at the 2022 ASCO Annual Meeting, held June 3-7. First, Dr. Sagar Lonial discusses a study on treatment for newly-diagnosed multiple myeloma in people under 65.   Dr. Lonial is a professor of Hematology and Medical Oncology at Winship Cancer Institute at Emory University, where he also serves as Department Chair. He is also the Cancer.Net Associate Editor for Myeloma. View Dr. Lonial's disclosures at Cancer.Net. Dr. Lonial: Hello, I'm Dr. Sagar Lonial from the Winship Cancer Institute of Emory University in Atlanta, Georgia. And today I'm going to discuss one of the Plenary abstracts at ASCO 2022, which was the DETERMINATION study, again, presented at the ASCO Annual Meeting. For the sake of disclosure, I just want to make sure I list that I was an investigator on this study. I also have consulting relationships with Takeda, Celgene, BMS, Janssen, and other companies that have agents in the context of multiple myeloma. So the reason I want to talk about this study today is I think it's a really important study that was designed over a decade ago to really ask the question, with a really powerful induction regimen that uses what we now call the RVd regimen, lenalidomide with bortezomib and dexamethasone, do you really still need to have high-dose therapy and autologous transplant as part of the treatment approach? And so the trial was a very simple randomized trial that everybody received RVd induction. And then there was a randomization between early transplant and then going on to consolidation and continuous lenalidomide maintenance versus no transplant going on to consolidation and lenalidomide maintenance. So both arms actually received continuous lenalidomide maintenance, which is really one of the important endpoints of this study overall. And the reason I say that is there was a smaller study done in France a few years previous to this where patients only received 1 to 2 years of lenalidomide maintenance. And in that trial, clearly the use of transplant was better. And the remission duration for the group that received the transplant was about 48 months. So the question was, with continuous lenalidomide maintenance, can you make that longer? So randomized trial, over 600 patients were randomized between these 2 arms. And the follow-up now is somewhere around 7 years in total. And what was demonstrated both in the ASCO Annual Meeting as well as in the paper that came out at the same time in the New England Journal of Medicine was that the remission duration was clearly longer in the group that had the transplant than the group that did not, even with both arms receiving continuous lenalidomide maintenance. And it was almost 66 months in the group that received the transplant, 21 months longer, almost 2 years longer than the group that did not receive the transplant. And so I think this is really important because what it says is that even in an era of really good induction therapy, transplant continues to offer significant benefit in terms of progression-free survival. Now, the reason progression-free survival is so important in this study is that we know that no time is more sensitive for treatment of myeloma than that first time we treat the patient. And so prolonging that first remission is really important because the disease is at its most sensitive at that time point. Now, there were questions about overall survival. Should we see an overall survival benefit? And I'll tell you, A, this trial was never designed to measure an overall survival benefit. And, B, the median survival for myeloma patients is now between 10 and 15 years on average. And so with only 7 year follow-up, it seems to me unrealistic to expect this to have a survival benefit at this early time point. So rather than saying there's no difference in overall survival, I think it's a fair statement to say at the short follow-up we have, there is no difference in survival. But I actually don't think survival is the right endpoint for newly diagnosed myeloma trials in fit patients because we do have so many important treatments to discuss. Now, there was also discussion about adverse events. Obviously, the quality of life during the transplant dropped a little bit. Not a big surprise. That lasted about 2 to 3 weeks, and then quickly, by 3 months out, returned back to baseline for almost every patient in the study. Additionally, there was a concern about second primary malignancies. If you look at this data, it's really no different than what we saw in the French study. There was a slightly higher risk of second primary malignancy, but we know that this is the case not only in myeloma, but in patients who receive alkylate-based therapy. And despite that, the progression-free survival was 2 years longer in the group that received the transplant than the group that did not. So I think, in summary, this is really an important trial because there are many groups that are making the case that perhaps we don't need transplant in this modern era of myeloma therapy. And I think that it's important to recognize that what we're looking at are not short-term endpoints. We're not looking at early MRD (minimal residual disease) negativity. What we're looking at is really ultimate measurement of clinical benefit, which to me is prolonging that first remission as long as you can. And so this trial clearly demonstrates that for young, fit patients, transplant continues to offer significant benefit, almost 2 years of benefit with continuous lenalidomide maintenance. And while there's a push to say perhaps we can think about which patients may or may not need a transplant, honestly, as clinicians, we're not good enough to make that prediction. And what I think is really important is that we not lose sight of trying to prolong that first remission with the best tools that we have. And I think even in this modern era of 2022, high-dose therapy and autologous transplant continues to be one of those tools, and we want to use it to maximize the duration of that first remission. So thank you again for listening to this brief summary of the DETERMINATION trial presented at the 2022 ASCO Annual Meeting and published in the New England Journal of Medicine. ASCO: Next, Dr. Norah Lynn Henry discusses new treatment advances for people with metastatic breast cancer, as well as 2 studies in early-stage breast cancer. Dr. Henry is an Associate Professor in the University of Michigan's Division of Hematology/Oncology in the Department of Internal Medicine and is the Breast Oncology Disease Lead at the Rogel Cancer Center. She is also the Cancer.Net Associate Editor for Breast Cancer. View Dr. Henry's disclosures at Cancer.Net. Dr. Henry: Hi. I'm Dr. Lynn Henry, a breast cancer oncologist from the University of Michigan Rogel Cancer Center. Welcome to this quick summary of updates in breast cancer from the 2022 ASCO Annual Meeting. I have no conflicts of interest for any of the trials that I will talk about. First, I'm going to give a very brief overview of the types of breast cancer, then talk about some research that was presented on both metastatic and early-stage breast cancer. As a reminder, there are multiple kinds of breast cancer. Some breast cancers are called hormone receptor-positive or estrogen receptor-positive and are stimulated to grow by the hormone estrogen. We typically treat those cancers first with antiestrogen treatments, which block estrogen or lower estrogen levels. Other breast cancers are called “HER2 positive.” These are often more aggressive cancers, but because they have extra copies of HER2, they often respond to treatments that block HER2. Finally, there are breast cancers that don't have hormone receptors or very much HER2. These are called triple-negative breast cancer and are also often aggressive cancers. One of the biggest stories from the ASCO Annual Meeting was the results of the DESTINY-Breast04 trial. In this trial, researchers studied a type of medication called trastuzumab deruxtecan, which is also called Enhertu. This drug is a combination of the anti-HER2 antibody, trastuzumab, plus a chemotherapy drug, and the antibody targets the drug to the cancer sort of like a guided missile. Trastuzumab deruxtecan is currently routinely used to treat patients with metastatic HER2-positive breast cancer. Now, the interesting thing is there was already data from studies that suggested that this drug might also work against breast cancers that have some HER2 receptors on the surface of their cells, but not so many that they meet the true definition of being HER2 positive. For the DESTINY-04 study, patients' tumors had to have either 1+ or 2+ HER2, which some people called “HER2 low,” and could be either estrogen receptor positive or negative. Two thirds of the patients were treated with trastuzumab deruxtecan, and the other one-third were treated with 1 of 4 different standard chemo regimens that their physician thought was the best treatment option for them. Treatment with trastuzumab deruxtecan was shown to lengthen the time people were able to remain on treatment. Importantly, it was also shown to increase the overall survival of patients compared to standard chemotherapy by more than 6 months for patients with estrogen receptor-positive cancer and by more than 10 months for patients with estrogen receptor-negative cancer. Since this is a drug that we currently use to treat patients with other types of cancer, we actually know a lot about its side effects. One key toxicity is it can cause a very severe inflammation of the lungs in a very small subset of patients. So this is something that we have to watch for very carefully. Otherwise, it is a relatively well-tolerated drug, especially compared to standard chemotherapy. The main side effects are nausea and fatigue. Another clinical trial presented at ASCO called TROPiCS-02 also studied a drug that is currently used to treat a different type of breast cancer. In this case, the drug is sacituzumab govitecan, also called Trodelvy. It is also a combination of an antibody that is targeted against cancer cells plus a chemotherapy drug. Sacituzumab govitecan is currently approved to treat metastatic triple-negative breast cancer. In the TROPiCS-02 trial, however, it was tested to see how effective it is for treating hormone receptor-positive, HER2-negative metastatic breast cancer. All of the patients enrolled in this trial had already been treated with antihormone therapy medications as well as at least 2 chemotherapy regimens. Half of the patients were randomized to treatment with sacituzumab govitecan, and the other half were treated with 1 of 4 standard chemotherapy drugs that their physician thought was the best for them. Those patients who were treated with sacituzumab govitecan had a longer time on average that the treatment worked compared to those who received standard chemo. They also had improved quality of life based on responses that the participants themselves provided on questionnaires. Although the overall benefit was rather modest, this drug may represent a new treatment option for patients with hormone receptor-positive, HER2-negative metastatic breast cancer, although at this time it isn't yet approved for treatment of this type of breast cancer. Both of these are examples of being able to take drugs that have been shown to treat 1 type of cancer and potentially expand it so that they can be used to benefit more patients with breast cancer. These drugs are also being tested to see if they are beneficial for treating early-stage breast cancer. So we await more hopefully very exciting results in the future. To switch gears a little bit, I'll now talk about another study I found interesting. This one is in the setting of early-stage breast cancer. So typically, radiation therapy is recommended after lumpectomy since it reduces the likelihood of cancer returning in the breast. However, questions have arisen about how much benefit radiation is actually providing for some patients whose risk of having cancer return in the breast is really low to start with. Therefore, these patients may be at risk of the side effects of radiation as well as other risks, such as financial problems, without actually getting much benefit from the treatment. Therefore, this trial, called LUMINA, evaluated whether radiation therapy was beneficial after lumpectomy for patients who have small, low-risk breast cancers and no lymph node involvement. The trial included 500 women who were at least 55 years of age with invasive ductal cancers that were no more than 2 centimeters in size. They had to be estrogen receptor-positive, HER2-negative, either grade 1 or 2, and Ki-67 low. Everyone had to be planning to take antihormone therapy for at least 5 years. During the 5-year follow-up period, a total of 10 patients out of 500, about 2.3% of all patients, had their cancer return in the breast. The researchers therefore concluded that for patients with this type of very low-risk breast cancer, it is reasonable to omit radiation therapy and just take endocrine therapy. Similar results have previously been shown for patients over the age of 70 with small lymph node-negative low-risk cancers, but this trial expands that option to patients who are as young as 55. Finally, I will touch briefly on the updated results from the ABCSG-18 clinical trial. So this trial enrolled postmenopausal women with early-stage estrogen receptor-positive breast cancer who are being treated with aromatase inhibitor therapy. Aromatase inhibitors are known to cause reductions in bone density. This trial therefore evaluated a medication called denosumab, also called Prolia, which is used to treat osteoporosis. Participants were randomized to treatment every 6 months with either denosumab or a placebo. They found that the patients who were treated with denosumab were half as likely to have a bone fracture. Importantly, patients treated with denosumab also had an improvement in bone density despite taking the aromatase inhibitor medicine, whereas those who received placebo had a decrease in their bone density over time. The other very interesting thing from this study is that patients who received treatment with denosumab were less likely to have their breast cancer return or to develop a new cancer during the 8-year follow-up period. So it's actually already recommended that postmenopausal patients with all types of early-stage breast cancer consider treatment with a different type of bone strengthening medicine called a bisphosphonate as part of their breast cancer treatment. The goal is to further reduce their risk of cancer returning. These new results will now lead experts to debate whether to also include denosumab as a potential additional breast cancer treatment option, not just to help protect people's bone density. There were a lot of other research findings presented that were related to treatment for both early-stage and metastatic breast cancer at the meeting. Importantly, we got glimpses of the many new drugs on the horizon for treatment of breast cancer, and we eagerly await the results of large, randomized trials so that the drugs that work can be used to care for patients with breast cancer. But for now, that's it for this quick summary of important research from the 2022 ASCO Annual Meeting. Stay tuned to Cancer.Net for future updates from upcoming breast cancer conferences. Thank you. ASCO: Thank you, Dr. Henry. Finally, Dr. Shakira Grant discusses 3 studies that looked at cancer in people 60 or older. This field is also known as geriatric oncology. Dr. Grant is an Assistant Professor in the Divisions of Hematology and Geriatric Medicine at the University of North Carolina at Chapel Hill and a board-certified Geriatric Hematologist/Oncologist. View Dr. Grant's disclosures at Cancer.Net. Dr. Grant: Hi, everyone. I am Dr. Shakira Grant. And I'm an assistant professor at the University of North Carolina at Chapel Hill. I'm also a clinician scientist with a focus on social disparities and how they influence the health and aging of older adults with cancer, primarily multiple myeloma. And for today's talk, I have no relevant conflicts of interest to disclose. It's such a pleasure to be able to talk today about the ASCO 2022 geriatric oncology and presenting key studies, which I believe were really practice-changing or really set up the foundation for informing future research directions. And to start us off, I wanted to start us with abstract 12012 by Dr. Mackenzie Fowler. And this was presented based on the University of Alabama at Birmingham's actual research group. And the title of their presentation was “Rural-Urban Disparities in Geriatric Assessment Impairments and Mortality Among Older Adults with Cancer.” And this was the result of a large registry study, predominantly patients with gastrointestinal cancer-- so cancers such as liver cancer, colon cancer. And what the authors really wanted to do here was to explore if whether or not living in a rural location, for example, is associated with having an impairment based on what people report in their ability to function at home, their quality of life. And they also wanted to see whether or not where you live, meaning a rural location, whether that can be associated with how long you are expected to live or your overall survival. So this was really a study that took patients who were truly older. There were patients who were above the age of 60. As I mentioned, these were patients predominantly with cancers of the liver, the colon, and the pancreas. And patients completed a baseline, what we call a geriatric assessment, to try to assess their overall or global health. And on these assessments, patients are asked questions about how they would rate their physical function and their quality of life. And what the authors found here is that in general, when patients lived in rural areas, this was associated with patients self-reporting more functional deficits, meaning that they reported that they had impairments in the ability to function at home from a physical perspective. They also had impairments in quality of life—so how you rate your general life and how you're doing from a day-to-day basis. And this was impaired if you lived in a rural residence. And then, importantly, this study also showed that living in a rural location—and, again, this study was centered in Alabama—that that was also associated with a reduced overall survival, meaning that people were found in rural areas to live a shorter life with these cancers compared to those who live in non-rural places or, as we call it, urban. And I think why I chose this particular study is because it's one of the first studies using a large data set of almost 1,000 patients that they have enrolled and really looking at the idea of the physical environment, so where a person lives, and how that really interacts with everything else to influence the health of an individual. And this study, I believe, really lays the foundation for an area of work in geriatric oncology where we are moving away from just thinking about the older adult, but we're also thinking about the older adult and the other identities. So we're really considering the sociocultural influence. So we think about race. We think about socioeconomic status, income. But now, we're also including the physical environment. And that is where people are living and spending the majority of their time. And that is in this study classified as rural-urban residency. So for this study, overall, I would say that this is really moving the field forward in a direction where we're moving away from just looking at just older adults, but we're thinking about older adults and all of the other stressors that they face, especially when they live in the community and how that impacts their health. The next study that I wanted to highlight was a study that was performed by Dr. Heidi Klepin at Atrium Health, Wake Forest Baptist. And this was a study that looked at evaluating the association between an electronic health record-embedded frailty measure and survival among patients with cancer. Again, this was an older adult population. It was just over 500 patients involved, and patients were over the age of 65. They had a new diagnosis of the most common cancers, which are lung cancer, colon cancer, and breast cancer. And the good thing about this particular study is that it sought to use data that is readily captured in the electronic health record to characterize a patient as fit, prefrail, and frail. So why is that important for the geriatric oncology community and even beyond is when we're dealing with older adults, we're always thinking about ways in which we can actually characterize their fitness and their ability to hence tolerate their therapies, being chemotherapy, and how likely they are to die if they're having these functional impairments. And so importantly, what this study showed was that in their sample, they found that up to 17% of people were characterized as frail using this index. And the significance of this finding is that when they looked at how long people were likely to live with these cancers, breaking it down according to if you were fit, prefrail, or frail, those who were frail had the shortest overall survival. So it means the time from which they were diagnosed until they die was much shorter than any of the other categories. And that equated to a difference between those who were fit and those who were prefrail of 10 months for those who were frail for overall survival and more than 54 months for those who were actually considered to be fit. So this is really, really important because what we are seeing is that if you are really fit, you are living on average with these cancers—the overall survival, at least for their institution, was more than 54 months. But then as you move across that spectrum of fitness, we're actually seeing that your survival decreases significantly. And so why is this important? So this is important because it's one of the first studies that is actually looking to operationalize the frailty measure for us to be able to potentially use and adapt into other health systems using data that we already collect. So it's no longer burdensome on patients to try to fill out additional forms or for other staff to be involved and collect this data. And this data is showing us that there is an association with this particular frailty index and the ability to predict overall survival-- so, again, a critical study in the geriatric oncology population looking at patients with the 3 most common types of cancer, which are lung cancer, colon cancer, and breast cancer, and really showing us that there is a way potentially to operationalize how we characterize the fitness level of an older adult and then using that data not just to say, "Yes, this person is frail," but for us in real-time to see results where we can see that there is a significant difference in terms of overall survival. Importantly, this is going to be a study where we continue to watch closely the developments over the next few years, especially as the authors and the research team note that their next steps involve looking at how to study how these frailty measures, or the frailty scores that people get when they come in and they're at baseline, how this changes throughout the course of treatment. And that has a lot of implications because now, we have the potential to start thinking about using a frailty-adapted approach to caring for older adults with cancer. What that means is when you're getting your treatment and we are following these scores, as we see things changing, this may be an indicator to us that, "Hey, we need to make some modifications in response to these frailty measures to make sure that our older adult population is able to tolerate their chemotherapies and have maximum benefit while also enjoying a good quality of life." So finally, I want to highlight this third study. And this was a study that was presented by Dr. Etienne Brain. And. Dr. Etienne Brain was also this year's B.J. Kennedy Award recipient. And each year ASCO recognizes the B.J. Kennedy Award recipient as an outstanding investigator who has made significant contributions in the area of research and clinical care of older adults with cancer. In this particular study, Dr. Etienne presented on behalf of his team the final results from a study that was looking at using endocrine therapy with or without chemotherapy for older adult women, so characterized as those who were over the age of 70, with a diagnosis of estrogen receptor-positive, HER2-negative breast cancer. And the importance for this study is that the question they sought to examine was whether or not patients who are in this age range still derive a benefit from receiving chemotherapy in addition to endocrine therapy. And what this study really showed is that there was no survival difference. Meaning when they looked at the data for 4 years, those who got chemotherapy plus endocrine therapy lived just as long as those who also just got endocrine therapy alone. And why this is important is because when you think about giving chemotherapy to an older adult population, as oncologists, we are always weighing the risks and the benefits associated with treatment. So we're always thinking about how tolerable is this drug likely to be? We want to minimize side effects because, at the end of the day, our goal is to treat the cancer, but we also want to focus in on the outcomes that matter most to the older adult population. And in general, these are things like maintaining your mobility, maintaining your mentation, maintaining good quality of life. And so we really want to make sure that we're balancing those risks. And this is why this particular study showing that with chemotherapy or without chemotherapy added to endocrine therapy, there seems to be no survival difference. This could be a way in which we move the field forward in thinking about a select group of patients with breast cancer and whether or not those patients truly need that extra toxicity or burden associated with using chemotherapy or whether endocrine therapy is enough. So with that, I will say across these 3 studies, even though they study different things-- we saw 1 study that looked at the intersectionality between older adults in terms of their chronological age but now starting to examine the influence of physical or social context and how that influences the health and outcomes for individuals with primarily gastrointestinal cancer. We also looked at the development of an electronic frailty index in patients with 3 most common solid tumors - lung cancer, colon, and breast cancer - and found that by using this frailty index collecting readily available data, that there was an association with predicting overall survival. And we saw that those who were characterized as frail had one of the shortest overall survivals. And then finally, in this study, looking at endocrine therapy alone versus chemotherapy and endocrine therapy, we saw that there was no survival difference again in an older adult population. And so what we are seeing here is a theme emerging as the importance of comprehensive evaluations of older adults and the importance also of these measures, when integrated across the research continuum, that they are useful in terms of predictive prognostic abilities and really lay the foundation for future research. So with that, I want to thank you for your time and thank you for listening. ASCO: Thank you, Dr. Grant. You can find more research from recent scientific meetings at www.cancer.net. Cancer.Net Podcasts feature trusted, timely, and compassionate information for people with cancer, survivors, and their families and loved ones. Subscribe wherever you listen to podcasts for expert information and tips on coping with cancer, recaps of the latest research advances, and thoughtful discussions on cancer care. And check out other ASCO Podcasts to hear the latest interviews and insights from thought leaders, innovators, experts, and pioneers in oncology. Cancer.Net is supported by Conquer Cancer, the ASCO Foundation, which funds lifesaving research for every type of cancer, helping people with cancer everywhere. To help fund Cancer.Net and programs like it, donate at CONQUER.ORG/Donate.

On this episode, I discuss denosumab pharmacology, adverse effects, clinical pearls, and drug interactions. Whenever I see an osteoporosis medication like denosumab used, I review the medications to ensure that we avoid medications that can cause osteoporosis. Denosumab is often used as a potential alternative in osteoporosis management for those that cannot tolerate bisphosphonates. We need to monitor calcium levels when using denosumab as levels can be dangerously low, especially when used in combination with other calcium lowering drugs. Loop diuretics and cinacalcet can have additive hypocalcemia effects when used in combination with denosumab.

Dr. Martin answers questions sent in by our listeners. Some of today's topics include: Psoriatic arthritis Temporal arteritis Glutathione supplementation  Brachial radial bursitis Fulvic acid Varicose veins Prolia shots for osteoporosis Calcium supplements Hydrochloric acid Celiac disease Tune in to hear Dr. Martin's responses!  

Host/Producer: Rhonda Feiman Co-Producer: Petra Hall Technical assistance: Joel Mann & Amy Browne Osteoporosis: The myths and facts in diagnosis, new developments in screening technology, and the pros & cons of current treatment options Key Discussion Points: 1. What are some ideas and strategies to keep your bones strong and healthy? 2. What are some ways to be safe in your house and with your everyday activities to try to prevent debilitating falls? 3. What is osteoporosis? 4. Why is bone density difficult to measure? 5. What is a DXA scan? How are DXA scans interpreted? 6. What is a Trabecular Bone Score (TBS)? 7. Why should Trabecular Bone Score software be used to interpret the results of your DXA scan? 8. What is osteopenia, and why is this a controversial diagnosis? 9. What are the pros and cons of current medicines being prescribed for osteoporosis, including biophosphonates such as alendronate (Fosamax), etidronate (Didronel) & zoledronic acid (Zometa), and monoclonal antibodies, such as denosumab (Prolia)? 10. How has pharmaceutical company research & marketing impacted and influenced medical diagnosis and treatment of bone density and osteoporosis? Guest: Cindy Pearson, the former Executive Director of the National Women's Health Network of Washington, D.C. She is one of the nation's best-known advocates for women's health, and is well known for her leadership in bringing grassroots organizations together to press for accountability from the government and other powerful entities. Cindy Pearson often testified before Congress, the National Institutes of Health and the FDA, and was frequently featured in the news as a consumer expert on women's health issues. Website of Interest: National Women's Health Network About the host: Rhonda Feiman is a nationally-certified, licensed acupuncturist practicing in Belfast, Maine since 1993. She primarily practices Toyohari Japanese acupuncture, using gentle and powerful non-insertion needle techniques, and also utilizes Chinese acupuncture and herbology. In addition, Rhonda is a practitioner of Qi Gong and an instructor of Tai Chi Chuan in the Yang Family tradition. The post Healthy Options 8/4/21: Osteoporosis: Myths and Facts first appeared on WERU 89.9 FM Blue Hill, Maine Local News and Public Affairs Archives.

PROSTATE PROS Series Finale On the last episode of the PROSTATE PROS podcast, Dr. Scholz and Liz recap important themes and talk about what’s new in prostate cancer, including Lutetium-177 and Orgovyx. Dr. Scholz: [00:03] We’re guiding you to treatment success and avoiding prostate cancer pitfalls. I’m your host, Dr. Mark Scholz. Liz: [00:09] And I’m your cohost, Liz Graves. Dr. Scholz: [00:13] Welcome to the PROSTATE PROS podcast. Liz: [00:15] We have a bit of a sad announcement to make, as this will be the last episode of the PROSTATE PROS podcast. Dr. Scholz and I have really enjoyed working on this project and we’ve covered so many important topics surrounding prostate cancer and men’s health. So for this last episode, we’re going to recap some important themes and talk about some promising new therapies. So Dr. Scholz, on our very first episode, we talked about how important it is to find the right treatment team. This is something that’s come up again and again and again. What are some tips you have for newly diagnosed men trying to find their doctors? Dr. Scholz: [00:53] I think what’s confusing is how much of the responsibility falls on the shoulders of patients. The prostate industry is a very powerful multi-billion dollar industry, and there is a lot happening really fast. When patients are diagnosed, they’re not in a thoughtful perspective, they’re in an action mode, they’re frightened. It is hard to sort out who to listen to and who to stay away from. This process can be aided by family members, primary care doctors, oncologists, and of course, online resources and books. I try to provide some of that information in the book, The Key to Prostate Cancer, but the process, if it was easy, we could give you one simple answer. It is not a simple process. Liz: [01:46] One thing that we’ve talked about is to get a quarterback. So this is a doctor that isn’t the treating doctor necessarily, but it’s someone that will oversee the treatment and work with the other teams of doctors. This is something I hear you doing Dr. Scholz, you’re always talking to other doctors about patients and kind of networking with them to make sure that the patient is getting the best care, even when they’re not in our office. Dr. Scholz: [02:12] I think the issue that you’re relating to is that many of these physicians have a conflict of interest. You’re asking them, what should I do? But they’re a surgeon or they’re a radiation doctor. And as a medical oncologist, I’m neither of the above. This is somewhat uncommon, but you can recruit your urologist or your radiation doctor to help you by explaining at the outset that, “you, sir, will not be my treating doctor, but I definitely need your aid and your assistance in picking the right doctor.” Liz: [02:43] Now you may be thinking that you have cancer and you don’t have time to see all these people, but as we’ve mentioned, prostate cancer is slow growing. So really taking that time to find the right doctor for you is crucial. Dr. Scholz: [02:56] Just yesterday, I saw a very sophisticated new patient who was feeling the rush job, the sense that the clock is ticking, and he did have a Gleason 9. We consider that the High-Risk category of prostate cancer. But, the idea that you have to make a decision within days or weeks is never substantiated by the literature and the science. Patients can take several months to sort out what they want to do. This sort of careful thoughtful process pays off in the long-term with better results. Liz: [03:29] So patients really need to take it under their control. One of the things is to educate themselves. In the past couple of years, there’s been a huge shift towards imaging. So we’ve had the approval of the PSMA PET scan and using 3T MP MRIs and color Doppler to help men diagnose their prostate cancer and watch it. Dr. Scholz: [03:51] What Elizabeth is referring to is that if you don’t have a clear picture of where the cancer is and whether it’s spread outside the gland, what part of the gland it’s located in, it’s not feasible to tailor treatment to the specific needs of the individual. Some men are fortunate enough to have prostate cancers residing on one side of their gland. This opens the door to something called focal therapy, enabling men to undergo treatment with less risk of erectile dysfunction. There were a lot of things we could have covered in this last podcast and the reminder that quality imaging and not only MRI and PSMA PET scans, but scans done at centers of excellence that are read by experts are going to help men be light years ahead in their selection of treatment, because they’ll have a clear picture of what they’re really treating. Liz: [04:43] So we’ve actually gotten emails from people all across the country saying, you know, my doctor’s never heard of the PSMA PET scan or my doctor doesn’t do 3T imaging. So it is really important that you take the time to educate yourself and bring these questions to your doctors. Finding the right treatment team and doing your due diligence to make sure you’re choosing the right treatment is all important because of where the prostate is located. Treatment related side effects can have damaging effects on quality of life. Because prostate cancer is so slow growing, hopefully you’ll have a very long life, so it’s important that that can be lived to the best of your ability. Dr. Scholz: [05:25] That’s so, so important. And these functions, sexual, urinary functions are something that people face every day of their life. In the hustle bustle to get treatment quickly, the fact that if the treatment is not done in an ideal way, that men can be left with permanent issues unnecessarily, certainly if there was no other option, we would live with these negative consequences. But, in most cases now with skillful care, these things can be avoided. Liz: [05:58] Over the past two years, Dr. Scholz and I have covered all the treatment options from active surveillance to surgery, radiation chemotherapy. These episodes will still be available even after the podcast ends, you can go back and re-listen and keep sharing with friends and educating yourself. Dr. Scholz: [06:16] One thing about this information provided in the podcast is not only the idea of which treatment is best and what kind of things to look out for, but the step by step process, the thinking process, the procedures, and how you can come to get the right doctors and the right treatment is implicit in the whole podcast system that we have provided. So you can also just learn from the thought process that leads to successful outcomes. Liz: [06:49] While there are a lot of challenges that newly diagnosed patients face, patients with advanced prostate cancer also are missing out on some tools like Xgeva and Prolia. Dr. Scholz: [07:01] These medicines are to help compensate for men who have disease that’s spread to their bones or men who’ve been on hormone treatment and the calcium is leaching out, a process called osteoporosis. The number of times this is overlooked and people coming to us for second opinions is really quite surprising, as they are FDA approved to help compensate for these problems. So simple second opinions can be so valuable for men, even if they have advanced disease. Liz: [07:35] As we segue into what’s coming up and what’s new in prostate cancer, we wanted to quickly mention that there are a lot of new drugs and things being tested for FDA approval through clinical trials. Clinical trials are a great way to get access to these new medications, if you have a specialist on your team who is constantly looking out for these and keeping tabs on what’s coming up. Dr. Scholz: [08:03] Every new medicine or treatment goes through a process of being researched. Once it’s validated as a treatment, it gets FDA approved. And then after that, it becomes commercialized and broadly available across the country. The things that succeed through that process are very valuable. And we’ll be talking about a Lutetium-177 and a new pill called Orgovyx. These medicines have been available, but now are commercially available. If your physician is not staying abreast of all the new developments, men who could benefit from these treatments will be denied access simply through unawareness. Liz: [08:43] Lutetium-177 is something that we’ve talked about on past podcasts. And it’s not even FDA approved yet, but you’ve actually had some patients who have had it, is that correct? Dr. Scholz: [08:57] Lutetium-177 a was purchased by a Novartis pharmaceuticals for $2 billion prior to all the testing being completed because all the preliminary data looks so favorable recently, they released the code for the large clinical trial that was performed confirming that it does prolong survival. This is a medicine that was evaluated in men with very advanced prostate cancer who had already had chemotherapy who had been on other powerful hormone treatments and they’d stopped working. The man who got treated with Lutetium-177 lived longer, statistically significantly longer, than the men who got an alternative, placebo-type approach. This medicine is well tolerated. It can cause some dryness of people’s mouths. It can lower blood counts a little bit, but it’s a simple injection every six weeks. And it is a potent treatment for men with advanced disease. It may even be a useful treatment for men with earlier stage disease. This will probably be commercially available within a year. Liz:  [10:05] To learn more about this medicine, we covered it in Episode 10, Don’t Reject Radiation.  So you can go back and listen to that.  At the end of 2020, there was a new FDA approval Orgovyx.  This is an oral anti-androgen, so it works kind of like a Lupron, but instead of it being an injection, it’s just a daily pill.  Dr. Scholz: [10:28] So how much do we really need a new pill? When if you could take an injection that lasts three to six months, and you don’t have to remember taking pills every day, but Orgovyx may have some other advantages when compared to head to head with Lupron and the other medicines like Lupron, such as Firmagon and Trelstar, Eligard, and Zoladex. These medicines all work by shutting down the production of testosterone in a man’s testicles. Orgovyx is interesting for two reasons. One is that the recovery of testosterone when treatment is stopped, seems to be much more predictable and consistent medicines like Lupron, and the others that I mentioned, can have a very protracted and prolonged effect even after they’re stopped, and it’s hard to predict when testosterone is going to return. Another thing that came out in Orgovyx trials was a lower incidence of cardiovascular complications. For years, I’ve made a strong argument that Lupron and other drugs do not cause cardiovascular problems directly, but indirectly in men who have a lot of weight gain, blood pressure goes up, blood sugars start to go out of control. Of course these things can lead to cardiovascular problems, but for some reason, in that randomized trial Orgovyx had a lower incidence of cardiovascular related issues. This is certainly an interesting and potential advantage for this medication. Liz:  [11:56] Technology and medicine around prostate cancer is improving almost daily.  And one of the things that’s really promising is immunotherapy.  We talked about this on Episode 9, The Intelligence of Immunotherapy, and we cover all sorts of different things that will benefit men with prostate cancer, like KEYTRUDA and OPDIVO YERVOY.  So if you’re interested in learning more about immunotherapy Episode 9 is a great place to start.  Making this podcast has been such a rewarding experience for Dr. Scholz and I, and we really hope that it’s helped you on your prostate cancer journey.  And we’ve left you with a little more education and knowledge and empowered you to take control of your prostate cancer diagnosis and spend time really learning about it and understanding, so you can have your medicine personalized to you.  You can find the right doctors, seek second opinions, and then take everything you’ve learned to spread awareness about prostate cancer.  Remember prostate cancer is a silent disease and it affects so many men and families and loved ones.  This really needs to be something that people are comfortable talking about.  So we hope our podcast has helped give you some points to talk about with your friends and family members and help them make those treatment decisions.   Dr. Scholz: [13:26] So Kaili, my business manager and myself are very grateful to Liz for all the hard work she’s done in compiling these episodes and helping us reach the things that really count. It’s been quite a bit of work along the way, which has been a delight to participate in for me. Liz, can you just share a couple of sentences of where you think you’re going to be going with your own professional career as you’re moving on? Liz: [13:51] Yes.  I am actually pursuing higher education to become a professional writer.  I am looking forward to it, but I’m definitely sad that I won’t be working with you and bringing this podcast to everyone.  I know I’ve had so much fun learning about prostate cancer and hopefully being able to help all of our listeners navigate this subject.  Again, these episodes have been archived, so you can go back and listen to all twenty-four of them on podcast.prostateoncology.com, or Apple Podcasts, SoundCloud, wherever you like to listen.  Another good tip is that the PCRI’s YouTube videos come out every week.  These are awesome videos that talk all about prostate cancer.  Dr. Scholz is a very frequent guest on there, so I would highly recommend you check that out.  You can find them at youtube.com/thePCRI.  Thank you for listening and supporting us.

Chris Demm has weak bones. See omnystudio.com/listener for privacy information.

Thank you for joining us for our 2nd Cabral HouseCall of the weekend! I’m looking forward to sharing with you some of our community’s questions that have come in over the past few weeks… Let’s get started! Lauren: Hi Dr Cabral, First, thank you! You continue to help me daily! This question is for my sister. She is 32 and after doing a month of whole 30 she found out she has a mild case of crohns in the tail of small intestine. She only got ct scan and colonoscopy with biopsy. The gastro told her to take lialda 1.2 (2tablets a day) and budesonide 3mg (3times a day) for two weeks while she is overseas and then come in to discuss treatment. I am very anti this as the doctor never discussed why she has all this inflammation in the first place. For background she also found out she had HSV-2 3 years ago right after she randomly got shingles. for the HSV2, she takes valtrex as she thinks its the only way. She has also been on birth control for 15 years. I believe since she started Valtrex, her stomach has been in shambles and her hair appears to be thinning. The doctor took her blood work and said everything seems 'fine' but she has elevated testosterone. First, Can you please recommend what she should do for crohns as well as what foods she should eat/avoid .. I want her to see a nutritionist to see what she can eat and/or a functional doctor or better yet you despite living in NY, to test for food sensitivities, organic acid test, heavy metals, thyroid etc. Secondly, can you please recommend the absolute necessary testing she should get done and how she can go about NOT taking these harsh treatment drugs doctors typically prescribe. I have a feeling her immune system already is poor and those treatments will make it worse and lead to later bigger problems. Third, could the valtrx and birth control and HSV2 in general be something causing the crohns? I want her off those medicines but I figured she may respond better to you rather than me telling her! Thanks in advance!! I really want to help her as she is overwhelmed and needs direction on what exactly to do/eat etc. Lori: Hi Dr. Cabral. I’m so glad I found your podcast. I tell everyone about it and love passing on information to them that I think will help them - I have a question about my loud stomach. My stomach seems extremely loud after I eat, but there’s even times when I haven’t eaten anything and it is still making gurgling noises. I drink a smoothie every morning using your daily nutritional support, and I just ordered the fruit and vegetable blend. I tried using the probiotic in the daily protocol but it made me so bloated and uncomfortable that I stopped taking it. My diet is okay. It could be better but I don’t eat red meat, have occasional chicken, and eat mostly fish. I don’t eat a lot of processed food, and I do some form of exercise every day, either rowing, elliptical, weights or yoga (my favorite). I also try to meditate daily. I do get heatburn and maybe 5 years ago I was put on Zantac every day. I went off after a year or two because I felt I didn’t need it anymore. Ironically, I was put on high blood pressure meds a few years ago even though I am not overweight and have no other risks factors other than high bp readings at dr.’s office. I’m 5’7”, 135, workout daily, limit salt, no red meat. In your podcast 108, it said low stomach acid could be a cause. I monitored my bp for one month at home and had very good readings. I brought that info to my pcp and he said I could possibly stop, which I did. I’ve been monitoring and am having good readings. It’s been almost 4 months that I’ve been off all medication, not even over the counter Tylenol. I’m wondering if you think my loud stomach is because of an overgrowth and should I give the probiotics another try? It really made me very bloated and it was very uncomfortable. Thank you for your help. I look forward to hearing what you think I should do. Deb: Dr. Cabral, I am a new 'convert' to your wealth of health insights thanks to friend Lisa. I am 68 female with Hashimoto's who has osteoporosis in both hips and osteopenia in spine. I have resisted taking any of the bisphosphonates or Prolia in the 15+ years I've experienced bone loss due to all the side effects. I eat healthy mostly Mediterranean diet (and no gluten, soy, or GMOs, eat organic 90%) and focus on exercises that will strength butt muscles and take 'all the right supplements.' A functional medicine osteoporosis expert proposes (while not a fan particularly) I take Prolia for 1 year and follow it up with a year on Fosamax reasoning that Prolia DOES build bone BUT if you stop it you are at greater risk of fracture. My integrative PCP is proposing Prolia and does not like bisphosphonates. What is your advice please? Sarah: Hi Dr. Cabral, I recently got introduced to your podcast through your interview on Jay Ferruggia's podcast and I've been tuning in often to your podcast ever since! I've also been sharing it with my friends and colleagues and family members when I hear something on your podcast that might help them! So thankful for your insights and simple, straight-forward approach to healing. Over the last year I worked with a nutritionist in the Ottawa, Canada area (I also got him hooked to your podcast). Together we identified many food sensitivities (through electrodermal testing) and I changed my diet and approach to food drastically since then. (I'm trying to get my family on board but that has been a bit more challenging. But that is a topic for another day!) I saw immediate and ongoing amazing results. I am 5'4", athletic body type although small, and when I was a teenager weighed around 105-110 lbs), but after my 2nd child I kept gaining weight and couldn't lose it even though I kept increasing my exercise and work-outs and considered myself to eat very healthy. I had reached over 130 lbs, felt tired all the time, and was experiencing early signs of depression. Removing the foods I was sensitive to, I lost 18 lbs in around 3 months, and I recently lost that last stubborn 5 lbs after a bout of the flu (I am now back to 108-110lbs!). I have more energy and more zest for life, etc. Among my food sensitivities are the usual culprits but also a curious list of fruits and vegetables: gluten, oatmeal, corn, soy, dairy, pork, tomatoes, peppers, eggplant, zucchinis, all legumes, papayas, mangos, kiwis, bananas, coconut products (except oil), sesame oil and seeds, garlic, food additives and stevia, etc. But I still experience frequent bloating and gas and sometimes constipation after having a "cheat meal" no matter how small the "cheat" ingredient is (which is on my food sensitivity list). The funny thing also is that my food sensitivities seem to change every few months. I also still struggle with psoriasis on my scalp - that has not gone away (had it for nearly 10 years now) and still is itchy even after 14 months of being on my program. I recently eliminated caffeinated coffee (still have decaf) and alcohol but this didn't seem to do anything. I have sugar maybe once a week in a larger amount, usually it is a teaspoon or less per day. I eat vegetables and protein every meal (usually meat protein since I can't do legumes) and do starch for lunch and dinner. I recently stopped eating between dinner and bedtime (and changed my bedtime routine based on your diurnal rhythms podcast episode. I go to bed close to 10pm and I naturally wake up close to 6am sometimes before. Whereas before I was so tired no matter how late I slept in!) I take magnesium glutamate (2 capsules before bed), a Vit B12 supplement (bought at pharmacy, Jamieson brand - my physician had identified low B12 levels through blood work before I started my diet change), and a Vit D3 supplement (also bought at pharmacy). I also take a probiotic capsule every day (mix of bifido and lacto) that my nutritionist gave me specifically for IBD-type of symptoms. I take the odd digestive enzyme before a cheat meal, and during periods of more cheating (e.g. holidays) I take glutamine powder every day. Wondering if you have any specific recommendations on how to figure out the problem around my digestion and my psoriasis (I suspect they are related). I listened to your previous podcasts on psoriasis and also on food sensitivities and digestion related. However, I am not clear what is the best protocol to start with: candida yeast overgrowth protocol, or the detox, and should I do the 7 or 14 or 21 day detox? and then what? (weight loss is not my goal). And, based on my body type, should I be eating a different proportion of macro nutrients? Also, my nutritionist's method did not identify the severity of food sensitivities, so I don't have a good sense for which foods to really remove completely and which ones are ok to cheat once in a while (other than dairy and gluten, they give me constipation for 3 days).Lent has started so this is a perfect opportunity to reset my body and my mind! Look forward to your suggestions. thank you so much. Thank you for tuning into this weekend’s Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes & Resources: http://StephenCabral.com/821 - - - Get Your Question Answered: http://StephenCabral.com/askcabral  

Pierrette a perdu 7cm ! Toute sa colonne s'est effondrée. 11 fractures vertébrales ! A 56 ans, elle doit s'accrocher à un déambulateur pour réapprendre à marcher. En cause ? L'arrêt du denosumab ou Prolia, un médicament « révolutionnaire » pour soigner et prévenir l'ostéoporose. Hôpital ne rime pas avec gastronomie. En 2006, l'OFSP affirmait qu'un tiers des patients souffraient de dénutrition, et en subissaient les conséquences. 36.9° se demande comment mieux faire en matière de goût pour que la nourriture joue enfin son rôle dans le bien être des patients.

The FITz and Healthy podcast is a talk show that shares weekly information to help you live a FITz and healthy life.  Join hosts Dr. Lauren Fitz and Cinthanie as they discuss topics ranging from fitness, health, and everything in between to help promote a better healthy lifestyle by design.  The FITz and Healthy podcast offer a series of shows on the official YouTube channel and other social sites.==========ABOUT THIS EPISODE:Welcome to the FITz Friday Q&A where Lauren, Cinthanie, and/or guests answer your questions during the live recording on YouTube.  Tune in for the live recording on Friday at 3pm central time to join future episodes and ask us your questions at: https://www.youtube.com/clubfitzfitness/live==========QUESTIONS IN Q&A:1) What is your motivation for watching your diet?2) Do you follow a specific workout plan? If so, which one?3) Best store bought bone broth and can my 4 year old have bone broth for his gut?4) My mom was recently diagnosed (from bone density test) with Osteoporosis and Dr wanting her to take Prolia shot. What advice do you give her?5) Any way to curb cravings when Aunt Flo is visiting? #thestruggleisreal6) I can't convince her to put down the spam musubis but maybe I can give her a small starting point?7) I heard something on Dave Asprey about ppl with hormone issues (hypothyroid) sweat less.  Know anything about it?==========Lauren FITz Website: http://www.laurenfitz.comClub FITz YouTube Channel: https://www.youtube.com/clubfitzfitnessFITz & Healthy YouTube Channel: https://www.youtube.com/laurenfitz==========FIND LAUREN ON SOCIAL MEDIA:Snapchat @clubfitzhttp://www.facebook.com/ClubFitzFitnesshttp://www.twitter.com/ClubFitzFitnesshttp://www.instagram.com/clubfitz==========FIND CINTHANIE ON SOCIAL MEDIA:Snapchat @ cinthaniephttp://www.facebook.com/cinthaniehttp://www.instagram.com/cinthanie==========Produced by Robert DeLeon @ http://www.mixzawa.comMusic by Kaine @ https://soundcloud.com/kainelegacy

Today in FirstWord:

In this episode, we review the National Osteoporosis Foundation's osteoporosis guidelines with a particular focus on two newer agents, denosumab (Prolia) and teriparatide (Forteo).