For people who have more advanced osteoporosis, prescription medications, as well as lifestyle modifications, may be necessary to control and mitigate the disease. When to Start Osteoporosis Medications In post-menopausal women and men >50 yrs old with T-score >2.5 and <-1.0 with a FRAX score of >20% for major osteoporotic fracture risk and .3% for hip fracture risk typical fragility fractures T-scores < -2.5, Multiple risk factors; particularly those who already had fracture The prescription drugs Alendronate, Risedronate, Ibandronate, and Zoledronic acid are the most commonly prescribed drugs in the treatment of this disease. They belong to a class of pharmaceuticals known as bisphosphonates. These medications are typically taken orally once a week or once a month or by injection once every year or once every three months. Bisphosphonates : synthetic analogues of pyrophosphates. Reduce bone resorption and bone loss by binding to bone and poisoning active osteoclasts. Medication shows yearly bone density increases of 2-3% at the lumbar spine. Brands Alendronate (Fosamax) 5mg/day for prevention, 10mg/day for treatment Risedronate (Actonel) prevention and treatment dose in the same. 5mg/day, 35mg once a week, 75mg 2x a month, or 150mg once a month Zoledronic Acid (Reclast) 5mg IV once yearly Instructions:

Cautions:  All people with osteoporosis are advised to avoid the risk of falling. People with advanced osteoporosis will be cautioned by their doctor to perform low-impact, low risk exercises such as water aerobics, walking, and swimming.  Many will be advised to avoid extreme sports, skiing, jogging, and climbing where falls are common. Future outlook on the condition:  Some experts estimate that Osteoporosis currently causes 1.3 million bone fractures a year. According to an article published in the American Journal of Medicine , the cost of osteoporosis death and disability in the United States was between seven and ten billion dollars in 1986. As the elderly population in the United States grows, the problem of osteoporosis will grow with it. Beginning in 2013, doctors were examining the relationship of magnesium to osteoporosis. Early analyses suggest that both low magnesium and elevated magnesium aggravate osteoporosis. Further research will be needed to verify these findings. For the most part, however, future research on osteoporosis is likely to focus on the development of new drugs that don’t just inhibit bone loss, but actually stimulate bone tissue formation. Because of the high cost of osteoporosis in the United States, research is needed to suggest ways to prevent and treat the disease

Lifestyle modifications, Vitamin D, and calcium supplements are the first and best line of defense against osteoporosis. This is because all osteoporosis prescription drugs come with side effects, some of which are quite serious. Side effects of bisphosphonates for example are esophageal ulcers, esophageal inflammation, nausea, stomach pain, and difficulty swallowing. These risks can be minimized by taking bisphosphonate injections rather than pills. Longterm use of bisphosphonates has been associated with thigh bone fractures. This is a rare outcome and happens only if a patient has been on the drug for five years or longer. Another unusual, but documented side effect is the deterioration and death of part of the jaw bone following tooth extraction. This condition is called osteonecrosis. Osteoporosis patients should bear in mind that when prescribing a medication, a doctor has weighed the risks against the benefits and determined that the benefits significantly outweigh the risks. Many patients will start on one type of osteoporosis medication and then be switched to another to keep longer term side effects in check.

Doctors often use two classification systems, called the TMN classification system or the Gleason system to characterize the tumor type. TMN classification To classify a tumor, doctors most often use a method called the TMN system, which is based on the tumor size (T), whether it has spread to lymph nodes (N), and if it has metastasized (traveled) to distant regions or organs of the body (M). Doctors additionally assign each letter (T, N, and M) a number, which measures how much the cancer has advanced. Larger numbers correspond to more advanced cancers. Doctors then use the TMN system to group multiple tumor types into a single staging group which allows them to provide appropriate treatment based on the severity of the cancer. T1 cancer is not large enough to be felt by a doctor, but it can be seen with certain visualization procedures. T2 cancer is large enough to felt by the doctor performing a rectal exam, but upon examination, the tumor remains confined to the prostate. T3 cancer is large and has spread outside of the prostate. T4 cancer has spread to distant tissues far away from the prostate. N classifications N0: The cancer has not spread to the lymph nodes.

Prostate cancer is the second most common cancer in men and typically develops in those aged >65 yrs. The American Cancer Society estimates that in 2016 over 180,000 new prostate cancer cases and 26,000 deaths will occur. Worldwide prostate cancer is more commonly found in developed countries. In the United States for example one in every seven men will be diagnosed with prostate cancer . Nearly 60% of these cases occur in men 65 or older and one in 39 men will die of prostate cancer. Prostate cancer is rarely diagnosed in men younger than 40. Recommended Read: How to Keep your Prostate Healthy Despite these statistics, the survival rate for prostate cancer is fairly high. For all stages of prostate cancer, the 5-year relative survival rate is nearly 100%, while the 15-year relative survival rate is 95%. Although an individual’s chance of survival depends on their individual circumstances it is highly likely a man with prostate cancer will survive at least 5 years.