Bone-strengthening medications

Your doctor may recommend medication to improve your bone density. Drugs to make your bones stronger can reduce the risk of fractures or osteoporosis.

Bisphosphonates

Bisphosphonates are drugs that:

• reduce the breakdown of bone
• make bone stronger and reduce the risk of fracture
• reduce bone pain
• correct or prevent high calcium levels in the blood ('hypercalcaemia').

These drugs may also act directly on cancer cells.

Zometa (zoledronic acid)

Zometa is usually given monthly as an intravenous infusion to patients with metastatic breast cancer.

Doctors often recommend Zometa to patients with early breast cancer who are at higher risk of recurrence. Zometa given every 6 months for 3 years has been proven to increase overall survival.

Zometa for prevention of breast cancer is not on the PBS. The medication for each infusion costs around $50.

People can usually tolerate the side effects of Zometa better than of other bisphosphonates.

Prolia (denosumab)

Prolia improves bone density and reduces the risk of bone fracture. It is often used to treat osteoporosis in postmenopausal women.

Treatment is via injection below the skin, usually every six months. Your GP or general practice nurse can give this injection.

Prolia is not on the PBS for prevention of breast cancer. The cost is around $400-500 per injection.

Bondronat (ibandronic acid) and Bonefos (sodium clodronate)

These are bisphosphonates that are taken daily as a tablet.

Biologic agents

A biologic agent has similar benefits to bisphosphonates. It reduces bone pain and the risk of fracture and helps control hypercalcaemia.

Biologic agents include Xgeva (denosumab).

These work to correct the imbalance between the cells that break down old bone (‘osteoclasts’) and cells that help form new bone (‘osteoblasts’).

Initially, you have an injection under the skin every four weeks. A nurse or doctor can give this injection. Ask your medical oncologist if you can have your GP involved in this part of your treatment.

Sometimes, if your cancer is under control, the doctor may suggest reducing how often you have the injections.

Some people find an injection more convenient than an IV drip (‘intravenous infusion’) because:

• you don't have to travel for treatment
• you spend less time in hospital.

Side effects

Like all drugs, bone strengthening medications can have side effects. Find out about Side effects of bone strengthening medications and how to reduce their impact.