Prostate cancer

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Potential side effects of bisphosphonate therapy for prostate cancer

Side effects can occur with any type of treatment for prostate cancer, but not everyone has them or experiences them in the same way. Side effects of bisphosphonate therapy will depend mainly on the:

  • type of drug
  • dose
  • man's overall health

Side effects can happen any time during bisphosphonate therapy. Some may happen during, immediately after or a few days or weeks after therapy. Most side effects go away after bisphosphonate therapy is over. Late side effects can occur months or years after bisphosphonate therapy. Some side effects may last a long time or be permanent.

It is important to report side effects to the healthcare team.

Bone pain

Bone pain can temporarily become worse when bisphosphonates are first given.

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Digestive problems

Nausea and vomiting, heartburn, abdominal cramps or diarrhea may occur, especially with oral bisphosphonates. These side effects may require an increase in fluid intake to prevent dehydration. Medications can be used to control these symptoms.

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Flu-like symptoms

Fever and chills, muscle and joint aches, pain as well as fatigue may occur. These symptoms can be treated with pain or fever medication.

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Injection site pain 

Intravenous bisphosphonates may cause pain at the site of injection.

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Destruction of the bone (osteonecrosis) occurs in the jaw in 1–2% of men taking zoledronic acid (Zometa). This causes loosening of the teeth and discomfort. A dental exam is required before starting treatment, and any dental procedures should be performed before starting treatment.

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Kidney damage

This side effect can be sudden (acute) or develop gradually. Some bisphosphonates are more toxic to the kidney than others. Any reduction in kidney function will be carefully assessed by the healthcare team and may require a reduction in the dose or stopping the drug completely.

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Other side effects

Other side effects that may occur with bisphosphonates are:

  • decrease in calcium level – treated with calcium supplements
  • inflamed, sore eyes – may require an eye exam and eye drops
  • gum swelling and pain – may be treated with a mouthwash

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Researcher Dr Stuart Peacock Research at the Canadian Centre for Applied Research in Cancer Control led to a new standard in leukemia testing.

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