A member asked:

Dad has advanced prostate cancer with bone metastasis. after orchirectomy, psa down from 270 to 10. shall he start zometa or xgeva (denosumab)? which is better?

6 doctors weighed in across 4 answers
Dr. Uma Swamy answered

See Below: Use of bisphosphanates for your dad can be controversial. Here is an excerpt from a recent review article on www.cancernetwork.com which you can use to discuss with your father's doctor to decide what is best for your dad. http://www.cancernetwork.com/bone-metastases/content/article/10165/105118.

Answered 2/25/2014

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Either : Xgeva (denosumab) does have some advantages over zometa: quicker administration and no kidney side effects. It is associated with fewer bone complications from cancer than zometa. On the other hand, zometa is now generic, meaning that is a lot cheaper. Neither is a curative treatment for prostate cancer and they are both considered adjunct treatments. Thes small differences may or may not justify its use.

Answered 12/9/2013

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Bones: Xgeva (denosumab) has less side effect profile in my opinion.

Answered 5/6/2013

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Off label: Neither zoledronate nor Denosumab is approved for disease that has not progressed on initial hormonal therapy. I would recommend waiting until disease progression and thus avoid potential side effects from these treatments.

Answered 6/25/2014

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