Osteonecrosis of the Jaw ?: Hi - My dad... - Advanced Prostate...

Advanced Prostate Cancer
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Osteonecrosis of the Jaw ?

ellie2211
ellie2211

Hi - My dad, 68, was diagnosed with stage 4 prostate cancer that has reached the bone in 4 places. it is not aggressive but it is advanced according to the oncologist. He is going to city of hope.

He recently started having pain in his mouth, he wear partial dentures and attributes the pain to that (he lost a tooth and it now moves around a bit)

I don't know what osteonecrosis of the Jaw is...but saw it on one of these forums. Can someone please tell me about this?

He is on the chem pill now and will be getting hormone/chemo iv (lupron?) sometime this month depending on the progress of his kidneys.

I was also wondering if i should take steps to prepare myself for his chemo treatments (shower seat, what diet?) or if he will have significant pain...he is in no pain atm ...occasional dizziness

Thank you!!

11 Replies
oldestnewest

Osteonecrosis of the jaw (ONJ) usually occurs after an extraction and the patient has been on a biophosophanate(Fosamex, Boniva, Zometa), Chemo has also been associated with ONJ. I'm a DDS in CA, when were last dental checkup and xrays done?

I fasted 2 days before chemo sessions and that helped my avoid most symptoms(did 15 taxotere sessions in 2015). Google fasting and chemo or check out my previous posts.

My best to your Dad - Randy theloopnewspaper.com/story/...

NPfisherman
NPfisherman
in reply to dockam

Your story is inspiring Randy....Thanks for posting....Fight on !!!

ellie2211
ellie2211
in reply to dockam

Thank you for responding, he was just diagnosed this Christmas eve. I am trying to learn as much as I can but am easily overwhelmed at this point. It's great to find this site.

I believe he hasn't gone to the dentist in some time but his tooth fell out last week and the pain started this week. he is on biophosophanate too

dockam
dockam
in reply to ellie2211

K, if it is ONJ - then an oral surgeon may be needed to treat it. Here are signs/symptoms:

pain, swelling, redness, or other signs of infection in the gums.

gums or sockets that don't heal after dental work.

loose teeth.

numbness or a heavy feeling in the jaw.

draining.

having bone become visible in your mouth.

Rottney
Rottney
in reply to dockam

I developed ONJ after a root canal, and after ~20 months of Xgeva / Lupron / Casodex for Stage 4 PCa. Treatment for the ONJ has been careful. Bone Mets checked and no longer detectable so dropped Xgeva (for now). Oral rinse for ONJ has produced little improvement. Consult with Oral Surgeon in Feb.

As I understand it the bisphosphonate use is the cause of ONJ and longer use results in higher chance of ONJ development.

Haniff
Haniff
in reply to dockam

Hi Kam,

Wow, amazing that you could do the marathons while undergoing chemo. Its a game changer for me for sure after reading your article you shared.

My very best to you, take care.

Regards,

Haniff

dockam
dockam
in reply to Haniff

Thank you, that was my stress relief and now is my new purpose to wear a sign on my back. I tell a brief story of my PCa and now have listed men who were taken by PCa - some from this forum and others from FB groups. So far, I have 18 men on there and will wear it at the Surf City marathon on Super Sunday. If you peruse my previous posts, you should see the other back bibs. Fight on Brother

My excellent dentist says this is a problem in 10-15% of folks on a biophosophanate.

ONJ (also called BRONJ, MRONJ, and a bunch of other acronyms) is a condition of bone metabolism. Bisphosphonates are primarily used to treat osteoporosis in women, but also used to treat bone metastases--most often from prostate or breast cancer, as well as bone cancers such as multiple myeloma. In cancer patients usually intravenous infusions are used, and here problems with osteonecrosis are more common than from oral medication. I've seen all kinds of figures for the percentage of patients that will develop ONJ. The duration of treatment is related to the probability of development of ONJ. Still, it is not terribly common.

Treatment is controversial--some will clean it out surgically, others say surgery is of little help. Drug "holidays" have been proposed, but given the long half-life of these meds that strategy is controversial as well.

My father had a terrific response to Zometa infusions--his bony mets basically disappeared on scan. He never developed ONJ despite having significant periodontal issues. He was eventually taken off Zometa because of deteriorating kidney function.

Steve (DDS)

j-o-h-n
j-o-h-n
in reply to dentaltwin

You're another Ace up our sleeve... THANK YOU!!!

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 01/10/2019 6:15 PM EST

ncbi.nlm.nih.gov/pmc/articl...

up to 18% of cancer patients will have ONJ with biophosophanate treatment.

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