Dental work + Delayed treatment

[dvcarola2]

May I ask if anyone had a dental work done (root canal + crown) while on Xgeva? My husband had a very painful tooth infection with abscess last month, had very high fever and then dentist recommended root canal and then putting a post before the crown because the tooth is no longer stable. This was dentist’s recommendation because our MO doesnt want any tooth extraction.

My question is, my husband stopped Xgeva injection for a month and now on its 2nd month without Xgeva. He has been on Xgeva for 7months prior.

Should I be worried that his bones doesnt have any protection for the past 1-2months considering he has lots of bone mets? Also, he is supposed to be doing chemotherapy (Docetaxel:Taxotere) last month of March due to his rising/doubling PSA after only 7th month in Zytiga (Feb 2019) but because of his tooth infection we still cannot proceed. So we are still continuing with Zytiga at the moment.

And now a prostate cancer doctor in Singapore wants to see us asap because he is suspecting a genetic mutation (BRCA gene mutation) on my husband’s Pca considering that he is young to have Pca (44yo), very high gleason score (GS9) and early failure on Zytiga. So, we will see him in 2wks at the same time that we are about to start supposedly with Docetaxel.

Question, is it ok to delay chemotherapy until early next month and find out first if my husband will test positive for genetic mutation so we can have a more targeted treatment afterwards? In total, 2months is lost.

Appreciate all your inputs. TIA.

[Hidden]

Oocch , the tooth pain alone sound horrible. I had two root canals soon after radiation therapy. Not on bone meds yet . Thanks for sharing this scary story . Best luck moving forward. You impress me as the person to save him with your love . That’s the best medicine. . I cant answer the medical questions . Others shall reply. This APC is a twisted and tricky opponent . I believe you will choose the best for him. Good luck..

[dvcarola2 in reply to Hidden]

Thanks Lulu700 for the kind words. I have been in so much stress when he had the tooth infection because he was alone in China for a business trip at that time with no antibiotics, it was only 3 days after high fever started that he got to drink antibiotics because i couldnt fly out to China because I didnt have visa and so we had to get one of his staff who has a visa to fly to him and bring the antibiotics/medications. Our MO and myself got really scared because he might suffer from sepsis. He was even rushed to an emergency hospital there in China but nobody there wants to give him antibiotics so he had to wait for the antibiotics from his staff 3 days after. Im just thankful that he is now better and his dentist is making sure that all his teeth are in good condition before resuming Xgeva injections.

[Hidden in reply to dvcarola2]

I’m glad that he pulled through that one.. my drs will speak t9 me about Xgeva at some point. Kinda scary.... thank you for sharing. I will follow his progress .. Take care🌵

[GP24]

I think you can or may even have to extract teeth when there is necrosis of the jaw caused by Xgeva. BillDoc reported to get teeth extracted probably because of Xgeva:

healthunlocked.com/advanced...

You may want to chat with him to learn more about this.

I would not worry about a delay of two months. Prostate cancer is usually progressing slowly. Better treat on the basis of a good diagnosis than rush.

[dvcarola2 in reply to GP24]

Thanks for your inputs but theres no need for tooth extraction and no jaw necrosis as of this time (and hopefully there will never be).

[GP24 in reply to dvcarola2]

You wrote: "This was dentist’s recommendation because our MO doesnt want any tooth extraction." Therefore I thought the planned treatment by the dentist would be a workaround since you could not do a tooth extraction.

Anyway, I hope your husband will recover quickly.

[pjoshea13]

You asked:

"Should I be worried that his bones doesnt have any protection for the past 1-2months considering he has lots of bone mets?"

"The elimination half-life of denosumab is 32 days" [1]

My wife is on Xgeva (Denosumab). She recently had to have an extraction. As far as her oncologist is concerned, a 3 month delay is required (& is sufficient) before & after invasive dental work. Your husband's dental work was far less invasive.

My take is that (i) he continues to have some degree of Xgeva protection, & (ii) importantly, a low risk of necrosis of the jaw.

-Patrick

[1] ncbi.nlm.nih.gov/pmc/articl...

[dvcarola2 in reply to pjoshea13]

Thanks Patrick for pointing out how impt Xgeva is. Anyway, we will have the injection asap in order to protect his bones.

[j-o-h-n]

Sana napanatili niya ang pagkain ng polvoron. <--- from google translate....

I hear it's extremely hot in the Pines right now...

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 04/07/2019 5:54 PM DST

[dvcarola2 in reply to j-o-h-n]

Hi John, yes very hot and i heard its gonna get worse soon, so eating ice cream everyday helps 😊

[j-o-h-n]

Magnolia?

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 04/07/2019 8:11 PM DST

[dvcarola2 in reply to j-o-h-n]

Yes for me but for hubby, its a more expensive local brand that is vegan, dairy free, sugar free, but very yummy!

[Kevinski65]

I've had 3 root canals on Zometa.