Xgeva shot

[rpeacock]

Well I had to have a root canal and now I have to be without my Xgeva shot for 3 months at least. Can anyone tell me if they have been off the shot and if so for how long and any problems you had from not taking it?

[Barbteeth]

I find this a bit strange but maybe your oncologist is being over cautious

Barb xx

[rpeacock in reply to Barbteeth]

Drs day if you are taking Xgeva the dental work won’t heal properly.

[kearnan in reply to Barbteeth]

My last CT scan showed two holes in spine from the breast cancer when previously it had been only in my lungs. Last month was my first Xgeva shot for the spine. I get another one tomorrow in addition to my falsdoex.

My onco was very firm and asked me if there was any dental work I needed done before starting the injections last month. I said no not now. She said because once you start on these injections, you cannot have any type of dental work done while on it. If I wanted any invasive dental work done, I would have to stop the injections for a while before having the work done. I read on a board (I thought it was this one) that one lady had had all implants put into her mouth which is a very invasive time-consuming process. She had had it done several months prior before starting the shots. But she had to stop after three months because she was having severe pain in jaw and her her implants. She was in too much pain.

This is on the warning label of getting Xgeva injections. Great, now I have to worry that I don't need any dental work done.

"Osteonecrosis of the jaw (ONJ) has been reported in patients receiving XGEVA®, manifesting as jaw pain, osteomyelitis, osteitis, bone erosion, tooth or periodontal infection, toothache, gingival ulceration, or gingival erosion. ... Avoid invasive dental procedures during treatment with XGEVA®"

[SoCalLady]

I am also in the middle of a root canal and was taken off of Zometa (also a bone drug taken by infusion). My understanding is the reason they take you off is because it interferes with healing when you have dental work done. I believe, however, that Zometa stays in your system for 11 months and Xgeva for 3 months. So, I'm sure that's why your onc is okay with you being off for 3 months to insure you heal properly.

[Pbsoup]

My doctor wants me to start Xgeva, but is making me do a whole slew of dental work first as anything invasive into the bone like extractions, implants etc. can cause a rare but nasty side effect called necrosis of the jaw. It's one of those medication ironies--a med for bone strength can weaken bones in other areas... When I said I was worried about delaying the Xgeva, my NP said that the Ibrance/Anastrazole is the most important, and the Xgeva is helpful, but kind of icing on the cake so not to worry about the delay.

Interestingly, both the oral surgeon and dentist advised against implants and said just do extractions and live without several back teeth so I can start the Xgeva. My NP pushed for implants as she worried that the lack of teeth could impact my ability to get nutrition down the road when "my organs start to fail" (Yes she really said that. Um, thanks for the optimistic advice!) I decided to postpone "organ failure" for now by treating the cancer aggressively... So elected not to do the implants. With the money I saved I am getting crowns on two front teeth that are discolored due to bad fillings. I have wanted to do this for years, but never got around to it. A silly indulgence under the circumstances? Perhaps. But at least I will smile pretty when the organs fail. (sheesh!)

I have also heard that Xgeva has a long half life, so perhaps that also factored into your doctor's decision?

[Boogitymom]

I had to have 2 teeth extracted in April. I was off xgeva 4 months prior and 2 months after. I had no problems without it. I had been getting the monthly shot for about 3 years prior to the dental stuff and I do feel like there was probably some residual xgeva in my system. I have to say, though, that I was anxious to restart.

[Rhwright12]

I’ve taken time off before. No side effects from not taking it. And it’s only 7% effective at what it does...and keep in mind it’s a bone strengthener it doesn’t fight cancer. 😀

[PJBinMI]

I'm a long timer with mbc, bone mets only (over 1 years!) When I started treatment, it was not known that the bone meds (Aredia and Zometa at that time) could cause osteonecrosis of the jaw, and I had a tooth pulled after a few infusions. I did okay, but shortly after that, ONJ became known and the protocol became to be off the bone meds for 3 months before and 3 months after any invasive dental work, if possible. Sometimes the 3 months before isn't possible, when the dental work is urgent. I had to have surgery for a non-cancer related problem at L4-L5 in my spine, about six years ago, and the surgeon found my bones to be "brittle on the outside and soft on the inside" so I was taken off bone meds (Xgeva by then) and was off for a few years, I don't remember exactly how long. I've been fine as far as my bones are concerned. I am back on Xgeva, except again I have had to be off for dental work, a root canal due to an abcess at the bottom of the root. I'll have my next Xgeva in early Jan. The bone meds have been real life savers for those of us with bone mets and some of us live a long long time. But being off for 3-6 months should be okay and really isn't worth worryig about. When I started out, my dentist knew nothing about ONJ from the bone drugs but within a year or so he's been to a continueing ed program about it and knew just who he'd refer me to if my lower jaw looked iffy! A friend with bone mets did develope ONJ and kept having infections. She was seeing an oral surgeon at a major dental school and he suggested that she brush her teeth with Arm and Hammer Peroxicare and use original Listerine mouth wash. She quit getting infections when she started doing that. So I've been using those products......a bit superstitiously, I guess, but hoping those will help prevent problems.

[SoCalLady in reply to PJBinMI]

Thank you for the mouth care info.

[illini9]

I have not been off of it but I have heard of some doctors moving people to every three months for shots which would be similar. I asked my onc about that and she didn't want to go there with me. Not sure what the science is currently saying about dosage for xgeva.

[Klamato]

Why have you been taken off of Xgeva?

[rpeacock in reply to Klamato]

Because I had a root canal done

[rpeacock in reply to Klamato]

Because I had a root canal. You are not suppose to have dental work while taking xgeva, because it can prevent your dental procedure from healing properly.

[lilybank]

I'm on 3 monthly shots here in uk. Oncologist said the medical evidence show just as affective as monthly

[laurac1014 in reply to lilybank]

Me too by my choice. I’m terrified at getting ONJ and thought every 3 months is better than not at all.

[rpeacock]

Thank you all for your replies!