Post # 28 – Just Another Side- Effect

Dear Family and Friends,

I recently went to the dentist to have an extraction of a tooth that has seen better days. I knew that there were some risks involved with extractions because I am getting a shot every twenty – one days to help strengthen my bones. Since the cancer has moved to my bones this shot is supposed to help reduce my risk of broken bones or serious bone problems. Well, there are some serious side-effects to this shot. I got the following information from the official Xgeva website here:

http://www.xgeva.com/

What is the most important information you should know about XGEVA^®?

Do not take XGEVA^® if you take Prolia. XGEVA^® contains the same medicine as Prolia^®(denosumab).

Severe jaw bone problems (osteonecrosis)

• Severe jaw bone problems may happen when you take XGEVA^®. Your doctor should examine your mouth before you start, and while you are taking XGEVA^®. Tell your dentist that you are taking XGEVA^®. It is important for you to practice good mouth care during treatment with XGEVA^®. In studies of patients with bone involvement, the rate of severe jaw problems was higher the longer they were being treated with XGEVA^®.

I had to go to my dentist to get a clean bill of health before my oncologist would begin giving me the Xgeva injection, as well as many other tests to be sure that I was healthy enough to begin the shots. I think I have been doing pretty good for three years trying to correct fifty plus years or poor dental care. When I reached fifty and still had most of my teeth, I thought I had done pretty well considering the lack of dental care throughout my life.

As a parent, you give up things so that your children’s needs can be met. And one of those things for me was my dental care, plus I did not have very good dental care a a child growing up in a very large family. My father died before I turned two years old, which left my mother with five children. She only had barely a sixth -grade education and five children to raise.

Unusual thigh bone fracture

• Unusual thigh bone fracture has been reported. Symptoms of a fracture include new or unusual pain in your hip, groin, or thigh.

Risk of high calcium levels in patients who are still growing

• Patients with bones that are not fully matured are at a greater risk to develop high blood calcium levels after they stop taking XGEVA^®, that can be serious.

Increased risk of broken bones in the spine after discontinuing XGEVA^®

• After your treatment with XGEVA^® is stopped, your risk for breaking bones in your spine can increase, especially if you have a history of risk factors such as osteoporosis or prior fractures.

Possible harm to your unborn baby

• You should not become pregnant while taking XGEVA^®. Tell your doctor right away if you are pregnant, plan to become pregnant, or suspect you are pregnant. XGEVA^®can harm your unborn baby.

Tell your doctor if you:

• Are taking a medicine called Prolia^® (denosumab) because it contains the same medicine as XGEVA^®
• Have symptoms of low blood calcium such as muscle stiffness or cramps
• Have symptoms of severe jaw bone problems such as pain or numbness
• Have ongoing pain or slow healing after dental surgery
• Have symptoms of high blood calcium such as nausea, vomiting, headache, and decreased alertness
• Are pregnant, plan to become pregnant, suspect you are pregnant, or breastfeeding

While taking XGEVA^®, you should:

• Take good care of your teeth and gums and visit a dentist as recommended
• Tell your dentist that you are taking XGEVA^®
• Tell your doctor if you plan to have dental surgery or teeth removed
• Talk to your doctor before you stop taking XGEVA^® about your risk for broken bones in your spine
• Women of child bearing age should use highly effective contraception while taking XGEVA^® and for at least 5 months after the last dose of XGEVA^®

What are the possible side effects of XGEVA^®?

• In patients with bone metastases from solid tumors using XGEVA^®, the most common side effects were tiredness/weakness, low phosphate levels in your blood, and nausea. The most common serious side effect of XGEVA^® was shortness of breath.
• In multiple myeloma patients receiving XGEVA^®, the most common side effects were diarrhea, nausea, low red blood cells, low blood platelets and calcium levels, back pain, swelling of the lower legs or hands, upper respiratory tract infection, rash, and headache. The most common serious adverse reaction in multiple myeloma patients was pneumonia.

These are not all the possible side effects of XGEVA^®. For more information, ask your doctor or pharmacist.

How does XGEVA^® work?

Normally, your body is continually breaking down and rebuilding your bone. This helps keep your bones strong.^2,3

In people with breast, prostate, lung, or other solid tumors: When cancer spreads to bone, your bone breakdown and bone building are not balanced.³

Over time, this can make bones weak and can lead to serious bone problems.³*

In people with multiple myeloma:
The breakdown and rebuilding of your bones can become unbalanced. Over time, this can cause weak spots in the bones and can lead to serious bone problems.^2,4

XGEVA^® works by stopping cells that are breaking down bone from becoming overactive and may interrupt the process of bone breakdown.^1,2,5-7

1. Serious bone problems are defined as broken bones (fractures), the need for surgery to prevent or repair broken bones, the need for radiation treatments to the bone, and pressure on the spinal cord (spinal cord compression).¹

XGEVA^® helps prevent serious bone problems¹

1. Serious bone problems are defined as broken bones (fractures), the need for surgery to prevent or repair broken bones, the need for radiation treatments to the bone, and pressure on the spinal cord (spinal cord compression).¹

• XGEVA^® is a prescription bone-targeting medicine used to prevent serious bone problems* in patients with multiple myeloma and in patients with bone metastases from solid tumors¹
• It’s important to remember to take XGEVA^® only as directed by your doctor
• Talk to your doctor about whether XGEVA^® is right for you

How will I receive XGEVA^®?

XGEVA^® is given as a shot once every 4 weeks at your doctor's office. The shot is given under the skin and does not involve an infusion through a vein.¹

• XGEVA^® can be injected into your upper arm, upper thigh, or stomach area¹
• It is important to take XGEVA^® at the recommended treatment schedule¹
• Talk to your doctor about whether scheduling appointments in advance may help with your treatment regimen

What should I know before I start taking XGEVA^®?

• Your doctor will check your blood calcium levels before you start XGEVA^®. Low blood calcium must be corrected before you can start your XGEVA^® treatments¹

While you are taking XGEVA^®, you may be told to take vitamin D and calcium supplements to help prevent low calcium levels in the blood¹

The doctor has had me taking vitamin D3 and Calcium vitamins, but I had to stop taking them prior to my first total knee replacement in January of this year, then in May I just had the other knee done, so I just barely started back on my vitamins.  

• Sticking to the treatment schedule your doctor prescribes will help give you the best chance of preventing serious bone problems¹

So, the thing my dentist and my oncologist are concerned about is called Osteonecrosis. My dentist told me I should google it for more information, so I did and I thought I would share it with all of you. I go t the information for you from the following website:

https://www.niams.nih.gov/health-topics/osteonecrosis

What is it?

Points To Remember About Osteonecrosis

·    Osteonecrosis is a bone disease that may cause pain or limit physical activity.

·    Anyone can get osteonecrosis, but it is most common in people in their 30s, 40s, and 50s.

·    Osteonecrosis results from the loss of blood supply to the bone. Without blood, the bone tissue dies and the bone collapses.

·    Loss of blood supply to the bone can be caused by medicines or medical procedures, medical conditions, alcohol use, injury, or increased bone pressure. It is not always known what causes the loss of blood supply to the bone.

·    Most people with osteonecrosis need treatment. Your treatment options may be nonsurgical, surgical, or both.

Osteonecrosis is a bone disease. It results from the loss of blood supply to the bone. Without blood, the bone tissue dies. This causes the bone to collapse. It may also cause the joints that surround the bone to collapse. If you have osteonecrosis, you may have pain or be limited in your physical activity.

Osteonecrosis can develop in any bone, most often in the:

·    Thigh bone (femur).

·    Upper arm bone (humerus).

·    Knees.

·    Shoulders.

·    Ankles.

It is also called:

·    Avascular necrosis.

·    Aseptic necrosis.

·    Ischemic necrosis.

Who gets it?

Anyone can get osteonecrosis, but it is most common in men and people in their 30s, 40s, and 50s.

What are the symptoms?

Osteonecrosis does not always cause symptoms, especially when it first develops. As the disease gets worse, you may feel pain when you put your weight on a joint that is affected by osteonecrosis. Over time, you may feel pain in the joint even when you are resting. 

Pain caused by osteonecrosis may be mild or severe. If it causes your bone and joint to collapse, you may have severe pain and not be able to use the joint. For instance, if you have osteonecrosis in the hip, you may not be able to walk.

What causes it?

Osteonecrosis results from the loss of blood supply to the bone. Loss of blood supply to the bone can be caused by:

Medicines or Medical Treatments

·    Chemotherapy.

·    Radiation therapy.

·    High-dose steroids.

·    Organ transplants.

Medical Conditions

·    Cancer.

·    Lupus.

·    HIV/AIDS.

·    Gaucher’s disease.

·    Decompression sickness, also know as divers' disease, the bends, or caisson disease.

·    Gout.

·    Vasculitis.

·    Osteoarthritis.

·    Osteoporosis.

·    Blood disorders, such as sickle cell disease.

I have cancer, I am having chemotherapy every three weeks, I have had radiation therapy, so I have three of the above things that might cause osteonecrosis and I have had poor dental care most of my life. I am praying that the three strikes and you’re out doesn’t apply in my case😊 or yours either if any of this applies to you or those you care about.

Alcohol Use

Excessive alcohol use causes fatty substances to build up in the blood vessels. This can cause a decreased blood supply to the bone, which can lead to osteonecrosis.

Injury

A broken or dislocated bone, or a joint injury, may damage the surrounding blood vessels. This can cause a decreased blood supply to the bone, which can lead to osteonecrosis.

Some people develop osteonecrosis for no known reason.

Well, this is enough information to scare most people, but for me it is just information so that I can be more knowledgeable about the possible side-effects from this drug that I am taking to protect my bones. You can check out the website for more information as I do not want to make this post too long. I did want to share some of the information with you all, so that you can be aware of what might be going on with someone you care about and be a good support for them through all of the different side-effects they too may be subject to.

Have I mentioned before that we can do all things in the strength of the Lord? We can do this – with His help!! together with His help we can make it through any trial that comes our way in this life. So, you all keep your chins up, never give up hope, and put your trust in the Lord. Let's make it a great week!! Remember to hold on to your faith in the Lord!