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I am a dentist with a patient 70 y.o. male, with prostate…

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I am a dentist...

I am a dentist with a patient 70 y.o. male, with prostate cancer and met. to bone. he has been given Donosumab (120 mg, IM, in 5/10/17 and 8/30/2017), he also received Lupron (22.5 mg, IM, 11/1/2017). Now he needs 2 dental extractions, can you give me any advice on likelyhood of osteonecrosis and post op care to reduce the morbidity.

Doctor's Assistant: Are you keeping a personal medical record while dealing with this?

Yes

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

Also prednisone 10 mgn daily, and Neulasta 120 May 10, and cabazitaxel 50 mg every 3 weeks.

Submitted: 4 months ago.Category: Medical
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Answered in 3 minutes by:
12/5/2017
Doctor: Dr. David, Board Certified Physician replied 4 months ago
Dr. David
Dr. David, Board Certified Physician
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Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

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Doctor: Dr. David, Board Certified Physician replied 4 months ago

I am a cancer doctor who treats these prostate cancer patients.

denosumab is xgeva and can increase slightly risks for osteonecrosis, the risks are very very low.

Dental patients taking a bisphosphonate or denosumab should be informed that there is a very low risk of developing osteonecrosis of the jaw. The highest prevalence estimate in a large sample is about 0.1%.

https://lexi.com/individuals/dentistry/newsletters.jsp?id=december_11

is a good article

one option is to called the cancer doctor and talk about a drug holiday off of Xgeva for 3-4 weeks before dental extraction and restart the Xgeva after dental extraction

let me know if you have questions.

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Customer reply replied 4 months ago
Thank you
Doctor: Dr. David, Board Certified Physician replied 4 months ago

you are welcome

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