fionam
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Posts:6
Hi
my husband has had couple of years now of maintenance Alimta Avastin for ALK pos lung cancer ans is currently NED.
however teeth have been playing up worse than usual, so visited dentist and needed root canal treatment.
has started treatment, but much more painful than before chemotherapy, with severe pain thru all of jaw, not just in teeth under treatment.
has been treated for infection with antibiotics, but doesn't seem to make any difference.
oncologist has now stopped avastin for last cycle (also had protein, incr BP), but facing dentist next week.
?ostenecrosis. ?osteporosis?
anything we can ask dentist to look for?
can he have NSAID for pain relief?
we've just avoided it because of chemo adn stuck with panadol, codeine.
thanks
fiona
Forums
Reply # - September 12, 2014, 06:27 PM
Hi fiona,
Hi fiona,
The most common connection between cancer/cancer treatment and jaw pain is that if your husband has been taking bisphosphonates such as Zometa for bone metastases, osteonecrosis of the jaw can occur. But there are many other reasons for such pain, and those would be issues for his dentist or primary care physician.
Dr. West had this to say about the use of NSAIDs with Alimta:
"Here's the background information on Alimta and NSAIDs. Based on the package insert, there is a potential for a significant interaction of NSAIDs with Alimta, specifically that they can slow metabolism of Alimta and increase side effects with it. In patients with normal kidney function, ibuprofen at up at to 400 mg 4 times daily can be given. However, in patients with mild to moderate renal insufficiency, which is common (measured by an "estimated glomerular filtration rate (another abbreviation of EGFR) of 45 to 79 ml/min), NSAIDs with short half lives should be avoided for two days before, the day of, and two days after Alimta administration. Ibuprofen should be administered with caution in these patients. NSAIDS and salicylates (which include aspirin) should be avoided for at least 5 days before, the day or, and two days after alimta administration.
This is a pretty complex topic, so I think it's appropriate for patients on aspirin or any NSAIDs and who are starting or continuing on alimta to go over it with their doctor." - http://cancergrace.org/forums/index.php?topic=1771.msg10681#msg10681
I hope your husband's doctors can help him find relief from his pain.
JimC
Forum moderator
Reply # - September 12, 2014, 07:00 PM
Avastin is typically avoided
Avastin is typically avoided around the time of any potentially bloody procedure, such as a surgery or major dental work, since it is associated with slowing wound healing and potential bleeding complications. However, other than the well-known association of bone-directed therapies like Zometa (zoledronic acid) or XGEVA (denosumab), I don't know of any particular associations with jaw pain.
Good luck.
-Dr. West