Oncologist does not think ZA is worth the risk

Going through breast cancer treatment Targeted therapies
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Hi

I had a review with my oncologist today and was surprised when he said that he did not think that the benefits of zoledronic acid infusions outweighed the risks.

I was very surprised as I’d been expecting to begin them after some dental work next month.

I am 63 and ER + HER - Grade 3. I had a mastectomy, dose dense chemo and radiotherapy last year. I began letrozole in December and will begin Ribociclib soon

Has anyone else heard this from their oncologist? I am thinking that I will request a telephone appt to discuss further as I want to do anything to reduce the risk.

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I think you are right to question them if you don’t understand the rationale.

I was advised to have ZA and strongly resisted. After my own research and persuasion from oncology I reluctantly agreed to go ahead. I have one more treatment to go.

Hopefully for you it will be clear that there is no benefit so you won’t have the dilema.

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Thanks for replying @laneycass

I will ring the oncology secretary after my tooth extraction next month and try to get an appointment to discuss further.

He said it was more important to get the Ribociclib started and hopefully that will begin in the next few months.

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I was offered ZA and had one infusion but I had a bad flu like reaction to it (had to go to hospital) and because it was only giving me very marginal benefit (less than 1% on my Predict score) I’ve decided to drop it. For me I’ve got enough weird drugs going into my body, I don’t need something that’s hardly increasing my chances.

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Hi @sam1204 I think I’ll speak to his secretary after I get my tooth extracted next month.

I’d at least like to give it a try - throw everything i can at it x

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Hi murphysmum

You say you’d do anything, but you do need to weigh up the risks alongside the benefit.

I had a dental check-up and was given the all clear before commencing Anastrozole and zoledronic acid infusions. Only had 2 infusions, Jan and Jul, in the end as I stopped Anastrozole. Fast forward 2 years to when I had a dental flare-up resulting in 2 root canal fillings in adjacent teeth. One crown went ahead but before the other could be done, a third of the 2nd tooth cracked off in a downwards direction below the gumline. Even though the infusions were that far previously and I’d only had 2, the longlasting effect still posed a problem. There were numerous discussions about what was even a viable option, involving my own dentist (and all the others at the practice), an endodontist, a periodontist and a specialist in laser gum surgery. This vascillating went on for several months: extraction - too risky re causing infection and ONJ; resin filling: unlikely to attach to tooth successfully as difficult to mould onto broken tooth and near impossible to dry effectively next to gum; gumline lowering surgery: too risky re bone damage. (Happy to report resin filling did attach and is holding fast !) But it was a long old year from start to finish.

Even though I only had a third of the full zolendronic acid treatment, it will still afford some protection of the bones, for up to 5 years, in guarding against cancer cells attaching/entering . However, after only 2 infusions, my thigh bones were aching as a result of the changes to the bone makeup. (Ironically, as with so many trade-offs regarding the effects of drugs, the physical strength of the thigh bones can also become compromised, with rare incidences of these breaking and needing pinning.)

Hope my experience helps add to your general awareness in order to make the right decision for you. Please do verify the facts for yourself too, though. Good luck with everything. :slightly_smiling_face:

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Hi @MistyK

I’m so sorry you went through that dental nightmare! It sounds horrible - I’m pleased that your filling is holding out though x

I have a follow up appointment with the oncologist mid April, so I’ll ask if he can just run through again why he doesn’t recommend it for me. The dentist and an oncologist who covered for him at a previous appt saw no issues, but he is the lead and very experienced so I’ll try to find out why.

Thanks very much for your reply - take care x

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murphysmum

Thanks for acknowledging. See if your oncologist will explain the actual physical changes to the bones and all the, even very rare, risks. Hope all goes well for you. x

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