Tooth pain-need to see dentist. Will this impact Immunotherapy (Keytruda)?

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FindTheBestHelp
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Joined: Mon Jul 14, 2014 12:13 am

Tooth pain-need to see dentist. Will this impact Immunotherapy (Keytruda)?

Postby FindTheBestHelp » Sat Jun 08, 2019 12:05 am

If you experience tooth pain and need to see the dentist and possibly get a bad tooth removed, for example, will this impact Immunotherapy (Keytruda) in any ways?

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henry123
Posts: 201
Joined: Sun Oct 08, 2017 3:25 am

Re: Tooth pain-need to see dentist. Will this impact Immunotherapy (Keytruda)?

Postby henry123 » Sat Jun 08, 2019 8:18 am

Absolutely.
Please do NOT get any major or minor surgery done while on immunotherapy.
You never know how your immune system will respond.
Patients have been lost just due to surgeries while on immunotherapy.
Please treat it most seriously. Most regular doctors are not aware of this and you have to tell them. Ask them to research it.
46yo M msi-high Lynch +ve
5/16 lap AR 14/21 L nodes +ve
T4N2M1
7/16 Capox 9 cyc
9/16 cea 2
1/17 550
PET CT mets in lung & peri
iri+ avast fail
3/17 10577
4/17 regro fail
5/17 cea 28800
5/17 CT inc in size of mes nodes ,onset of multi nodules in liver
6/17 Opdivo start
7/17 26754
8/17 5623
9/17 497
10/17 52
11/17 12
CT all clear exc a nodule in Lung. liver norm
1/18 3.6
4/18 2
Aspirin start
6/18 1.5 CT clear
12/18 1.1 CT Clear NED
6/19 .9 CT clear
9/19 1.2
Vegan yoga juicing
Still on opdivo

AmyG
Posts: 246
Joined: Tue Dec 25, 2018 8:08 pm

Re: Tooth pain-need to see dentist. Will this impact Immunotherapy (Keytruda)?

Postby AmyG » Sat Jun 08, 2019 8:54 am

Is that the same for folfox + Avastin? I could probably just Google that but you guys are such a fountain of knowledge!
42 dx @ 9wks pregnant w/baby #8 8/18
Sigmoid colon resection 9/18
Adenocarcinoma, G2, T3N0M0..or so we thought
KRAS/BRAF wild
Liver biopsy is malignant, stage iv now boys!
Delivered healthy baby 3/19
FOLFOX + Avastin 5/19
CEA 167 to 24 after 4 rounds
Liver resection 8/28/19
NED!!

Rock_Robster
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Location: Melbourne, Australia

Re: Tooth pain-need to see dentist. Will this impact Immunotherapy (Keytruda)?

Postby Rock_Robster » Sat Jun 08, 2019 9:24 am

AmyG wrote:Is that the same for folfox + Avastin? I could probably just Google that but you guys are such a fountain of knowledge!

It varies by doctor and procedure, but many will recommend 4 weeks off FOLFOX and 6 weeks off Avastin before surgery. For more minor procedures there might be more leniency there, but both will delay healing and increase risk of infection, bleeding, etc. Of course this needs to be weighed up against the importance/urgency of the procedure (eg for an emergency obstruction, etc.), and the risk of being off chemo.
Male 37; Melbourne, Australia
10/2018 Dx 3.5cm RC adenocarcinoma, 12cm from AV
Mod diff, EMVI+ LVI+ PNI-
3 LN; 4 liver mets, resectable
pT3pN1apM1a; Stage IVa. MSS, NRAS (G13R)
CEA: Oct-18= 12; Nov-18= 14, Mar-19= 2.4, Aug-19 <2.0
11/18 - FOLFOX x 6
3/19 - Liver resection
4-5/19 - 25 x pelvic radiation; complete met. response, TRG 3
07/19 - ULAR (robot), temp ileo, 1/27 LN+
08/19 - Missed liver spot
08/19 - FOLFOX x 1, FOLFOXIRI x 1, FOLFIRI x 2
10/19 - Planned liver resection #2 & ileo reversal

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henry123
Posts: 201
Joined: Sun Oct 08, 2017 3:25 am

Re: Tooth pain-need to see dentist. Will this impact Immunotherapy (Keytruda)?

Postby henry123 » Sat Jun 08, 2019 10:41 am

AmyG wrote:Is that the same for folfox + Avastin? I could probably just Google that but you guys are such a fountain of knowledge!


Avastin prevents formation of new blood vessels so any surgery that involves incisions (as most of them do) can result in non stop bleeding.
I had blockage in stomach while on Avastin and onco surgeon refused to operate. Had to be resolved using conservative approach.

Folfox - no idea.
46yo M msi-high Lynch +ve
5/16 lap AR 14/21 L nodes +ve
T4N2M1
7/16 Capox 9 cyc
9/16 cea 2
1/17 550
PET CT mets in lung & peri
iri+ avast fail
3/17 10577
4/17 regro fail
5/17 cea 28800
5/17 CT inc in size of mes nodes ,onset of multi nodules in liver
6/17 Opdivo start
7/17 26754
8/17 5623
9/17 497
10/17 52
11/17 12
CT all clear exc a nodule in Lung. liver norm
1/18 3.6
4/18 2
Aspirin start
6/18 1.5 CT clear
12/18 1.1 CT Clear NED
6/19 .9 CT clear
9/19 1.2
Vegan yoga juicing
Still on opdivo

boxhill
Posts: 339
Joined: Fri Apr 06, 2018 11:40 am

Re: Tooth pain-need to see dentist. Will this impact Immunotherapy (Keytruda)?

Postby boxhill » Sat Jun 08, 2019 10:55 am

I had a cerebral angiogram while on Keytruda, which involved inserting a probe through the femoral artery and threading it up to my brain. It was actually supposed to be an angioplasty, but the degree of stenosis turned out to be less than anticipated, but in any case the change of course had nothing to do with my immunotherapy. My oncologist was consulted and approved this.

There were no problems afterward. Of course, oral surgery is a different type of procedure. I think you should consult your oncologist before undertaking anything.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 nodes,5 mesentery nodes
5mm liver met out
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/4/18 FOLFOX
Neulasta 6/28
7/9/18 CT NED
11/20/18 CT NED. Enlarged spleen.
12/20/18 Liver MRI 5mm liver met? and 2 lymph nodes in porta hepatis
12/31/18 Keytruda
6/5/19 Triphasic CT LN and spleen normal, Liver node stable
6/28/19 Pause Keytruda, predisone for joint pain
7/31/19 Restart Keytruda
9/10/19 CT stable

FindTheBestHelp
Posts: 92
Joined: Mon Jul 14, 2014 12:13 am

Re: Tooth pain-need to see dentist. Will this impact Immunotherapy (Keytruda)?

Postby FindTheBestHelp » Sat Jun 08, 2019 9:56 pm

Thanks for your replies. That's makes things kind of tricky, if there's a tooth pain and just having started immunotherapy (Keytruda) for just the 3rd infusion so far (one every 3 weeks). And what if the immunotherapy is hopefully effective and is to continue, there will be no good point to go to the dentist?

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CRguy
Posts: 9974
Joined: Sun Feb 10, 2008 6:00 pm

Re: Tooth pain-need to see dentist. Will this impact Immunotherapy (Keytruda)?

Postby CRguy » Sat Jun 08, 2019 10:33 pm

Talk to your Onc and your Dentist and let THEM both know what is going on

there IS always a solution ... IF everyone is on the same page
JMO

Best wishes
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
12 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far


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