The Colon Club

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?

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.

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

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.

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.

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.

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?

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