I don't want Xgeva or Zometa
For some reason the bone meds really scare me. I don't understand their purpose since it seems like they cause some of the very complications they are intended to prevent. Plus another med = more side effects - I don't do well on meds. And there aren't many studies on long-term effects of these meds (not sure if I'm hopeful or in denial in thinking the long-term effects might matter!) And the meds stay in/affect your bones for years even after you stop taking it, which freaks me out. But my onc wants my to strongly consider Xgeva. I have osteopenia and one small bone met. Not sure if I'm asking for encouragement that I'm making the right decision for myself, or a different perspective that might convince me to try the med.
Comments
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When I was diagnosed with 5 bone mets, I started Xgeva and Taxol. Within a very short time, I was without any bone mets. Naturally, I recommend Xgeva. I've been on Xgeva for 5 years now and have never had a side effect from it. I also have no bone pain.
Since then, I've had a met light up in my spine, then, the next scan, it's gone again. Right now, I have one met in my bones.
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I waited six years before agreeing to the Xgeva injection. I finally agreed since my spine is now affected and loosing my mobility is more scary to me than the side effects of Xgeva. I am still very cautious about how often I will allow them to give it to me.
*susan*
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I reluctantly agreed to Zometa and had my first IV a month or so ago. I am very afraid of long term effects. But with numerous bone mets and an advanced case of osteoporosis I don't have any good choices.
These are scary drugs. I don't know how long I will take them.
JJ
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I will have my 4th injection of Xgeva on Wed. I have had no side effects. Xgeva helps with bone strength and blocks the action of the cancer in the bone. Personally, for me, the benefits outweigh the risks. I don't want to worry about possible fractures or paralysis, when I'm concentrating on being as well as I can. I have multiple bone mets and osteopenia. Now this is just my opinion, of course.....
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hi,
I've been on Zometa for almost 5 years. I can say I look forward to the next cycle the last few days waiting for it, I feel my bones need it.
SEs are the last thing to consider for us, cos all treatment have a variety of SEs anyway.. And long term SEs? I hope I live that long to see them!
)
I tried off treatment for a while but qol dissappered immediately. At this stage, treatment is to provide qol over anything else..
If you consume Zyrtec the day before, during the day & the day after, the SEs are minimal. Also, drinking gallons of water. And DO ask for a longer infusion time. Normally they prefer 15 minute infusion.. Ask for 45 min ( for Zometa) and see it's sooo much more tolerable.
Zometa has been in the market much longer than Xgeva.. Onj is a risk with both meds.. So is death
)
Mood is the best meds. And trusting your team of docs. MBC is yucky..
Hugs
Ebru
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I have been on xgeva monthly for 4 years with no problems. Sometimes I get very tired for a day after and sometimes no se at all. I do worry about onj. with only one met I might be more reluctant but I have done well with it so I'm 👌 with it.
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I will be getting my third Xgeva injection at the end of the month. I've not had any side effects that I know of and actually kinda look forward to getting my shot. Quality of life to me means avoiding side effects from my bone mets that would limit my mobility. Xgeva has been proven to delay/eliminate side effects from bone mets and avoid/delay problems requiring radiation and/or surgery.
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Xgeva is my friend, too. Really helped with my bone healing, and luckily, no side effects.
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XGEVA has worked well for me. I started on Zometa for 4 years and 3 years on Xgeva. Completely relieved pain and gave me back my mobility. Only pain se on first infusion of Zometa.
Terri
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I had just been talking to my Onc about discontinuing Zometa, or moving to Xgeva. I still get some side effects after a Zometa infusion, even though I've been on it for four years now.
He pointed out to me studies that have shown how damned effective these drugs are at preserving quality of life for bone metsters, and keeping the bones strong. He mentioned that I should stay on Zometa, as the injectable form, Xgeva, stays in your system longer, so if I'm having side effects, I would be having them longer.
He did drop me down to four times yearly. The data doesn't lie. Zometa/Xgeva increase our disease free intervals for bone lesions, promote quality of live, and maintain bone strength and mobility.
I very much like physical freedom and mobility. Being pain-free ain't so bad either.
If I were you making the decision, I'd consider how much osteopenia I had, and where. Location makes a difference for mobility. Same with your met. Where is it? If it gets bigger, what will it do? For example, having a small met on a femur is different from having one close to the spinal cord on a vertebrae. Remember, your first infusion/injection is the worst. You will get flu like achiness and fatigue. Taking Zyrtec helps, but I don't know of anyone who has skipped first round side effects. But, after that, this stuff works.
Talk it out at length with your doc. Maybe they can radiate that small met, and wait.
You are young, and have had your ovaries removed. The osteopenia might be a larger concern than one small met. Remember, if we fall, we break. If we break, we take longer to heal.
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I was on Zometa for 5 years. It not only helped me compensate for any bone loss from AIs but I was actually able to increase my bone density from osteopenic to above average. Lifting weights and daily exercise as well as calcium and vitamin d probably played a part in that positive outcome. I've fallen on my bike and on skis many times and still haven't broken anything ((knocking on wood)). I stopped Zometa because I switched to Tamoxifen which supposedly promotes bone strength in postmenopausal women.
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Indenial, this is up to you. If you don't want Zometa or Xgeva, you don't have to have them. Or you can take one for a bit then stop if it bothers you (too much).
The "protocol" at my cancer center is once monthly Zometa for two years. Then every three months. There are some data which show that you only need it monthly for one year. Women who take it do take longer to progress than women who don't. I'd have to hunt down the reference -- it's old. Ask your onc for the primary data.
I agree that the first infusion of Zometa is the worst. I felt like I had the flu for a couple of days. After that, nothing. I switched recently to Xgeva because I got tired of having the IV placed. Shots are much easier.
Since you have osteopenia you're in more danger than some women. In theory the cancer cells will find it easier to break into the bone. At the very least you need to take a lot of calcium and vitamin D. One option might be to do that and see how your bones do. If you can reverse the osteopenia that way maybe your onc will backtrack on the Zometa. BUT. Even if you didn't have cancer, if your osteopenia got much worse they'd be prescribing a bisphosphanate.
Let me reiterate. You do not need to take any medication you do not want to take. I just ask that you understand the risks involved in your decision.
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I haven't been on a bone strengthener for 3 years, but did have infusions for the first 2 years after dx. SE's were minimal after first infusion. I have only one bone met which never caused pain, but if my mo thinks I should go back on Zometa I wouldn't hesitate. In the end it's up to you but these drugs can be very helpful and the se's are minimal and brief for most people.
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Thanks for the input. I'm still struggling to understand the benefits for me, personally. I think this is one I'm just not ready to take... maybe if the next bone density scan shows bone loss or more bone mets start popping up... I just can't seem to wrap my head around this. Most of what I read doesn't seem to show a huge benefit to these meds and some studies suggest they alter normal bone formation in a way that would put me more at risk for fractures down the line. So basically this is a med to prevent breaks and fractures, yet it may make me more likely to have breaks and fractures????
I've been taking vit D, calcium, magnesium, zinc, & K2 for a while... I've only had one bone density scan, so no baseline for comparison, and part of me just thinks I could have less dense bones to begin with (which I've read is often the case if you are slim/"thin-boned").
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Xgeva alert:
I have had Xgeva every 6 weeks for two years. Unfortunately, my doctors think it is responsible for osteonecrosis of the jaw. What that means is I have some gum that has receded (7mm) and left bone exposed. I have to use rinses two times a day to beat back infection. Supposedly it will never heal / I am not saying I regret xgeva but unfortunately it left me vulnerable to this situation. I say the head of the oral surgery department at Vanderbilt University today and he said he has seen cases far worse than mine that impact people's lives because they need surgery...I will be very compliant and hopefully not go to that level of treatment. Carolyn
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I should mention I have my Xgeva every other month. My MO says that they use it every other month for a year then switch to every 3 months to reduce the chance of osteonecrosis. The half life is 30 days.
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ugh Carolyn, sorry about your ONJ. I had it for a year (After having a tooth pulled and some dental screw ups), lost a tooth and a small part of my jaw where the tooth sat. ) Was NOT fun. I'm glad you are seeing a specialist at Vanderbilt. SO, once I had been healed with no signs of ONJ for two years, I went back on Xgeva... Yes I did! I had some progression in my bones and decided that I wanted that benefit. So far so good.
Indenial, don't do it if it makes you uncomfortable. IF you get to a place where you feel you might benefit from it (i.e.:progression) then deal with it at that time. Like I said, I was off for more than three years. Sounds like very minimal mets, so you shouldn't feel pressured.
Stefanie
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I'm a Zometa girl, myself. I've taken it for 6 years (7 in January). I don't have many side effects anymore. In the beginning, I had cold-like symptoms, but over time, it's dulled.
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Hi Indenial,
I've hesitated to respond to this, because I'm an outlier by just about every measure.
Maybe my story will help you make a decision.
4.5 years ago, I was diagnosed by CT with bone mets in one rib and T-2.
Decided to try Xgeva, but didn't like how I felt so stopped it after one treatment.
In the good handful of CT and PET/CT scans I've had since then, the spots were never noted again.
Maybe the Xgeva cured the mets? Since the rest of the cancer progressed, I sorta doubt it...but who knows?
Wish my story provided good data for others, but the plural of anecdote isn't data.
It's up to you to make your own decisions after weighing the risks and benefits personal to you!
There is no right answer for everyone - in cancer land or life.
Good wishes for all!
warmest healing regards, Stephanie
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Indenial, I'm another one who really dragged my heels on starting Xgeva, which had been recommended for me for more than a year while I underwent some dental stuff -- a couple of extractions, and then trying to save a slightly loose tooth. My UCLA onc finally sent me to an Xgeva expert @ UCLA. She did a pretty extensive workup including a jaw CT, extracted the questionable tooth, and eventually cleared me for Xgeva, which greatly eased my mind re. the risk of ONJ. So I've been on it for 5 mos. now (about to get #6), and I absolutely love it. No issues, except greatly reduced bone pain and I can stand up much straighter than I'd been able to for many months. My UCLA onc recently recommended doing only 6 monthly injections before going to every 3 mos. (because of a possible increased risk of ONJ for those of us on Ibrance, which tends to lower counts), and I was actually disappointed! Clearly, I'm a huge fan now. I consider it one of my miracle drugs, along with Ibrance. My only advice is to get any teeth issues well checked out prior to starting it.
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