It’s Breast to be Aware-Cancer and Osteonecrosis

October is National Breast Cancer Awareness Month and in support of this WYOMS would like to share the following information.

In 2013 at the Annual San Antonio Breast Cancer Symposium, it was announced that bisphosphonate use should be added to the standard of treatment of post menopausal women diagnosed with breast cancer. In a series of studies, it was found that adjunct bisphosphonate use with the already core standard of treatment dramatically reduced bone metastases and significantly increased the survival rate. 34% was the over all reduction of bone recurrence and a 17% or 1 in 6 reductions of the risk of breast cancer related death. Those statistics are incredible, and we are not denying that bisphosphonates are beneficial and a necessary treatment protocol, however, we would like to stress that before starting any new medication regiments, it should be encouraged to follow the correct pre-dose protocol.

Bisphosphonates were originally used solely for the treatment of osteoporosis. Prescribed as both preventative and therapeutic, they come in two forms; oral and intravenous. The job of a bisphosphonate is to dramatically decrease the break down or degeneration of bone, and they are good at their job. Some may be thinking, ok, if the drug is doing its job, isn’t that a good thing? And yes it is, however, the breakdown of bone is a natural process the body needs in order to reproduce new bone. With bisphosphonate use, this breakdown process is halted and without this necessary trigger, the body, in situations of surgery or trauma, does not know to reproduce and heal bone. So what about drug fasting? Bisphosphonate medications cannot be fasted from. Their effects are long lasting and, once taken, they immediately concentrate in the bones and remain there unaltered for decades. Even after full discontinuance, bisphosphonate medications are always present and cannot be fully metabolized out of the system. With such a systemic effect, it is incredible to note that complications because of their use have only been documented in the upper and lower jaws. So why the increase in cases of Osteonecrosis of the Jaw?

In the case of bisphosphonate use, the correlation of spontaneous Osteonecrosis of the Jaw is staggering. This condition can be the outcome from simple procedures such as routine dental cleanings or the unassuming situation of an ill-fitting partial or denture, to the more invasive procedures such as tooth extraction. ONJ does not differentiate and results in the chronic sometimes recurring exposed areas of dead bone.  We at WYOMS highly suggest following the outlined protocol below before starting any of the listed bisphosphonate medications. Your future oral health depends on it.