Randy Sheffield, a member of the Malecare Advanced Prostate Cancer Online support group recently has had his fight with advanced prostate cancer made even more complex when he developed Osteonecrosis of the jaw (ONJ). ONJ is an uncommon but terrible side effect of taking bisphosphonates.

Randy wrote a warning to all the members of the group, a warning that bears repeating to all the readers of the blog:

“I was diagnosed September 2004 with prostate cancer and initially treated with brachytherapy. This was followed overtime with Lupron, Casodex, External Beam Radiation, Quadramet, Zoladex, Ketoconazole and Hydrocortisone, Provenge, Taxotere, Zytiga, Xtandi, and I have finished four of six planned Xofigo infusions. During the course of this treatment, bisphosphonates were added to increase bone strength. Initially Fosamax (oral) and then Zometa (infused).

In January of 2014, family dentist, with referral to periodontist, neither of whom could diagnose swelling of jaw behind lower incisors. Drugs (doxycycline and penicillin) did nothing so the periodontist suggested the best/only way to diagnose was with surgery, initially on February 21 and again on April 4.

Still no diagnosis but metastases was ruled out after a biopsy came back negative. The teeth would not “firm” up in the jaw after surgery and the crowning blow was when one fell out August 25. The periodontist immediately referred me to an oral/maxillofacial surgeon who di