For Caregivers

Be prepared to care for their bones

Great care starts with you

It’s hard to hear that your loved one’s cancer has impacted their bones.1-3 Take time to come to terms with that news.

When you’re ready, take heart in knowing that there are proactive steps you can take to support their journey. You can play a role in protecting your loved ones by helping them learn about the serious bone problems* that can happen after cancer spreads to their bones.1,3

  1. Serious bone problems are defined as broken bones (fractures), the need for surgery to prevent or repair broken bones, the need for radiation treatments to the bone, and pressure on the spinal cord (spinal cord compression).4

You need to take care of yourself first. If you're not taking care of yourself, you can't take care of anyone else - Jane

Take an active role in preventing serious bone problems

  • Being informed means you will be better prepared to take care of your loved one
  • You may find it helpful to write down questions before each doctor’s visit and to take notes during appointments
    • This way, you and your loved one can review the information later
  • Don't hesitate to ask the doctor or nurse for more information or to explain something again. It’s important to understand your loved one’s health status and treatment plan
Learn more about XGEVA® important safety information.

Watch for signs and symptoms of serious bone problems

  • In addition to regular testing and monitoring, you should be aware of possible signs or symptoms associated with serious bone problems
  • If your loved one experiences a new symptom, he or she should tell the doctor right away. These symptoms may indicate the need for urgent medical care5:
    • Bone pain
    • Severe back pain
    • Numbness or weakness in parts of the body
    • Any bladder problems, such as trouble urinating or loss of bladder control
    • Any loss of bowel control
Talk to your doctor to find out if XGEVA® is best for your for serious bone problems.

Develop a plan for bone protection

Be sure to:

  1. Ask your loved one if they feel any pain or symptoms. Let your loved one's healthcare team know of any changes in pain and side effects
  2. Help your loved one by taking notes and asking questions about their bone health during doctor appointments
  3. Listen to their concerns and provide emotional support
  4. Prepare some questions for the doctor:
    • For people with breast, prostate, lung, or other solid tumors—what are bone metastases?
    • For people with multiple myeloma—what are bone lesions?
    • What are serious bone problems?
    • What are the risks of serious bone problems?
    • How can XGEVA® help prevent serious bone problems?
    • How can I help my loved one feel better during treatment?
    • What are the side effects of XGEVA®?
    • After starting treatment with XGEVA®, what side effects should we be aware of?

Important Safety Information

Do not take XGEVA® if you have low blood calcium (hypocalcemia). Your low blood calcium must be treated before you receive XGEVA®. XGEVA® can significantly lower the calcium levels in your blood and some deaths have been reported. Take calcium and vitamin D as your doctor tells you to. Tell your doctor right away if you experience spasms, twitches, cramps, or stiffness in your muscles or numbness or tingling in your fingers, toes, or around your mouth.

Do not take XGEVA® if you are allergic to denosumab or any of the ingredients of XGEVA®. Serious allergic reactions have happened in people who take XGEVA®. Call your doctor or go to your nearest emergency room right away if you have any symptoms of a serious allergic reaction, including low blood pressure (hypotension); trouble breathing; throat tightness; swelling of the face, lips, or tongue, rash; itching; or hives.

What is the most important information you should know about XGEVA®?

Do not take XGEVA® if you take Prolia. XGEVA® contains the same medicine as Prolia® (denosumab).

Severe jaw bone problems (osteonecrosis)

Unusual thigh bone fracture

Risk of high calcium levels in patients with Giant Cell Tumor of Bone and in patients who are still growing

Increased risk of broken bones in the spine after discontinuing XGEVA®

Possible harm to your unborn baby

Tell your doctor if you:

While taking XGEVA®, you should:

What are the possible side effects of XGEVA®?

These are not all the possible side effects of XGEVA®. For more information, ask your doctor or pharmacist.

Call your doctor for medical advice about side effects. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit, or call 1-800-FDA-1088.

Please see Full Prescribing Information.


XGEVA® is a prescription medicine used to prevent fracture, spinal cord compression, or the need for radiation or surgery to bone in patients with multiple myeloma and in patients with bone metastases from solid tumors.

  1. American Cancer Society. Understanding advanced cancer, metastatic cancer, and bone metastasis website. Revised December 15, 2016. Accessed November 26, 2018.
  2. Kyle RA, Gertz MA, Witzig TE, et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc. 2003;78(1):21-33.
  3. Heusschen R, Muller J, Duray E, et al. Molecular mechanisms, current management and next generation therapy in myeloma bone disease. Leuk Lymphoma. 2018;59(1):14-28.
  4. XGEVA® (denosumab) prescribing information, Amgen.
  5. American Cancer Society. Managing symptoms of bone metastases. American Cancer Society website. Revised December 16, 2016. Accessed May 2, 2018.