Bone Mets

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Pat from Apple Valley, CA - 16 Jun 2005 20:36 GMT

I have a question about radiation for bone met pain. Is Radiation
Therapy given like after a lumpectomy as a series of 30 or so doses or
is it a one time zap sort of thing. I am having increasing pain from my
bone mets and asked theOnc about rads. He said he didn't recommend them
as they interfered with the chemo treatments. That led me to think they
werea series. I didn't think to ask him at that time.
Also How long can I expect to survive after bone mets set in and there
is also liver involvement? I know you can't tell me precisely how long,
but is there a longish survival rate. 5 years? 7? 2?. I am on a chemo
treatment that has been slowly lowering my CA27.29 count, but it is in
the 800's and still shows a lot of cancer involvenment..Energey wise I
am doing pretty well with the chemo I am currently on, but the ribs and
back are getting worse..and getting harder and harder to control with
pain meds. I remember Catherine didn't last real long after the mets got
bad.
Pat from Apple Valley, CA

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Tim Jackson - 16 Jun 2005 22:16 GMT

> I have a question about radiation for bone met pain. Is Radiation
> Therapy given like after a lumpectomy as a series of 30 or so doses or
> is it a one time zap sort of thing.

One zap (per affected zone). Quite different from the post operative
treatment. It takes about six weeks for the pain to disappear after
that, and it lasts about two years before the mets grow back. (YMMV of
course.) Depending on the dosage used treatment may be repeatable, but
there is a total dosage limit per zone.

> I am having increasing pain from my
> bone mets and asked theOnc about rads. He said he didn't recommend them
> as they interfered with the chemo treatments. That led me to think they
> werea series. I didn't think to ask him at that time.

I think there are different opinions on that matter. You might want to
get an opinion from a radiation oncologist. Chemo will presumably delay
recovery of irradiated tissue, and there might be some white-cell
implications, but doing both together isn't totally prohibited. And
chemo isn't going to stop the bone-mets pain. Prolonging your life with
chemo is pointless if you have to be doped up to the eyeballs with
morphine. There is a balance to strike here.

> Also How long can I expect to survive after bone mets set in and
> there is also liver involvement? I know you can't tell me precisely how
> long, but is there a longish survival rate. 5 years? 7? 2?.

Bone mets don't kill, but, put it this way, a ten year bone mets
survivor is due congratulations. Currently the median is probably in
the region of 2 or 3 years.

Liver involvement does kill and is the one to watch. It all depends on
how well the chemo continues to handle it. If the chemo is barely
holding its own as you seem to suggest below, then sooner or later
(maybe a year or so) it will lose its grip and you'll need to look for
another treatment, or accept the inevitable.

> I am on a
> chemo treatment that has been slowly lowering my CA27.29 count, but it
[quoted text clipped - 3 lines]
> control with pain meds. I remember Catherine didn't last real long after
> the mets got bad.

Catharine was diagnosed with advanced bone mets (but none in soft
tissues) in 2000 and survived until 2004. I know she had symptomatic
mets in 1999 but it wasn't officially diagnosed until her femur was
about to break, and her first bone scan looked like a negative. It was
"real bad" long before she complained about it. On the other hand my
wife was diagnosed with bone mets in one vertebra and lived 18 months.

Tim

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Pat from Apple Valley, CA - 17 Jun 2005 00:21 GMT

>> I have a question about radiation for bone met pain. Is Radiation
>> Therapy given like after a lumpectomy as a series of 30 or so doses or
[quoted text clipped - 20 lines]
> chemo is pointless if you have to be doped up to the eyeballs with
> morphine. There is a balance to strike here.

I thought the pain would cease right away, I didn't think that it would
take so long to work. I guess the wound in the bone would have to heal?
I don't hurt unless I move. I am still handling the pain with Vicodan
either 7.5 or 10 mg. So I still function OK. At night it is the worst as
I wake every time I turn over. I sleep on one side or the other and stay
that way for hours, so as not to move.

>> Also How long can I expect to survive after bone mets set in and
>> there is also liver involvement? I know you can't tell me precisely
>> how long, but is there a longish survival rate. 5 years? 7? 2?.
> Bone mets don't kill, but, put it this way, a ten year bone mets
> survivor is due congratulations. Currently the median is probably in
> the region of 2 or 3 years.

I figured it would be about 2 years.

> Liver involvement does kill and is the one to watch. It all depends on
> how well the chemo continues to handle it. If the chemo is barely
> holding its own as you seem to suggest below, then sooner or later
> (maybe a year or so) it will lose its grip and you'll need to look for
> another treatment, or accept the inevitable.

I feel, except for the bone pain, real well. I am on an oral chemo
Etoposide and Emcyt 7 days in a row with 2 weeks off between. I started
with Taxotere in Aug. of 2004. Then when it quit working after

8 or 9 sessions went onto Cis-Platin and Gemsitabine for 2
sessions( these almost killed me) at least all my blood. I was face down
for the better part of 3 months and did nothing for my CA count either.
Now I am taking the oral, Emcyt of which is used for Prostate Cancer and
Etoposide . I don't care as long as it worksand I feel reasonably well.
This one I finish today is my 15th.

>> I am on a chemo treatment that has been slowly lowering my CA27.29
>> count, but it is in the 800's and still shows a lot of cancer
[quoted text clipped - 10 lines]
> "real bad" long before she complained about it. On the other hand my
> wife was diagnosed with bone mets in one vertebra and lived 18 months.

Catherine must have been strong. I was diagnosed with the bone mets in
2003 in a couple of places, a lot more last year. Now, LOTS!

> Tim

Thanks so much Tim,
It seems that everyone I talk to, who don't have or are not
knowledgable about cancer, and, some that do or have had BC, think I am
going to live forever. Or tell me and want me to believe that anyway.
They can't seem to realize that I am not planning a future, that I am
living only in the now and that my apathy about the future is because
there is not one for me. In fact I have just moved into a new house and
have no interest in decorating it and getting new furniture etc, and
people just can't understand. At least on this NG I hear the faacts told
like it is and not embellished. I like that.
I am going on a road trip (I might regret it pain wise) with my
Daughter and Grandkids and plan on having a GREAT time. There won't be
many after it, I know and I want to have fun. Wish me luck!!
Pat from Apple VAlley, CA Where the earth is shaking....

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Tim Jackson - 17 Jun 2005 09:10 GMT

> Thanks so much Tim,
> It seems that everyone I talk to, who don't have or are not
[quoted text clipped - 10 lines]
> many after it, I know and I want to have fun. Wish me luck!!
> Pat from Apple VAlley, CA Where the earth is shaking....

Go for it! Mets is a slippery slope, all too soon you realise that you
can't do the things you wanted to, or if you can, you can't enjoy them.

It is hard for people to talk rationally about terminal disease unless
they have confronted it, and so come to terms with their own mortality.

The price of having done that is, even for me who is perfectly healthy,
seeing my life as a finite unit, knowing that dreams that cannot be made
to fit into it should be abandoned, and thinking about death almost
every day.

Tim

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