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Medical Forum / Diseases and Disorders / Breast Cancer / October 2005Stage 4 with letrozole (hormone) & lapatinib therapy
Wife recently diagnosed with hormone-sensitive stage 4 with bone mets, as reported before. I said it was inflammational, and indeed it has all the symptoms (initial itching, no lump, nipple inversion, etc.), but the medics didn't actually say this, and when asked say that only detailed tissue study, not yet done, can 100% confirm it's inflammational. Surgery, chemo, radiation inappropriate. Treatment is letrozole, plus clinical trial 50% chance of placebo or lapatinib (aka GW572016): "A substance that is being studied in the treatment of cancer. It belongs to the family of drugs called ErbB-2 and EGFR dual tyrosine kinase inhibitors." This is one instance, early days, anecdotal (no statistics), but after a month or so of this/these drugs nothing is worse, and there is less bone pain, and doctor is very optimistic. Some new digestive problems, though, probably drug side-effects. I don't know if I'm posting anything which might be useful about the effectiveness of treatments, or simply unjustifiable optimism and hope in the drug(s). Unlike the first 3 appointments, no recent close encounters with loony bombers, which makes a change. Best wishes,  Signaturegabriel > Wife recently diagnosed with hormone-sensitive stage 4 with bone mets, > as reported before. I said it was inflammational, and indeed it has all [quoted text clipped - 21 lines] > > Best wishes, Well it is early days yet, but that response gives hope. Bone mets are generally rather unresponsive to chemical treatments. As I mentioned in another post, digestive problems can also be associated with long term use of NSAID painkillers, which are commonly used to combat bone mets pain. Tim Jackson > As I mentioned in another post, digestive problems can also be > associated with long term use of NSAID painkillers, which are commonly > used to combat bone mets pain. Thanks. In this particular case, she's been taking paracetamol/Tylenol for about a month, and now is going for days without; so unlikely candidate. She was told that digestive system problems are not uncommon with the medication. Best wishes, SignatureGabriel Excellent news! Hopefully it will just get better and better, as estrogen-inhibitors ramp up slowly. Chris > Wife recently diagnosed with hormone-sensitive stage 4 with bone mets, > as reported before. I said it was inflammational, and indeed it has all [quoted text clipped - 21 lines] > > Best wishes, > This is one instance, early days, anecdotal (no statistics), but after a > month or so of this/these drugs nothing is worse, and there is less bone > pain, and doctor is very optimistic. Hormone blockers usually do a better job of reducing the symptoms of bone mets than chemo. Signaturemadiba > I wrote: > > > This is one instance, early days, anecdotal (no statistics), but after a > > month or so of this/these drugs nothing is worse, and there is less bone > > pain, and doctor is very optimistic. madiba responded: > Hormone blockers usually do a better job of reducing the symptoms of > bone mets than chemo. Thanks; good to know. >Hormone blockers usually do a better job > of reducing the symptoms of bone mets > than chemo. That's what I thought when I a bone scan showed extensive bone mets last April and I had constant discomfort (deep aches/pain) in my femurs, hip joints and back. Plain xrays to assess bone integrity revealed that the mets were all osteoblastic. I had been on arimidex and femara, but apparently it didn't work. I was using a cane outside when my onc finally said that chemo would be necessary to try to relieve symptoms. I went on weekly taxol just 4 wks ago. I got immediate relief from all bone pain and have not needed pain killers since the first treatment. I was totally surprised and remain very grateful for this. However, it's not all a success (yet?) because I've also had lung mets for 2 yrs and I've only noticed a very limited improvement in my lungs. The last xray taken before starting taxol showed more nodules, pleural effusion and low volume so I guess I can't expect a miracle after only 3 weekly low-dose treatments. Next treatment Wed. I certainly remain surprised at how much better I'm moving around and free of the ache and pain in my femurs, hips and back. I can also sleep so much better at night. Kathie > That's what I thought when I a bone scan showed extensive bone mets last > April and I had constant discomfort (deep aches/pain) in my femurs, hip [quoted text clipped - 5 lines] > bone pain and have not needed pain killers since the first treatment. I > was totally surprised and remain very grateful for this. Did this pain relief correlate with an improvement in your bone scan? Not that it matters much, main thing is you have less pain. Signaturemadiba Regarding my post about getting immediate relief from bone pain in my femurs, hip joints and back after starting weekly Taxol, Madiba asked: >Did this pain relief correlate with an > improvement in your bone scan? Not > that it matters much, main thing is you > have less pain. I only started the weekly Taxol treatments 4 weeks ago so I don't want to have another bone scan until I give it much more time. I'm not one who wants scans and xrays more than necessary. (Bone scan in April showed mets in neck, ribs, humeri, thorasic and lumbar spine, femurs, hips and pubic bone.) I just just wish I could find out more detailed info re: osteoblastic bone mets. Apparently they mostly are associated with prostate cancer but there's not much info there. I did read in several articles that zometa does not have much effect on blastic mets. I had 4 cycles of zometa prior to taxol and was in worse pain every time. I think it was because zometa retards bone resorption and encourages bone growth. Exactly what I didn't want. Blastic mets are an overgrowth of bone, although this is abnormal bone. I read in one article that they are researching to try to find a gene that might be triggering the bone marrow to keep building up unstable bone. Unfortunately, I have a rather "spacey" onc that only gives very vague answers (or non-answers) to most questions, so I have to pretty much do my own research and prescribing. When I told her that zometa was making me an invalid she said to quit it. Don't know how or why weekly taxol worked so well so fast, but it's been a big relief. Fourth treatment tomorrow. Kathie Kathie: Zometa stops the blastic process. It does not promote tumor growth. Zometa s a bisphosphonate. It slows the bone-destroying activity caused by bone metastases. Bisphosphonates work against the abnormal cells that cause the resorption (wearing away) of bone. Bisphosphonates also help slow the abnormal buildup of unstable bone.It is effective against blastic mets (demonstrated in clinical trials). The FDA approved Zometa for the treatment of bone metastases from solid tumors including breast cancer becasue it was found to be effective in clinical trials. What you revealed about your history, demonstrates that you are an exceptional person and a true survivor. You are an inspiration and I wish you all the best. Fran Cartwright, PhD,RN,AOCN Fran, Thank you very much for all the information you provided about zometa and it's action on osteoblastic bone mets. I could not find information as extensive as you've given in your post. I'll print this out so I'll have it. Since I've had such a good response from weekly Taxol on my bone pain, and I'm moving around much better, I'll bring this up with my onc for future treatment. Don't know what the game plan is length of taxol, but soon I'm going to go on a 3-wk-on, 1-wk-off schedule. I think it may depend on lung xrays I'll have after about 3 months. Hoping it works as well on my lungs. Again, thanks for your post. Kathie |
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