I am trying to get a quick education on this disease to help make
sense of my Mother's condition and provide some hope for our family.
My Mother has a genetic kindney disease and began hemo dialysis approx
5 years ago. She has done remarkably well, the "poster child" for how
to live on dialysis. Last week she began to get weak, unable to walk
without help. It got exponentionally worse each day but questions to
her about it were met with strong opposition. Today she fell in the
bathroom and broke her upper femur, admitting finally that she had
breast cancer as well. She has had it for slightly more than 5 years,
untreated.
She made a decision based on her desire to spend as long as she could
living a somewhat normal life. It was an informed decision I believe,
however contrary to my personal desire to fight hard against anything
like that (I am very agressive with my health). I believe it was a
brave thing and certainly a huge burden keeping it from us all.
Debate over whether this should be the course of action for others can
be held by others, but I would greatly appreciate some support and
information.
An oncologist will be consulting tomorrow (the hospital would be
remiss if they didn't consult with him, the cancer was obvious to them
when she went in to have a rod put in the femur). My Mother has
agreed to allow me to sit in with her during the discussion, and I
would like to ask some intelligent questions. My Mother is 74 years
old, has an irregularly shapped left breast at least 2x to 3x normal
size. When lying down, the right brest "melts" into the chest while
the cancerous one sticks out with more form (though very irregular).
The past 5 weeks she has complained of back pain (not from strain) and
now weakness and some numbness in her legs) Here are some of the
questions I am thinking of asking. I would appreciate your
suggestions for others, as well as any of your own answers to these.
1. Is it possible such a cancer is not malignant? Is the test fairly
basic to determine this at this stage?
2. Understanding that my Mother is not interested in taking on
chemo-therapy and radiation, or perhaps even major surgery, is there
anything with light side effects that might help give her even a short
period of "normal time" at home? I've heard interesting things about
Tamoxifen for instance.
3. If, by some miracle, the tumor is benign, could it still have
caused damage that can't easily be repared?
Aside from just asking where she stands right now, these are my only
questions so far. I'm not interested in what might have been, but how
I can get my Mother home to live just a little longer (she wants this,
not just for my own pain avoidance) while having some reasonable
quality of life (walking even if by walker, able to eat and be
mentally aware. I am assuming that this is the best one can ask for
after 5 years untreated.
Thank you to anyone who can understand the pain of losing a loved one
and might be able to help give me something positive to act on. Many
good things were said today with my Mother and Dad, sister and me. I
thank God for the opportunity to say and hear those things, and help
lift the awful burden of that secret from her shoulders. I would like
to do as much as I can now to help give her the best options I can,
because she really does deserve them!
xavernus
Tim Jackson - 22 Dec 2003 08:42 GMT
> I am trying to get a quick education on this disease to help make
> sense of my Mother's condition and provide some hope for our family.
....
> My Mother is 74 years
> old, has an irregularly shapped left breast at least 2x to 3x normal
[quoted text clipped - 4 lines]
> questions I am thinking of asking. I would appreciate your
> suggestions for others, as well as any of your own answers to these.
> 1. Is it possible such a cancer is not malignant? Is the test fairly
> basic to determine this at this stage?
That would be extremely unlikely. If it has spread to the bones it is not
only malignant but incurable. This is metastasic cancer (stage IV) where the
original tumour has spread around the body. While it may be possible to
remove the visible and symptomatic tumours, you can be sure that others will
soon appear to take their place.
I would imagine that while they were in her leg dealing with the fracture,
they will have taken a sample of the tumour that caused it, and microscopic
examination will have shown it to be composed of breast tissue. That would
be solid evidence of metastatic breast cancer.
> 2. Understanding that my Mother is not interested in taking on
> chemo-therapy and radiation, or perhaps even major surgery, is there
> anything with light side effects that might help give her even a short
> period of "normal time" at home? I've heard interesting things about
> Tamoxifen for instance.
Subject to the tissue testing positive for estrogen receptors (ER+ for
short), then a hormone drug that blocks estrogen would slow the spread of
the disease. This is how Tamoxifen works, but for a post menopausal woman,
and aromatase inhibitor such as Arimidex would be more effective. (This
blocks the estrogen production path outside the ovaries only, so doesn't
work if the ovaries are still active)
The main treatment for metastases to bone is localised radiation. This is
very effective and can set back a large tumour by a couple of years, perhaps
longer in older patients. It is a one-shot process (unlike the wide-field
radation used after lumpectomy) and has minimal side effects, the main ones
being sunburn and lethargy. It takes a month or so for the benefit to be
felt. The repair to her femur won't last long without this, and it could
also be used on her spine if that turns out to be also affected by the
cancer.
They should offer a bisphosphonate drug like Zometa to speed up repair of
the bones.
Chemotherapy would not really be indicated at her age and at this stage, at
least unless there were detectable metastases to lung or liver, and quite
possibly not at all.
> 3. If, by some miracle, the tumor is benign, could it still have
> caused damage that can't easily be repared?
If it has spread around the body, it isn't benign.
> I'm not interested in what might have been, but how
> I can get my Mother home to live just a little longer (she wants this,
> not just for my own pain avoidance) while having some reasonable
> quality of life (walking even if by walker, able to eat and be
> mentally aware. I am assuming that this is the best one can ask for
> after 5 years untreated.
Radiation can do this, but it is inevitably for a limited time.
You might get some other answers from our FAQ site at
www.cancersupporters.com
Tim Jackson
J - 22 Dec 2003 10:23 GMT
> I would imagine that while they were in her leg dealing with the fracture,
> they will have taken a sample of the tumour that caused it, and microscopic
[quoted text clipped - 19 lines]
> They should offer a bisphosphonate drug like Zometa to speed up repair of
> the bones.
If it (the fracture) can heal and/or be repaired.
There was a man on s.m.d.c. who said his femur healed.
Mom was laid up for about a month while such healed.
Can sometimes be a problem with kidney diseases. (bisphosphonates)
> Chemotherapy would not really be indicated at her age and at this stage, at
> least unless there were detectable metastases to lung or liver, and quite
> possibly not at all.
>
> Radiation can do this, but it is inevitably for a limited time.
radiation might help but she's probably already on fairly high-dose pain meds.
If her mother knew 5 years ago, then surely she's had it for many years earlier?
they'll need help at home, unless they're keeping her in hospital.
J
J - 22 Dec 2003 10:37 GMT
> []Thank you to anyone who can understand the pain of losing a loved one
> and might be able to help give me something positive to act on. Many
[quoted text clipped - 3 lines]
> to do as much as I can now to help give her the best options I can,
> because she really does deserve them!
HI there,
I do understand, lost my mother and my father.
In light of your mother's fracture and kidney disease, I thought it best
to post this
and forgot on my other reply.
Maybe I'm reading the situation worse than it is, but it sounds very
advanced.
<http://www.thebreastcaresite.com/Eendcom/USAmoena/HomePage.nsf/0/BEA7E53287C3D34
405256AE900535071?OpenDocument>
J - news:alt.support.cancer if you need us
Kaye301 - 22 Dec 2003 16:33 GMT
Hi, sorry to hear about your mom. I won't repeat what others have written
since they tell it 'like it is' but wanted to mention that chemo is not
contra-indicated for older patients, although am not sure whether or not your
mom's kidney condition would preclude that or not. Prior to my starting chemo,
my feelings about it were based on past memories, both of what I had seen on
television and other films as well as experience of deceased relatives. It was
NOTHING like that. I had 3 pregnancies which were relatively easy, and chemo
was much easier than that with the new anti-nause medications which work for
most.
Also, depending on your mother's tumor type--there are are newer experimental
treatments which show promise. I know of a gal who had been dx'd stage IV with
mets to several areas who tested positive for a very aggressive
oncogene---Her2+ She was given an experimental vaccine which put her into
remission. She said her dr. said she was 99% 'cured.'
That treatment is not available to most and one must meet certain criteria to
be eligible for the vaccine and clinical trial, but depending on the
characteristics of your mother's cancer, there might be some other, related
helpful treatments available (i.e. Herceptin).
If you would like more info. about vaccine trial, let me know.
Take care and again sorry that your mom has to deal with all this. All the
best!
Richard Faulkner - 22 Dec 2003 22:59 GMT
>I know of a gal who had been dx'd stage IV with
>mets to several areas who tested positive for a very aggressive
>oncogene---Her2+ She was given an experimental vaccine which put her into
>remission. She said her dr. said she was 99% 'cured.'
>That treatment is not available to most and one must meet certain criteria to
>be eligible for the vaccine and clinical trial,
What was the vaccine? My partner is Her2+ and has had Herceptin for a
year - it would be good to know of this vaccine as, presumably, it can
be bought at a price?

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Richard Faulkner
Kaye301 - 23 Dec 2003 00:44 GMT
Richard wrote: << it would be good to know of this vaccine as, presumably, it
can
be bought at a price?
I am not sure it has a name yet but was referred to me as the Her2 autovac. It
has only gone through Phase I trials. Phase II trials will begin sometime
around the summer, at least according to a contact nurse whom I spoke with. I
am not sure it can be purchased yet--at least at this point in time. If you or
anyone would like more info, email me and will get back to you same way.
madiba - 27 Dec 2003 14:06 GMT
> I am trying to get a quick education on this disease to help make sense of
> my Mother's condition and provide some hope for our family. My Mother has
[quoted text clipped - 5 lines]
> femur, admitting finally that she had breast cancer as well. She has had
> it for slightly more than 5 years, untreated.
IF the fracture is not simply due to osteoporosis/chronic dialysis but
tumor mets, then keep it simple. Tamox or Arimidex tablets, radiation
for painful bone mets.

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madiba