Bone Mets diagnosis 18 mos, lesions on liver on CT last week
Hello,
my wife was diagnosed with stage IV breast cancer with bone met about 18 mos ago. She is currently on kisqali (400 mg), and Letrozole with monthly Zolodex shots and Zometa every 4 months.
On her most recent CT (last week) the report said she has 3 lesions on the liver, 14 mm, 14 mm, and 15 mm. Still awaiting report of SPECT.
We are meeting the oncologist in a week. It seems like the cancer has spread to the liver, and the Kisqali is not working! About 4 months ago she received radiation for a new growth in her armpit. That growth is no longer showing up on the scans.
I would appreciate any info on what to expect in the meeting with the oncologist. I just want to be prepared for what she might say. For the sake of my wife, I’d don’t want to be shocked! I need to be prepared and keep my cool. So any insights would be most appreciated.
Thank you.
Comments
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First, the lesions on the liver may or may not be mets. Talk with your oncologist about what they think. Can they/ are they planning on doing a biopsy on them? Are they planning on doing a PET scan?
Second, if they are mets, then they will give you options for the next line of treatment. They may change up the current treatment, or they may move to another med altogether. There are several other options for meds.
Hopes this helps some.
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In January 2023, I went from stage 3 to 4 with mets to bones and some "lesions" that appeared on my liver. Was put on Verzenio, Fulvestrant, and Zometa. The lesions were identified with one being a cyst, and a couple of others being referred to as "hypodense lesions" or "too small to characterize". They continued to be basically the same for the last year and I was told they were "neither here nor there" and were not a particular concern. My last scans in early June showed things the same size, but all of a sudden the reading radiologist referred to them as "metastases". My oncologist then began talking to me about possible "radio embolization" of the "likely metastases", but said I could remain on my current Verzenio and Faslodex, i.e. they would treat the liver lesions independently. Well I had questions, because to me, from my reading of the reports, it seemed like they were seeing the "same old stuff" that no one had yet decided was metastases. The oncologist then ordered a follow up MRI to get a better look. That reading radiologist also called the lesions "metastases", but said I still have the cyst and he saw no size change from whatever they've been seeing for over a year now. The oncologist now says not only can I continue on my current med regimen, but we can watch and wait on the lesions until the next scans in September. He did agree that this looks like the same old stuff, but he too now says he would call it metastases. Why, I don't know.
No biopsy to confirm that these are indeed metastases has been suggested or performed. They all seem to think they can tell from what they see on the scans. Maybe sometimes they can? I find the whole thing very puzzling and do not know why something they have all said was not of any particular concern, now is of concern and called "metastases" when it's all the same stuff. I think in your wife's case they'll need to know if it is indeed metastases, as apparently we can all have all sorts of stuff (lesions) on our livers that are not necessarily cancer or metastatic. It looks too that if it is cancer, it can be stable and simply monitored for any change, or there are a number of treatments they can offer separately from her current med regimen, so she could possibly stay on the same meds and not have to switch that out. There is radioembolization, ablation, and other things that I'm not familiar with that can specifically be used for liver lesions exclusively and separately from the current treatment. That's all I know myself at this point, I hope it helps you and your wife in some way.
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