Newly diagnosed with bone mets
I'm not sure whether to post here or in the Stage IV forum. I had a PET Scan on Monday. I was called in by the nuclear medicine doctor and told there were mets in my femur, which were causing the pain I have been having. I then received the written report confirming a large met in the femur with fracture risk and spots lighting up all over the place, as I expected would be the case. (I do not live in the US and the procedures here are different). In capital letters, it was written that there are no mets in the liver or lungs. I see my onc in two days to discuss. I don't know if I'll be having a biopsy or just what will happen.
I am 14 years to the day from my original diagnosis. I did 10 years of Letrozole, didn't suffer any side effects, and hoping that getting back on that plus one of the new targeted drugs and some Zometa will work for me.
If there are others with similar situations, I'd love to hear from you. If you had a biopsy of the bone, can you tell me what to expect? What type of anesthesia to request? Anything else you want to share?
Thanks.
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@mary625 I'm really sorry you've gotten this diagnosis. It's relatively good news that you have bones-only metastases, as you probably know. There's a lot of hope that this is more of a chronic disease now. Still, it's a lot to take on. I'm sure you'll have a biopsy to see what kind of cancer it is, ie. whether it has mutated. I had a biopsy to a lesion in my iliac crest. They gave me fentanyl, which made me understand why people get addicted to it! I felt only pressure, no pain, and was fine the next day. I'm two years out now and doing pretty well.
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I'm very sorry to hear of your new diagnosis, @mary625 . Fortunately, bone-only estrogen-positive metasasis is a relatively good place to be in Stage IV breast cancer world. I was diagnosed with de novo Stage IV breast cancer two years ago. At first, my team missed my bone metastases, so I did AC-T chemo first, then was prescribed Kisqali/letrozole and Zometa. I am very stable on these meds so far. I had a biopsy to a lesion on my iliac crest which was done with fentanyl. I was awake, but felt only pressure and recovered quickly. There is a lot of hope since breast cancer research is advancing by leaps and bounds. I wish you a long life.
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Hi Mary,
Sorry you're joining us, but wanted to second the above comments by @tougholdcrow . If you have to be Stage IV, bone only is the best option. I also had a biopsy of the iliac crest, remember nothing during the procedure, and only mild soreness for a day or two after. I have been Stage IV for almost 3.5 years, still on my first line of treatment and able to live a reasonably normal life.
We're here to lend support and answer questions as best we can. You have much to look forward to.
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Hi, @mary625 and all. I (age 66) have a very similar situation to yours, Mary, diagnosed at the end of January this year - BC recurrence from 2010, bone mets only. The absolute worst part for me was the two weeks between the "bone lesions consistent with metastatic disease" MRI report and not seeing my oncologist until over two weeks later after more scans, tests, and the biopsy she wanted before seeing me. NOBODY telling me I was going to be okay, there is treatment for this, etc. I had visions of mastectomies and chemo (again) running through my brain. So let me be the one to tell you YOU ARE GOING TO BE OKAY!!! I started two weeks of daily radiation immediately on the two painful areas on my spine and that took care of the pain within a few weeks (I had mostly spine and pelvis and ribs mets but did have a spot radiated one time on my femur). Laying on my back on that hard surface in radiology brought tears of pain to my eyes and the radiologist did tell me, "You are going to feel better!" And he was right. The markings for radiation are even easier than 15 years ago. My biopsy was in the hip/pelvis bone, laying on my side, awake but the anesthesia was terrific, no pain, and really no pain afterward, either. I have been on twice-daily Verzenio 100 mg, monthly Faslodex injections, and 3-month Zometa bone infusions since completing radiation. I have been coping and managing with the G.I. and diarrhea issues, to be honest, since starting the drug treatments on Feb. 21. So I am a little over six months in with the drug treatments, have been in physical therapy to rebuild strength and stamina (after a year of decline from pain we all thought was caused by worsening scoliosis from bone loss due to years of Tamoxifen and Arimidex) and I am doing my home exercises, progressing, getting stronger, walking 2 miles a day and building on that, keeping up with my normal activities again. I'm just hoping my G.I. issues are under better control and I can travel again soon, injections and infusions schedules permitting. You are going to be okay!!!
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Thank you, @tbos805. I feel much better reading your story. I feel much better knowing that the biopsy anesthesia was terrific and that I will be okay!
Since I wrote, I've seen the onc. She ordered a biopsy and radiation consult. She also started me back on an AI and an oral bisphosphonate once weekly. If the biopsy comes back with the original ILC ER+ PR+ markers, I will then start on Kisqali and IV Zometa. I've been put on crutches until I get past the radiation. It's helping the pain tremendously.
I've scheduled two radiation consults this week, so that I have a choice. I'm still waiting to hear from interventional radiology about the biopsy. I hope that doesn't hold things up.
By the way, my son and DIL live in Seattle. When he first moved there, I went for sort of a 2nd opinion at Fred Hutchinson/Seattle Cancer Care Alliance. I loved that place. I'm now living in Portugal. I was wondering if you are going to SCCA.2 -
There's no more SCCA. It all got incorporated into Fred Hutch and UW.
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@mary625 So glad you are well underway with your consultations and feeling a little better today! It is overwhelming! And to respond to yours and @threetree 's comment, I am fortunate that I have a cancer center at Swedish Hospital in Issaquah where I have been able to have all of my appointments, scans, tests, treatments, etc. Some Seattle-based docs even come to Issaquah once or twice a week and I have never had to go into Seattle. I'm so thankful for that bit of potential stress taken off my plate.
I was only able to take AI's for six years due to bone and joint pain - while trying to teach first grade - ugh - after my first surgeries-chemo-radiation. So I was not prescribed AI this go-around and why I am on the monthly Faslodex injections instead.
Best wishes for your biopsy and radiation treatments. Peace and healing thoughts!!
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Hi All,
I’m most likely to have bone mets to femur. My CA15-3 tumor markers & alk phos were elevated and been having on off pain on my left thigh. Just did my PET-CT (a few hot spots on the femur area) & MRI last Thursday, seeing oncologist Monday but she didn’t say anything about biopsy only radiation. My first bc diagnosis was on this month exactly 10 years ago so i really don’t know what to expect 😞
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@faith71 So very sorry to hear that the cancer has come back. I am sure they will do testing to confirm the diagnosis and to see whether the cancer has mutated, since you will be receiving ongoing medication to keep it under control. Not sure why they'd be doing radiation unless there's danger of fracture or because they are treating it as oligometastatic, but I'm sure your oncologist will explain on Monday and you can keep us posted here.
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@faith71 My initial scans showed bone lesions mostly cervical-to-sacral spine, ribs, hip, and pelvis and I received two weeks of radiation for the painful areas (which helped). The radiologist saw one spot on the femur in those initial scans and treated it one time as a precaution (versus daily for two weeks like the other areas). Best of luck to you with radiation and I hope it helps with your pain.
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Thank you @tougholdcrow @tbos805
It’s confirmed bone mets to femur, 1 small spot about 1cm and a bigger area 8.2cm which is a mix of sclerotic & malignant lesion, hence it becomes more complicated as radiation might cause long term damage to the non cancerous part of the femur.
Oncologist recommended hip replacement surgery for a “tumour reset” and also to send the tumour for biopsy & next generation BRCA / ESRI sequencing. Will be seeing the orthopaedic surgeon tomorrow, then decide by end of this week. Had a Denosumab injection as well though not sure about the oral therapy until after the biopsy since I’ll not be continuing with Letrozole.
A lot to take in but at least I know the treatment options.
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