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Sep 20, 2015 11:59AM
Sep 20, 2015 02:47PM
All, happy Sunday!
Wendy thank you for your welcome. Now my turn to welcome Misparki!
Cheers to all the improvements in pain management and good results of scans (have to be general, can't go back to get the names)!
Misparki, I believe I also have very widespread bone mets. I so far have done two sets of scans (CT and bone scan for each set done by two hospitals reapectively ) since the diagnosis in the end of Feb. this year. They all just tell their own stories without commenting each other. So I have to treat them all as separated sections of the base-line imaging. Currently I do not have serious bone mets pain. But I do still have minor discomfort (a kind of mild burning sensation) mainly at the ribcage (lower sides). I used to have severe pain surrounding my lower ribcage, sternum, and right shoulder prior to my treatment three times. Each episode begun after a long walk. Then the severe pain subsided by itself after about 6 weeks every time. My only thoracic MRI taken last month revealed my T9 has deformity and shows mild compression fracture. So now I understood why I had the tree strange injury like incidences (I was very puzzled why a long walk would bring so much muscle pull like severe pain). It was that my T9 has fractured three times and got healed each time basically on its own. The repeated compressional fractures, or, the gradual compression, caused the T9 to deform. The current mild fracture shown is the remaining of the third episode which probably will not completely healed eventually due to the advance of the disease. So, my impression of the pains caused by our bone mats is that the mets on the surface of the bones more likely would not cause very much pain. Severe compression and fractures are the major reason for serious pains. Deeper, more eat-in lesions (lytic lesions) damaging the bones like knife cutting in probably also cause noticeable bone pains. However, the pain I understand belongs to the physical, substantial pain caused by the physical damages, which is simple and easier to manage. The field under the name of pain is vast and much more complicated and the complicated part is beyond my experience and understanding. So, my thinking here is worth only 2 cents.
I would assume MBC tends to spread in multi focal form, sometimes very tiny but in large number, if it is the latter, it is called diffuse. It is probably quite common to have both focal and diffuse bone mets at the same time (mine is in this group). It seems also common to have both lytic and sclerotic lesion types. Lytic lesions are the result of the rather aggressive cancer activities. If the offense of the cancer is aggressive, the bone has no time to counter but retreat, leaving a hollow to the cancer. When the offense of the cancer is less aggressive, the bones have the time to fight back by producing more of themselves, we have the sclerotic lesions present. Then the bone healing also takes the form of producing more of themselves. So the sclerotic phenomenon on the bone scan imaging could be both cancer lesions and healing. I was very much worried about my T9 compression fracture, because my onc decided not to do any immediate local treatment. I did ask for the procedures such as bone cement. My onc said the prognosis of the procedures for mets patients is not good. I have to guess it is because the damage will not stop after the procedures. Then the occasional dull pain surrounding the T9 became milder and milder. Now it is not really noticeable if there is any. I think I got my onc's reason. He probably assumed that my mets is not yet becoming aggressive, given it took 13 years to show themselves, so the bone might have the time to heal under the systematic treatment (I am taking daily Letrozol and monthly Zometa).
As for Zometa infusion, I had terrible reaction to the first dose (severe whole body shaking and shortness of breath caused by very high body temperature, ended up in the ER). Then my onc told me to take 2 Tylenol and 2 Advil together prior to the infusion and after every 6 hours for one or two days. I am doing that and free of problems. SE of Zometa for me is very minimal. Just some general mild ache in a couple of days after each infusion.
Good luck to the Zometa newbies!
12/2002, IDC, Left, 4cm, Stage IIB, Grade 3, 5/12 nodes, ER-/PR-, HER2-
1/1/2003 Mastectomy: Left
2/27/2015, Stage IV, metastasized to bone, Grade 3, ER+/PR+, HER2-