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What can be expected with mets to the spine and hip just dx?


Melinda

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Hi, everybody--

Thank you for your warm welcome to this board.

My fiancee is really confused/scared about what mets to the bone actually means.

Right now he is trying to just spend as much "quality" time (watching funny movies, seeing friends, doing projects together) with his mom before she starts treatment--and my "job" (and natural bent) is to do what "research" I can and pass the information on to him so that they can ask the doctors more informed questions.

Is it posible that mets to the bone can be *eradicated* or is treatment simply "pallitiave"? Or is it somewhere in-between (trying to keep it stagnant)? I have read on this board that mets to the liver seems to heal in cases, but I know that the liver has such wonderful powers of regeneration. Bone, I'm sure, is a seperate case entirely. And I have read that it provides the cancer with a lot of what it needs to proliferate.

We are under the assumption that surgery to the spine/hip is not an option for mets to the bone. Would they ever consider a hip replacement for someone with mets to the hip?

We are also assuming that lung surgery is not an option for people with mets to the bone, based on the research we've done. Why exactly is that? Why don't they operate on the primary site (the lung) after an initial round of radiation/chemo/drugs to attack the bone mets? I'm sure there's a good reason, but to those of us who just learned about this whole darm dx on Friday 3/12/04--it seems like leaving a tumor in her lung/nodes is just a yet another ticking time bomb.

Most of the research I've done over the weekend on lc with mets to the bone was superficial. Frustrating.

Also, what side effects may be coming our way (bone pain to be treated be drugs--what drugs?)? Trying to avoid fractues and hypercalcimia. Anything else? Right now she has NO bone pain, whatsoever. No pain at all, in fact, except that she is tired from excessive coughing and she is hoarse. And scared by this mack-truck that just smacked into her last week.

Any insight would be most welcome.

Don, you sound like you may know a great deal about this.

Thanks.

Melinda

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Zometa (a biphosphonate) is usually given for bone mets. It will help prevent fractures and mets and new research indicates it may treat bone mets.

There are three types of bone mets: lytic, blastic and mixed. Lytic breaks down the bone (thus the potential for fractures), blastic causes bone growth and mixed is a combonation of lytic and blastic

Surgery is not usually done, since the cancer has spread to the other parts of the body it is considered "systemic" not local. There is little point to remove a lobe (which would reduce ones lung function) when the cancer is already spread.

It certain cases of isolated metastasis (solotary brain met, I think solatary adrenal met) and when other conditions are met surgery will be done in multiple places.

Since you are in the city it is probably best to go to one of the NCI designated centers - like Sloan.

Memorial Sloan-Kettering Cancer Center*

1275 York Avenue

New York, NY 10021

(800) 525-2225

www.mskcc.org

New York University Cancer Institute*

New York University Medical Center

550 First Avenue

New York, NY 10016

(888) 769-8633

www.nyucancerinstitute.org

Herbert Irving Comprehensive Cancer Center*

College of Physicians and Surgeons

Columbia Presbyterian Center

177 Fort Washington Avenue

6th Floor, Room 435

New York, NY 10032

(212) 305-8610

www.ccc.columbia.edu

Cancer Research Center*

Albert Einstein College of Medicine

1300 Morris Park Avenue

Chanin Building, Room 209

Bronx, NY 10461

(718) 430-2302

www.aecom.yu.edu/cancer

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John,

Thank you for the information--I have passed it on.

She is currently being treated by Dr. David Wolf at New York Hospital (who is WONDERFUL!) but has an appointment to get a second opinion at Sloan Kettering next Wed. (We concur with you about ALWAYS getting a second opinion).

Her Chemo may start as soon as this Friday, though (one week from dx; that's good, right?). We are taking her to see the radiologist and get a tube in her chest for the Chemo tomorrow.

Thanks, again.

Melinda

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