Zometa-Induced Bone Pain

[Bill]

Has anybody been given any helpful advice on how to differentiate bone cancer pain from bone pain induced by Zometa ? Maybe things like location, intensity, frequency, sensation, etc ?

Thanks much.

[Angie Daughter of Bill]

Bill,

When Dad gets Zometa, he gets it on Tuesday. On Friday and Saturday he has a good bit of pain. It is always in his legs and lower back. By Sunday morning, the pain is much better.........little to none.

Dad is currently undergoing radiation to the T12 vertebrea. When this met came on, the pain was constant and got increasingly worse.

Hope this helps.

Angie

P.S. The pain from the Zometa was enough that Dad had to take Lortab 7.5.

[Bill]

Bill,

When Dad gets Zometa, he gets it on Tuesday. On Friday and Saturday he has a good bit of pain. It is always in his legs and lower back. By Sunday morning, the pain is much better.........little to none.

Dad is currently undergoing radiation to the T12 vertebrea. When this met came on, the pain was constant and got increasingly worse.

Hope this helps.

Angie

P.S. The pain from the Zometa was enough that Dad had to take Lortab 7.5.

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Angie :

Thanks for the reply. We are faced with a very complicated and confusing set of symptoms. Despite numerous tumors in her lungs and brain my wife has no identifiable respiratory or brain symptoms. All of her current symptoms ( pain ) are concentrated in her hips and lower back with some intermittent leg pain. If you mesh together two lower spine surgeries with Gemzar-induced radiation recall in the same area plus extensive damage to the pelvis plus monthly Zometa you've got plenty of causes for hip / low back pain but have fun sorting it out. Radiation to the pelvis is available but the med onc and rad onc aren't in any hurry to use that option until it's certain that it's absolutely medically necessary. Case in point, 3 months ago she presented with severe left hip pain. The med onc stops her chemo and sends her over to the rad onc that same day. Pelvic radiation is scheduled only to have the left hip pain completely disappear the next morning and shift to mild right side pain. Pelvic radiation was canceled and the drs. are left scratching their heads. Now the left hip pain is back but we are very reluctant to mention anything because of the likely multiple causes and it will wreak havoc on her treatment plan. BTW, ditto on the pain med ( Vicodin ES ).

[SJAS]

Bill,

Steve has been on either Zometa or Aredia since beginning treatment in Aug '03. He has had considerable pain, but his seems to be completely from the cancer. Now that his cancer is stable (on Iressa), he has been able to completely remove himself from pain meds.

You don't mention any involvement of the liver, but if there is you might want to be careful with the Vicodin. Due to liver involvement, Steve was told that morphine (MS Contin) was a much better choice as it was not so hard on the liver.

[BoBennett]

I have often wondered that question myself. Just going by my own symptoms and such as I have not been given any advice from a Doctor or nurse I’ll chime in on this.

I had tremendous pain from the bone cancer mets for six months prior to diagnosis. 6 weeks after starting treatment, ( Zometa) all bone cancer pain went away. I never had bone pain, per say, up that point from chemo. Upon starting Taxol I had bone pain in my legs and hips and lower back, no where else, that lasted about week after the treatment. As for intensity it was uncomfortable but no where near the misery of the bone mets. I had a bone met in my right hip and the differentiation between the two pains were marked in all aspects, bone pain wasn’t jack, cancer pain was unrelentingly miserable.

But that was just me, its so difficult to compare as we all have different perspectives on pain.

Not knowing absolutely, I do attribute the bone mets healing to the Zometa.

Bo

[Bill]

Has anybody been tracking their blood calcium and alkaline phosphatase levels before, during and after Zometa therapy ? If so, did you notice any particular trend with these blood values ?

[BoBennett]

Interesting question. I have blood weekly CBC reports and monthly metabolic so its hard to be definitive on calcium or phosphates trends. There is a slight correlation with calcium being flagged low after a Zometa treatment. . I know there is a connection to bone cancer and calcium levels in blood, I think its hypo or hyper calcaemia and I think I’ve read where that can cause (dementia of sorts). I was not tracking for a period of time while the bone mets were active, in any case I’d be interested in your thought on these trends

Bo

[Bill]

Interesting question. I have blood weekly CBC reports and monthly metabolic so its hard to be definitive on calcium or phosphates trends. There is a slight correlation with calcium being flagged low after a Zometa treatment. . I know there is a connection to bone cancer and calcium levels in blood, I think its hypo or hyper calcaemia and I think I’ve read where that can cause (dementia of sorts). I was not tracking for a period of time while the bone mets were active, in any case I’d be interested in your thought on these trends

Bo

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Bo :

For several months now my wife's blood calcium level has stayed between 8.4 - 9 mg / dL and her alkaline phosphatase level has stayed between 260 - 329 U / L. These blood values don't seem to be revealing much about whether the Zometa is helping or not. My wife has stage 4 NSCLC with mets to the brain, spine, pelvis ( extensive ) and left femor. But, she has no symptoms attributible to her brain or lungs. All of her symptoms are chronic pain - low back ( incl. rad recall ), hip ( primarily left side ) and intermittent left leg ( including shin ). Nobody can determine much from this pain profile either. Wish we knew more about this.

Bill

[BoBennett]

Bill,

I can definitely appreciate your search for info and answers. I did not nor have symptoms from the lung or bronchial area and all my pain was from the bone mets that’s why I have such an interest in Zometa. Following a PET and plane old X-ray showing the disappearing of the cancer and new bone growth my Onc just didn’t seem very interested. I thought it was a miracle. It sounds like your wife is still in Pian from the Mets. I’ve talked to more than one person with spine mets who have also “healed”. I don’t know if it’s a matter of time in treatment or like most other stuff with cancer one works for one and not for another. I believe answers are out there we just have to be persistent. I also believe the doctors don’t have a good handle on things because they don’t deal with personal issues its on a mass basis. I wish I had information that would help.

Bo