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Update on Bill


kimblanchard

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Hi friends,

We received the results of last week's CT scan and bone scan. The good news is 30% shrinkage on the primary tumor. Others are stable. For this we are so thankful.

Now the other news came with the bone scan - new mets on 3 ribs, the sternum and the scapula in addition to the ones on the vertebrae and hip. Bill has been on Zometa for a long time so I don't understand why he keeps getting new mets while the lung cancer is shrinking. Any advice or thoughts on this for us??? Bill is so pleased about the lungs but is so worried about the bone mets.

Thanks for any help,

Peg

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I don't think zometa will actually treat the cancer in the bone, it just prevents fractures and hypercalcemia. I am not sure you can ask the Dr.

Here is something I found during a search

- rhenium-188 with a diphosphonate

August 6, 2003

Together with US colleagues researchers from the University of Bonn have developed a new treatment which enables certain types of cancer to be treated more effectively than was previously the case. The radioactive substance becomes particularly concentrated in metastases in the bones and partially destroys them. To date such metastases have been incurable. In repeated application of the new medication, however, some patients survive on average almost twice as long as in the past. What is more, the medication is almost without side effects. The researchers have now published their findings in the prestigious Journal of Clinical Oncology (August 2003, pp.2869-2875).

Bone metastases are formed when the bone marrow is flooded with tumour cells ‘ e.g. of cancer of the prostate. There the cancer cells can proliferate uncontrollably as metastases, thereby also destroying the bone trabeculae which are so important for stability. In order to alleviate bone pain, doctors have for many years been using radio-isotopes. These are radioactive substances which accumulate in the area of the tumours. The radioactivity of the the standard substances used in the treatment does not, however, have enough energy to slow down the tumours, let alone to destroy them; their only effect is to alleviate pain.

Researchers of the Oak Ridge National Laboratory in Tennessee (USA) and the Clinic for Nuclear Medicine at the University of Bonn (Director: Professor Hans-Jþrgen Biersack) have now developed a radio-isotope which emits far more high-energy radioactivity. For this purpose the researchers linked up radioactive rhenium-188 with a diphosphonate. The substance emits high-energy beta radiation which becomes weak enough after a few millimetres to become almost harmless. However, since proliferating bone metastases act like a magnet to radioactive phosphorus compounds, these collect near the cancer cells and can damage or even destroy them. At the same time the medication emits low-energy gamma radiation with a wide range. Nuclear medicine researcher Dr. Holger Palmedo explains: "By using a radio-sensitive camera we can thus check whether the diphosphonate is actually reaching those parts where it is supposed to."

Dr. Palmedo tested the substance in a wide-ranging study in which the Urology Clinic (Professor Peter Albers), the Medical University Clinic I (Professor Ingo Schmidt-Wolf) and the Institute of Medical Biometrics (Dr. Fimmers) were involved. The study involved a total of 64 patients suffering from cancer of the prostate and bone metastases. In all these cases the standard hormone therapy was no longer effective. One group of patients only received one injection of the new medication; those forming part of the second group were given it twice at an interval of eight weeks. The results were particularly promising in this second group: "In 39% the amount of the tumour marker PSA decreased by more than half ‘ an effect which continued for at least 8 weeks." PSA is a protein substance which the tumour cells produce. The more tumour tissue forms, the higher the PSA level is in the blood. A low PSA level therefore shows that the tumour is growing more slowly or is even retreating. After one injection the disease came to a standstill for an average of 2.3 months, after more than one injection this even increased to seven months. At the same time the survival rate of the patients to whom more than one injection was administered rose from seven to 13 months," is how Dr. Palmedo summarises the findings. Furthermore, the treatment does not have much in the way of side effects: "In some patients the blood count becomes a little worse, but the patients usually do not even notice this." A follow-up study is to investigate whether the positive results will be further improved if the new medication is administered three or four times.

Clinic and Polyclinic for Nuclear Medicine of the University of Bonn

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Peg, I believe what John is saying is correct or could be correct. If the chemo is working one place and not the other then that type of chemo is not for the bone. What does the onc say about this? What are his plans for Bill now? Surely he is going to try something else along with the current chemo for the lung.

I have you both in my prayers every night and I sure hope they can come up with a chemo for the bones to get them under control. Buddy had radiation for the bone mets if he had bone mets. Nothing there now or nothing showing on scans which can't be relied upon now per the new onc.

I know if you are like me, it is not a Merry Christmas but a tolerable one. WE both can only hope and pray that some miracle comes along and finds its way into our loved ones bodies. That is if God is willing.

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Peg, right after Lucie finished chemo in May, she got a new bone met on her sacrum and had to have radiation on it as it was hurting. It has since disappeared. She has had rib mets come and go, and has a small spot on one rib right now even taking Zometa. I can't explain it either. She has no cancer in the lungs right now. It sounds like mostly good news on your end and for that, I am grateful. Enjoy your holidays. Don

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Peg

First I want to tell you how happy I am about Bill's news that his tumor is shrinking, that is so wonderful.

As far as the bone mets, I had a bone scan about 3 months ago and found out I had several bone mets, of course I was very alarmed but my oncologist was not, she told me that the chemo would take care of the mets, unless they were very painful then they could do radiation. She also told me that none of them looked very bad, (whatever that means). At the time of scan I was having quite a bit of low back pain but it has since gone away so I guess she was right. I would ask the oncologist what type of chemo would be good for Bill's bone mets. I hope you find a solution soon.

Bess B

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Hi Peg.

Also glad you gave us an update on Bill, have a happy and joyous holiday!!

and know you guys will be in my prayers,

God bless and stay well

Bobmc- NSCLC- stageIIB- left pneumonectomy- 5/2/01

MRI's taken 12/18 - 2 brain mets found- named em Frick & Frack

"Absolutely insist on enjoying life today!"

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Peg,

Sorry I don't have any answers for you. I just wanted to let you know I was happy to see the update and even happier to read about the shrinkage of the lung tumor. Many blessings to you, Bill and your family this holiday season. You always remain in my thoughts and prayers. Hugs to you.

Andrea

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