From the first moment my wife discovered
she had breast cancer, there was a deafening silence from the men I know. Even
ones whose wives, mothers or girlfriends had breast cancer seemed to have
received a gag order from some Central Cancer Command and did little more than
mumble about the experience. Not one to shut up for any known reason, I started
this blog…That was four years ago – as time passed, people searching for
answers stumbled across my blog and checked out what I had to say. The
following entry appeared in December of 2011…
We just got news
this week that a “cancer friend” of ours had a bone scan, and after an extended
time of treatment, she is cancer free!
But just what IS
bone cancer and why did she get it?
The cancer,
while it can certainly occur by itself, is what is called metastatic breast
cancer. It happens when cancer cells from the breast escape into the blood
stream or the lymph system and invade MORE new flesh.
While bone
cancer is the most common – 70% of metastatic breast cancers are of this ilk –
the other 30% is made up of brain cancer (10%) and lymph, lung and liver
cancer. Let me emphasize here that these cancers are NOT the peculiar type of
cancer cells that initiate these diseases in people who have never had breast
cancer. These cancers are BREAST CANCER cells that have invaded other organs
and therefore are called metastatic breast cancer. The word “metastatic” was
used in the 1570s and comes from the Greek metastasis which
means "transference, removal, change.” The roots are meta which means "over,
across" plus the word histanai which means "to place,
cause to stand.” The medical use for "shift of disease from one part of
the body to another" dates from 1660s in English.
Bone cancer
caused by the invasion of breast cancer cells into the bones can first show up
as back, bone, or joint pain lasting more than two to three weeks that seems to
be getting worse; numbness or weakness in a particular part of the body; a
change in bowel or bladder activity, such as problems with incontinence or not
being able to urinate or have a bowel movement. This may be a sign that the
nerves in your backbone are getting pinched by the cancer.
As well, blood
tests can reveal a buildup of calcium or tumor markers (special proteins in the
blood) like CEA (carcino-embryonic antigen), CA (cancer antigen) 15-3 or CA
27-29 that suggest the cancer might be in the bones. Calcium build up might
also show up in a routine bone scan. These tests are NOT usual and are
typically ordered only if the symptoms appear.
Metastatic bone
disease (MBD) caused by invading breast cancer often behaves in a “mixed
osteolytic (destroys bone cells) and osteoblastic (causes abnormal growth of
bone cells) manner”. Bone destroying or bone growing MBD occurs because the
different cancer cells give off chemicals that interfere with the naturally
occurring cells in the bone and cause bone destruction, new bone formation, or
both. MBD weakens the affected bones, people with the disease are prone to
fractures. Broken bones caused by MBD are termed "pathological fractures."
The most common
treatment options for MBD include radiation and medications to control pain and
prevent further spread of the disease, and surgery to stabilize bone that is
weak or broken. By killing the cancer cells, radiation relieves pain, stops the
tumor from growing and can prevent the bone from breaking. Radiation can also
be used to control the cancer after surgery to fix a broken bone.
MBD is a
systemic (body-wide) problem and radiation therapy may be use just to lessen
symptoms and pain in more advanced cases, or to completely destroy disease in
the affected bone.
Different
cancers respond differently to radiation. Several types of radiation therapy
are available. Local field radiation is the most common type of radiation used
to treat MBD in which radiation is directed at the metastatic tumor and the
immediate adjacent tissue. Entire bone segments or multiple bones can be
targeted by local field radiation, depending upon how many areas are affected
by the disease. This usually results in complete pain relief in 50% to 60% of
cases and partial relief in more than 80% of cases. How well MBD responds to
radiation depends on many things, including cancer type (for example, breast
cancer typically responds very well to radiation, while kidney cancer does
not), and where the tumor is located.
Pain usually
begins to subside in the first 1 to 2 weeks, but maximum relief may take
several months. Therefore, pain medication is prescribed throughout the
radiation treatment course.
For our “cancer
friend”, the treatment has been effective and with the pain greatly reduced, we
are planning to actually meet for the very first time for dinner over the
holiday season!
FEBRUARY 2014
UPDATE: Yesterday, this friend got a CLEAN BILL OF HEALTH!!!
References: http://www.breastcancer.org/symptoms/types/recur_metast/where_recur/local.jsp
, http://orthoinfo.aaos.org/topic.cfm?topic=A00093
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