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…
I know, I know,
RIGHT after I say that there’s nothing else to say, something happens…not with the
love of my life, but with a friend of ours.
After she got a “clean
bill of health” and the doctors said that the cancer was in remission, they
discovered multiple lesions of bone cancer scattered through her body. For a
second, I’m going to ENCORE! The post on bone cancer from December 2011:
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.
Bone cancer is the
most common form of metastatic breast cancer (MBC) – 70% of MBCs 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 MBC. 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.” Literally,
“to cross over to another place 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.
OK, enough
textbook talk.
The upshot has to
be that while it’s treatable and manageable, it must be demoralizing in the
extreme. To have been told “it’s in remission!” and then to hear, “Oops. It’s
back…” has to come close to crushing the spirit.
So…I know that I
usually stay away from religious stuff, but in this one case, I’m going to ask
anyone who reads this to hold this friend of ours up in prayer, or unconditional
positive regard, or meditate on this woman’s pain that it might be removed or
lessened, send positive energy, hold her in your thoughts, empathically absorb her
pain then wring it out of your mind (?) …anything that works for you when you
are considering the pain of another.
Thank you.
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