ENCORE #102! – Metastatic Breast Cancer: Brain Cancer

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 first appeared in January 2014.

While I don’t usually go to Yahoo Ask for my medical information, I decided today to START there because the answerer is both an MD and clear:

“Interesting that you bring this up. Primary brain malignancies have always been called brain ‘tumors’ rather than ‘cancer of the brain’. Yet many are clearly cancerous, locally invasive, progressing malignancies. Strange the way people perceive words. If you tell patients they have a ‘tumor, it does not seem as ominous to them as saying they have ‘cancer’…there is confusion that many people have in regard to this topic. A person with lung carcinoma that has spread to the brain has lung cancer in the brain. It is not a brain cancer. It is still lung cancer that is growing in the brain area. A person with a glioblastoma multiforme has a brain tumor - but these are usually aggressive cancers. As for cures - that depends on the primary brain cancer/tumor type and the stage.

Interesting question regarding the semantics of this.”

Source(s): MD medical oncologist - cancer specialist doctor Spreedog, 2010 http://answers.yahoo.com/question/index?qid=20091114024633AADSsIx

This is in concordance with what I’ve already found out about bone cancer and lung cancer – when you have had breast cancer and is spreads (which is what Metastatic Breast Cancer is), you have breast cancer cells growing wild in the bones, liver, lungs, brain and various  other places.

So what happens? This seems to me to be a truly horrible kind of MBC because the brain is the seat of Human consciousness.

The writer here expresses this terror: “It was because of a few unusual symptoms, that several months ago I requested a brain scan. By the time the date arrived for the scan, the symptoms, along with my fears, had disappeared. Imagine my surprise when the next day my oncologist called to say that they had found 2 tiny spots on my brain. The news was devastating. While breast cancer is every woman’s nightmare, and metastasis is the nightmare of everyone who has breast cancer, brain metastasis is the nightmare of everyone who has metastatic disease. It was so frightening that I couldn’t speak to anyone about it. I could barely allow myself to think about it. None of this is news to you. You wonder how many tears you can actually shed. You wonder if you will ever feel like your old self again and if your friends and family will ever think of you in the same way. You wonder if you will lose the person you are. It is the most terrifying diagnosis anyone can have, even those of us who are used to bad news.”

What are the symptoms? Please keep in mind that the symptoms are DIFFERENT depending on where the cancer attacks first. Also, OTHER things can cause these symptoms. My wife works as a classroom aide with kindergartners – she gets headaches sometimes, as anyone would who tries to work with a room full of five-year-olds!

Symptoms include: “changes in the ability to think, understand and use words correctly; emotional changes; weakness; dizziness; seeing lights, seeing double, or narrowing of vision; problems with balance; seizures; nausea and vomiting; changes in smelling, taste, hearing. If any of these symptoms persist (that is, stick around for a while) like a headache that is worse in the morning, lasts for days, or recurs every day, then you’ll want to talk to your health care authority.

Once you report to the cancer care center or your doctor and there appears to be reason to suspect MBC-brain cancer, an MRI (magnetic resonance imaging) is the most effective technology for diagnosing breast cancer brain metastases. It does a better job in distinguishing a single metastasis from multiple metastases, which is an important factor in determining what kind of treatment a patient needs.

Unfortunately, treatment for MBC-brain cancer is problematic still. In m0st cases, whole brain radiation (which is exactly what it sounds like) is the first line of offense. There is good evidence that this treatment is effective almost half of the time in completely reversing the effects of the cancer. In MOST cases, it reduces the symptoms significantly. It is also a shorter-term treatment than the original chemotherapy with radiation doses given daily for 5-10 days (though this is sometimes spread over a longer period to lessen the side-effects.

At other times, the radiation is aimed from multiple directions at specific metastases. This has the advantage of fewer side-effects, but there is no clear EVIDENCE yet that this is as effective as whole brain radiation treatment.

Other, less common treatments include brain surgery (physical removal of the cancer), chemotherapy (not effective usually because the chemo can’t break through the barrier into the brain through the blood (called the blood-brain barrier); and a combination of the above.

Finally: “‘So much depends on the aggressiveness of your individual cancer, the time to recurrence from original diagnosis, any other metastases, and overall health—and, the number, location and size of the brain mets (metastases), and whether they are symptomatic or not,’  Patty observed. ‘I was so sure that I would die within 18 months of my first diagnosis with brain mets.  I readied for the time of my death. Now, I’ve had to revise things a few times.  I wonder if I hold some kind of record for brain MRI’s, having had them on average every two months for five years—that would be around thirty, with bad veins! I’ve had brain mets for five years and have been living with eight lesions for two and a half years.’”

References: http://brainmetsbc.org/

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

GUY’S GOTTA TALK ABOUT…Alzheimer’s #21: Stages and Levels…

Dad’s diagnosis of Alzheimer’s stayed hidden from everyone until I took over the medical administration of my parents in 2015. Once I found out, there was a deafening silence from most of the people I know even though virtually all of them would add, “My _____ had Alzheimer’s…” But there was little help, little beyond people sadly shaking heads. Or horror stories. Lots of those. Even the ones who knew about the disease seemed to have received a gag order from some Central Alzheimer’s Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this part of my blog…

The residence my dad lives at does annual care reviews. This past month, because of changes in his behavior and abilities, my dad was advanced from Level 1 (for which he receives minimal care beyond what is normally provided to all of the community (someone is always there to help him, room & board, medication delivery, recreation and facility use, programming, nurse assessment, care conferences, etc.) to Level 3. He’ll now receives help taking a shower, shaving, some help dressing (mostly dressing appropriately), behavioral intervention (he has done “exit-seeking” practically since he moved into the facility, often complaining that he feels like a prisoner)but which as recently escalated to following a woman he thinks is my mother and holding her hand (while the woman’s HUSBAND was sitting there), his incontinence has increased, and he has a prescription for olanzapine: “used to treat nervous, emotional, and mental conditions…may also be used alone or with other medicines (lithium or valproate) to treat bipolar disorder (manic-depressive illness) or mania that is part of bipolar disorder”, which they use as needed when he gets agitated and really tries to “escape” the place.

What does this mean? Well, by now you know I prefer the 7 Stages of Alzheimer’s over the

Stage 1: No memory problems are evident.

Stage 2: Minor memory problems but not distinguishable from normal age related memory loss.

Stage 3: Friends and family members begin to notice memory and cognitive problems like not being able to find the right word during conversations, forgetting new acquaintances, an frequently losing valuables.

Stage 4: Clear cut, classic symptoms of Alzheimer’s disease are apparent.

Stage 5: Need help with many day to day activities. Significant confusion, forgetting person information like phone number but still able to bathe and toilet independently. They also usually still know their family members and some detail about their personal histories, especially their childhood and youth.

[Dad is probably here-ish.]

Stage 6: Confusion or unawareness of environment and surroundings, behavior problems, assistance with activities of daily living, recognizes only friends and relatives, loss of history, incontinence, wandering.

Stages 7: Lose ability to respond to their environment or communicate, assistance with all activities of daily living is necessary, and many lose the ability to swallow [Dad has trouble with this already].

For me the Three Stages of Alzheimer’s (Early, Middle, Late) seem…more open to a “shoulder shrug” interpretation, like “Well, he has trouble coming up with the right word or name, remembering names when introduced to new people, challenges performing tasks in social or work settings, forgetting material that one has just read, losing or misplacing valuables, increasing trouble with planning or organizing, so OMG!!!! He MUST HAVE ALZHEIMER’S!!! Quick let’s get him institutionalized....” for Early Stage Alzheimer’s.

As far as I recall, Dad was in this stage well before we forced him and Mom to move.

With the Middle Stage, comes forgetfulness of events or about one's own personal history, moody or withdrawn, especially in socially or mentally challenging situations, unable to recall their own address or telephone number or the high school or college from which they graduated, confusion about where they are or what day it is, need help choosing proper clothing for the season or the occasion, trouble controlling bladder and bowels in some individuals, changes in sleep patterns, such as sleeping during the day and becoming restless at night, an increased risk of wandering and becoming lost, personality and behavioral changes, including suspiciousness and delusions or compulsive, repetitive behavior like hand-wringing or tissue shredding…

Late: Needs round-the-clock assistance with daily activities and personal care, lose awareness of recent experiences as well as of their surroundings, experience changes in physical abilities, including the ability to walk, sit and, eventually, swallow; have increasing difficulty communicating; become vulnerable to infections, especially pneumonia.

Now, not to be cynical or anything, but with the weed-like propagation of Memory Care facilities (which charge exorbitant fees and seem to be a really good financial investment), the moment a parent forgets something, with three Stages, families might throw their arms in the air and place their parents in a Memory Care Facility when the vague Early Stages of Alzheimer’s show their ugly head.

Dad would have been in Late Stage for the past year or so…but with Seven Stages, when I started this blog, Dad was between Stage 5 and 6. Most recently – like last week – it’s clear that he’s advanced to Stage 6 with clear signs that Stage 7 is imminent. In particular, since this summer, Dad has exhibited a marked inability to assess his environment, to wit: he called me two nights ago 23 times starting at 1:40 am and calling for the last time at 3:42 am. He had no recollection of that when I went to pick him up for his doctor’s appointment. He frequently has no awareness of time of day, and lately he’s been unable to read his old watch, becoming entirely confused when I ask him to describe… “What’s the big hand pointing to? What’s the little hand pointing to?” I haven’t even tried to ask him about the minute hand…

At any rate, I’ve been working to reconcile myself with Dad’s decreasing ability…and to be perfectly honest with you, I’m not doing really well and I find myself pulling away.

Resource: https://www.alzinfo.org/understand-alzheimers/clinical-stages-of-alzheimers/?gclid=EAIaIQobChMI6JqT09vW3wIVhSBpCh2f9AuFEAAYAiAAEgICQ_D_BwE

Image:  http://az616578.vo.msecnd.net/files/2016/06/25/6360242025150255191939281878_Alzheimer-disease-patients.jpg

ENCORE #101! – Metastatic Breast Cancer: Liver Cancer

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 0f 2011.

This is not a cancer you hear about frequently, though it is third worldwide after lung and stomach in the number of deaths each year. It is uncommon in the United States with three fourths of all cases diagnosed in Southeast Asia, Mozambique and South Africa.

It is one of the least common of the metastatic breast cancers with bone cancer being 70% of the metastases and brain cancer being 10%. The remaining 20% are distributed between liver, lung and non-specific systemic diseases.

Metastatic breast cancer-caused liver cancer can show up as a significant weight loss, jaundice (getting yellow skin – this condition is sometimes seen in newborns (our son was jaundiced at birth)), and elevated liver enzymes (Inflamed or injured liver cells leak higher than normal amounts of Alanine transaminase (ALT) [This enzyme causes certain reactions to happen in the body that provide for cell energy and brain signal transmission] and Aspartate transaminase (AST) [which helps in the formation of the amino acids used to make several different body proteins such as hemoglobin], into the bloodstream). Other symptoms of MBC are abdominal pain, loss of appetite, fevers, nausea, sweats and vomiting. In some cases, there are no symptoms.

Tests that may be done to diagnose liver metastases include a CT (Computer Assisted Tomography) scan of the abdomen, liver function tests (to check for the elevated enzymes mentioned above), MRI (Magnetic Resonance Imaging) of the abdomen, PET (Positron Emission Tomography) scans or ultrasound of the liver

Pain from this kind of liver cancer responds to chemotherapy and analgesia. Doctors can also try radiation therapy to relieve pain and shrink the cancers.

How well you do depends on the location of the original cancer and how much it has spread to the liver. As recently as January of 2011, doctors have added a new treatment to the arsenal: Resection (removing parts of the liver affected by the cancer) of breast cancer liver metastases paid off in a survival benefit in patients with chemotherapy-responsive, estrogen receptor (ER)-positive primary tumors, according to data from a retrospective chart review.

“Although the cases were small in number, they are relevant in the context of changing views about cancer that metastasizes to the liver…I think there has been a [dramatic change in thinking] over the past 10 years or so, where it has been realized that this surgery can lead to long-term survival…I don't think that was recognized previously…I think there has been something of a nihilistic attitude toward breast cancer metastasis to other organs in the past…Generally incurable, most liver metastases from breast cancer are treated with chemotherapy or hormonal therapy,” said Daniel E. Abbott, MD, of the University of Texas MD Anderson Cancer Center in Houston. “I think this information is most valuable when people are willing to counsel patients and make the tougher decisions about who should and should not have surgery and then let patients make informed decisions.”

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

BREAST CANCER RESEARCH RIGHT NOW! #65: Breast Cancer is Like An Old Movie From My Youth – “A Thief In The Night”…

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…

Every month, I’ll be highlighting breast cancer research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: How breast cancer avoids immune system detection.

“The team broke the data down into different groups and identified seven clusters of breast cancer patients based on the immune evasion mechanisms that breast cancer uses to avoid detection. Some of the types even used a combination of ways to hide from the immune system.”

The idea of breast cancer cells hiding from the body’s immune system brought to mind a movie I saw in the mid-70s called “Thief In The Night”. In it, life was going on fine and dandy for the Christian Church when suddenly, all the Christians disappeared in an even called the Rapture of the Church. At that point, becoming a Christian (the disappearance of their Christian friends made some people realize that what they’d said was TRUE…) but at the cost of their lives (sort of like becoming a Christian in several Muslim countries now).

A Biblical figure called the Anti-Christ appeared – sort of out of nowhere, from whence the title of the movie comes, which was lifted from the Bible: 1 Thessalonians 5:2 “For you yourselves know full well that the day of the Lord will come just like a thief in the night.”

The upshot of this is that breast cancer is NOT like other cancers. It’s sneaky.

It is a thief – I don’t think even the most devout atheist would argue that breast cancer is a thief that steals life, love, peace, and joy. At least at first.

Why were they sifting through the data? Because the majority of breast cancers have proven resistant to immunotherapy – “…also called biologic therapy…a type of cancer treatment that boosts the body's natural defenses to fight cancer. It uses substances made by the body or in a laboratory to improve or restore immune system function. Immunotherapy may work by stopping or slowing the growth of cancer cells.” It creates a double problem – any cancers that travel from the original breast cancer site and lodge elsewhere causing metastatic cancers – are also untreatable with the newer immunotherapies.

The end result for this team of researchers: “Knowing more about breast cancer tumors and how they work will give oncologists more tools to treat patients, whether it is with yet-to-be developed immunotherapy drugs or the traditional combination of chemotherapy and radiation, researchers said. It may also help researchers design clinical trials for potential drugs…Cancer treatment isn't as personalized as it should be…We've been trying to understand what's really going on with these tumors and how they operate. That way doctors can ultimately better treat their patients.”

If researchers can design new “security systems” in the body to protect it from both breast cancer and for blocking breast cancer cells from invading other parts of the body, then we can better prevent this “life-thief” from stealing more from us.

Resources: https://www.sciencedaily.com/releases/2018/12/181218115202.htm

Image: https://www.imdb.com/title/tt0070795/mediaviewer/rm2694724864

ENCORE #100! – Metastatic Breast Cancer: Lung Cancer

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 – only a few months after my wife was originally diagnosed.

Some twenty-two years ago, my wife’s mother passed away from lung cancer.

A child of her times, she smoked often and heavily for a number of years while raising four children, then quit – long before I met her.

Diagnose with lung cancer in 1994, she took chemotherapy, went into remission and finally succumbed to the disease in (I think – and my wife will correct me!) 1997.

Her disease was DIFFERENT than the type of lung cancer that can flare up after a woman (or rarely a man) is treated initially for breast cancer. Lung cancer after breast cancer is most often caused by 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.

“Metastatic cancer to the lungs is the spread of cancer from another region of the body to the lungs. The place where cancer begins is called the primary cancer. For example, if breast cancer spreads to the lungs, it would be called breast cancer with metastasis (spread) to the lungs. In this case, breast cancer would be considered the ‘primary’ cancer.”

Symptoms that would lead doctors to believe that the breast cancer had metastasized to the lungs are similar to those of “regular” lung cancer and would be warning signs that a person would need to see their doctor as soon as possible. They include: a cough that persists over time, or does not go away with treatment; coughing up blood, difficulty breathing (due to decreased airflow by a tumor obstructing the large airways or spread through the lungs); wheezing (caused by the interference of airflow through an airway obstructed by a tumor); pain in the chest, back, shoulder, or arm (when a lung tumor presses on nerves around the lungs); repeated lung infections such as pneumonia or bronchitis; hoarseness; and lastly, lung cancer CAN have no apparent symptoms and only appear  when a chest x-ray is done for another reason.

As well, “general symptoms” of lung cancer can sometimes present with vague concerns such as fatigue, weight loss, loss of appetite. Even depression can be a symptom of lung cancer – as well as many other conditions.

Treatment for cancer metastatic to the lungs is usually determined by the primary cancer, or origin of the cancer. Systemic therapy (chemotherapy, biological therapy, targeted therapy, hormonal therapy), local therapy – which might include surgery or radiation therapy), or a combination of these treatments. The choice of treatment generally depends on the size, location, and number of metastatic tumors; the patient’s age and general health; and the types of treatment the patient has had in the past.

References: http://lungcancer.about.com/od/symptomsoflungcance1/a/symptomslungca.htm, http://www.cancer.gov/cancertopics/factsheet/Sites-Types/metastatic

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

ALZHEIMER’S RESEARCH RIGHT NOW! #1: Marijuana In Minnesota

From the first moment I discovered my dad had been diagnosed with Alzheimer’s, it seemed like I was alone in this ugly place. Even ones who had loved ones suffering in this way; even though people TALKED about the disease, it felt for me like they did little more than mumble about the experience. Not one to shut up for any known reason, I added a section to this blog…

Every month, I’ll be highlighting Alzheimer’s research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: Marijuana in Minnesota!

Odd this…referencing the article below, published in July of 2017, over a year ago, has this to say: “The currently available examined evidence is weak and limited. It would be premature to say that the cannabis and related compounds have any effect on dementia symptoms or progression. Robust study designs with larger samples are needed to clarify the utility of Cannabis in AD.”

So why the rush (no pun intended)? Why the stampede to give cannabis to Alzheimer patients when this review of two (2) studies specifically targeted Alzheimer’s and “were predominantly used for the management of neuropsychiatric symptoms (NPS). Two studies on THC reported no change in NPS and no severe side effects. The other three studies reported variable and inconsistent improvements in NPS.”

Oh! I missed this from the Alpha News article: “State officials say there is some evidence the use of medical marijuana may improve the quality of life for people with Alzheimer’s by improving their mood, sleep and behavior.”

That sounds like a ringing endorsement, a reason to rush to dope seniors who have Alzheimer’s.

Surely there must be a more solid foundation, a larger study that exhibited startling or even clear results that cannabis resulted in improvement of moods, sleep, and behavior. How MUCH of an improvement?  What were the parameters of the study that caused this bill to be passed?

Oh! I missed this definitive research in the StarTribune: “The Minnesota Department of Health announced Monday that it was adding the degenerative neurological disorder to the program, despite limited evidence on the effectiveness of treatment with cannabis.”

Honestly? I don’t understand this – patients who have been diagnosed with “hepatitis C, juvenile rheumatoid arthritis, opioid use disorders, panic disorder, psoriasis and traumatic brain injury” will get no relief from MaryJane.

Irritatingly, the state I live in seems to be the target of some exciting business growth opportunities: “Nic Easley, a national cannabis consultant and CEO of Denver-based 3C Consulting, said that based on market growth, the industry in Minnesota soon could prove lucrative for two to three players.”

Hmmm…I’m not convinced this is a good thing. But what do I know? I’m just a bofwhig and a Christian and not a terribly important demographic. While I understand it may alleviate some of the conditions of Dad’s Alzheimer’s, “Some studies have found that cannabis disrupts the tau proteins that are a hallmark of Alzheimer’s and inhibit brain function. But they were only in animal models, said Petersen, who directs the Mayo Clinic Alzheimer’s Disease Research Center and serves as a science adviser to the Alzheimer’s Association.”

In a coda that didn’t make it to the headlines, Peterson added, “‘We have cured Alzheimer’s disease time and time again’ — in lab and animal models, he said. ‘But that hasn’t translated to humans yet.’”

Resources: http://alphanewsmn.com/republicans-applaud-addition-of-alzheimers-to-medical-marijuana-list/, https://www.alzheimersanddementia.com/article/S1552-5260(17)30907-X/fulltext, http://www.startribune.com/alzheimer-s-added-to-minnesota-s-medical-marijuana-list/501803661/, https://mjbizdaily.com/what-are-the-medical-marijuana-business-hurdles-in-minnesota/

Image: https://www.meduniwien.ac.at/web/fileadmin/_processed_/e/1/csm_shutterstock_142671010_4683b6bf13.jpg

ENCORE #99! – Metastatic Breast Cancer: Bone Cancer

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 2011.

What IS bone cancer and why did do people 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!!!

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg