My wife Jennifer age 59 had a r nephrectomy 11/06. has mets to the l acetabulum and has just finished the third month of Sutent with good results all areas of mets are either stable or shrinkage 33-50%. although the mets are responding, the ct also showed a fracture of the l acetabulum. the tumor area is aprox 6 cm in diameter. Doctor's don't think because of her overall weakness that she could tolerate a total hip replacement surgery. We are continuing the Sutent at 37.5mg 4 wks on and 2 wks off. for the next three months then rescan. My question is: Can anything be done to relieve her hip pain besides drugs? She is currently barely controlled by Methadone 30 mg every 8 hrs and Dilaudid 8 mg in between for break thru pain. but this leaves her mostly bed bound. or up in wheel chair for a short period of time as tolerated. She just lays in bed all day can't turn because of the hip pain. no skin breakdown or Pneumonia yet but I'm sure it's on the way at some point.,Will the acetabula eventually heal if the cancer continues to shrink? Can new bone grow into the cancerous area? Any thoughts or ideas appreciated. Thanks Mike
Pathologic factures (due to cancer) do not usually heal well without intervention. Your wife's condition is complex, and treating the cancer is most important and that is her current regimen. It is unfortunate that she has a hip fracture, as this is a debilitating problem, as you stated. There is not a great solution to the pain beyond medication and surgery (which would ultimately help her quality of life). If she is not getting out of bed during the day, I would suggest having her do deep breathing exercises (you get an incentive spirometer that patients get after surgery) to help expand the lungs and prevent pneumonia. This and trying to get her up in a chair or shift weight will help with skin breakdown. Once her course of sutent is complete and she has more strength, perhaps a hip surgery can be re-addressed.
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