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Breast Cancer (Expert Forum)
What are available chemo options with recurring bone metastasis
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
What are available chemo options with recurring bone metastasis
by MaryH, Mar 15, 2004 12:00AM
My friend was diagnosed with infiltrating duct cell carcinoma (grade II, 2.2 cm.) in 1999. She also had 6 of 17 lymph nodes positive and HER2/neu FISH test was negative.The estrogen and progesterone receptors were positive. She was 36 years old at the time (never married, no children). She had a lumpectomy followed by radiation. She was put on a regimen of fluorouracil, adryamicin and cytoxan (thorough 8/00). She was also placed on Tamoxifen. She had bone metastasis by May of 2000. She was placed on Taxotere in July of 01 through December 01. She was also placed on Herceptin from August 01 through October 02. In addition she was also taking estrogen suppressing medication such as Femara, Aredia, Zoladex. By September of 03 she had her first brain metastasis which was treated with sterotactic radiation. She also had new bone activity. She was placed on Navelbine on October of 02. She was also placed on Zometa. She had a second brain metastasis in October of 03. This was treated with a gamma knife. She was then placed on cytoxan and epirubicin. She continues to have new bone activity (spine and femur).The doctor recommends her now going on a regimen of taxol and carboplatin. Do you concur? Is there anything else she should be doing at this point? What is the toxicity level of taxol and carboplatin? Do these work in a different manner than the other regimens that have failed to stop the bone and brain metastasis? She is depressed and not willing to continue to fight. I am trying to help her find options.
Doctor's Answer
by CCF-RN,MSN-JS, Mar 15, 2004 12:00AM
Dear MaryH, There are multiple possible regimens that can be used in metastatic breast cancer. The decision on what to use is based on prior treatment responses, expected toxicity, and the patient's and oncologist's perceived benefit. These drugs, and most traditional chemotherapies, do not cross the blood-brain barrier and therefore will not affect the development or treatment of brain metastasis. A major goal of care at this point would be symptom control. Your friend may benefit from the help of a social worker or counselor who can help her sort through pros and cons of therapy and determine options that best fit with her priorities.
