Follow Up about a friend with Bone Mets

[TommyGun548]

I have a friend who has Stage IV mets to her spine that are inoperable and she is taking femara as well as Vicodin and Methodone for pain. I saw her today and she has lost a lot of weight but is still working. She told me today that her Dr. told her she has hips that look like swiss cheese due to the holes in them from the cancer. Does anyone have any experience with these conditions and what they say about her prognosis. She seems to think she can get a lot more quality life to live thru the femara as well as adding some weight back that she has lost. Is there hope that the holes in her hips will be able to heal and if not then what does she face ? Her mind is still sharp and she has a fighting spirit still.

[zouzi]

If I were you I would stop worrying and breaking my head about all the details of your friend's situation. I am sure that she knows perfectly well what her situation is.Her doctors and oncologist must be taking all the necessary steps to make sure that her treatments are the best she can have.If your friend's situation is in fact terminal and even if she is in denial,she will eventually need you to be close to her and to support her.Only God knows when it's the time for her to go.We can only speculate and think for the better or the worse.So please don't fill yourself with too much anxiety.about all the details..just love her and be there for her when the time will come that she will need you the most. Take care...

[TommyGun548]

Again thanks to both of you for being kind enough to share your thoughts and info. on this subject. I am very grateful. I guess what has me most confused is the info. from so many that bone mets are very treatable and women can survive for years if it's only in the bone. That is very promising obviously. What isn't is that her hips are like "swiss cheese" as per her Dr.  She walks sideways for lack of a better description and has inoperable tumors on her spine. Also her weight loss is very noticeable and that really concerns me. The other issue I see is that it's in her blood stream but they haven't done anything to treat that but are just focused on palliative treatments so it would seem it's bound to appear somewhere else its just a matter of time. One Dr. told me that the problem also is her quality of life isn't good now and will continue to diminish as time passes.

[bluebutterfly2222]

Since none of us can really answer your question, my suggestion to you for dealing with your uncertainty and anxiety would be to follow that time-honored advice, "Hope for the best, but prepare for the worst."

If you work really hard to get yourself prepared for the fact that you could lose your friend TOMORROW, then you will be better able to ride along with her through whatever ups and downs may  occur, during whatever  period of time she may have left.

My thoughts and prayers will be with you both....

[katarina777]

I think it is a good sign that your friend is working, it's a good sign to/for showing her spirits. And ultimately, those matter the most? Kat

[katarina777]

THE ZOMETA SHOULD HELP A LOT WITH THE BONES AND THE BONE PAIN. THANKS, BB2222 FOR POSTING THIS ALL HERE. (sorry for the capital letters, accident)

TommyGun548, I think you are not too off. I get the same feeling. Your friend though seems to be telling the truth.

Just be there as you have been.

Kat

[TommyGun548]

Thank you very much for all this info. I am grateful to learn about what she is dealing with and I do appreciate your help. Everyone tells me to trust my instincts when it comes to things like this but honestly I've never known anyone who has had this type of cancer until now. I fear she is really facing the last few months of her life but that is just my feeling, nothing has been shared to that effect. Based on what I've shared do you think my friend is in that stage/time frame ? I know everyone is different but there are a lot of signs it seems pointing to her disease being very advanced and even though bone mets are treatable as some have shared, It does seem that her situation based on my limited knowledge is very advanced. Any thoughts on this would be welcome.

[bluebutterfly2222]

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What  SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet. Eat and drink normally on the day(s) you receive a dose of zoledronic acid. Be sure to drink at least 2 glasses of water or another liquid within a few hours before you receive zoledronic acid.


What should I do IF I FORGET to take a dose?

If you miss an appointment to receive a zoledronic acid infusion, call your doctor as soon as possible.


What SIDE EFFECTS can this medicine cause?

Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.


Zoledronic acid may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:


redness or swelling in the place where you received your injection
red, swollen, or teary eyes
constipation
nausea
vomiting
diarrhea
stomach pain
loss of appetite
weight loss
heartburn
mouth sores
excessive worry
agitation
depression
difficulty falling asleep or staying asleep
fever, chills, and other signs of infection
white patches in the mouth
swelling, redness, irritation, burning, or itching of the vagina
white vaginal discharge
numbness, burning, or tingling in fingers or toes
hair loss


Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:


rash
hives
itching
swelling of the eyes, face, lips, tongue, throat, hands, arms, feet, ankles, or lower legs
difficulty breathing or swallowing
upper chest pain
irregular heartbeat
numbness or tingling around the mouth
sudden tightening of muscles
unusual bruising or bleeding
painful or swollen gums
loosening of the teeth
numbness or heavy feeling in the jaw
poor healing of the jaw


Zoledronic acid may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

What STORAGE CONDITIONS are needed for this medicine?

Your doctor will store this medication in his or her office and give it to you as needed.


What should I do in case of OVERDOSE?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.



Symptoms of overdose may include:


fever
weakness
muscle cramps
fast, pounding, or irregular heartbeat
dizziness
depression
difficulty walking
seizures
confusion
shortness of breath
sudden tightening of muscles
numbness, burning, or tingling in fingers or toes
muscle weakness
double vision
difficulty speaking



What OTHER INFORMATION should I know?

Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.



Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to zoledronic acid.



It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

[bluebutterfly2222]

Continued from previous post:
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What SPECIAL PRECAUTIONS should I follow?

Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.



Before receiving zoledronic acid injection,



tell your doctor and pharmacist if you are allergic to zoledronic acid or any other medications.

you should know that zoledronic acid injection is available under the brand names Zometa and Reclast. You should only be treated with one of these products at a time.

tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: aminoglycoside antibiotics such as amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex), neomycin (Neo-Rx, Neo-Fradin), paromomycin (Humatin), streptomycin, and tobramycin (Tobi, Nebcin); cancer chemotherapy medications; loop diuretics ('water pills') such as bumetanide (Bumex), ethacrynic acid (Edecrin), and furosemide (Lasix); oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); and thalidomide (Thalomid). Many other medications may interact with zoledronic acid, so tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

tell your doctor if you have ever had a low level of calcium in your blood. Your doctor will probably check the level of calcium in your blood before you begin treatment and may not prescribe this medication if the level is too low.

tell your doctor if you have been treated with zoledronic acid or other bisphosphonates in the past; if you have ever had surgery on your parathyroid gland (small gland in the neck) or thyroid gland or surgery to remove sections of your small intestine; and if you have or have ever had heart failure (condition in which the heart cannot pump enough blood to other parts of the body); anemia (condition in which red blood cells cannot bring enough oxygen to other parts of the body); any condition that stops your blood from clotting normally; any condition that prevents your body from absorbing nutrients from food or problems with your mouth, teeth, or gums; an infection, especially in your mouth; asthma, especially if it is made worse by aspirin; or parathyroid, kidney, or liver disease.

tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. You should use a reliable method of birth control to prevent pregnancy while you are receiving zoledronic acid. If you become pregnant while receiving zoledronic acid, call your doctor. Talk to your doctor if you plan to become pregnant at any time in the future because zoledronic acid may remain in your body for years after you stop receiving it.

you should know that zoledronic acid injection may cause severe bone, muscle, or joint pain. You may begin to feel this pain within days, months, or years after you first receive zoledronic acid injection. Although this type of pain may begin after you have received zoledronic acid injection for some time, it is important for you and your doctor to realize that it may be caused by zoledronic acid. Call your doctor right away if you experience severe pain at any time during your treatment with zoledronic acid inejction. Your doctor may stop giving you zoledronic acid injection and your pain may go away after you stop treatment with this medication.

you should know that zoledronic acid may cause serious problems with your jaws, especially if you have dental surgery or treatment while you are using the medication.A dentist should examine your teeth and perform any needed treatments before you start to use zoledronic acid. Be sure to brush your teeth and clean your mouth properly while you are using zoledronic acid. Talk to your doctor before having any dental treatments while you are using this medication.
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*********************TO BE CONTINUED *****************************************

[bluebutterfly2222]

Yes, you got the name right. Here's the scoop on it:
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WHY is this medicine prescribed?

Zoledronic acid (Reclast) is used to treat osteoporosis (condition in which the bones become thin and weak and break easily) in women who have undergone menopause ('change of life,' end of regular menstrual periods). Zoledronic acid (Reclast) is also used to treat Paget's disease of bone (a condition in which the bones are soft and weak and may be deformed, painful, or easily broken). Zoledronic acid (Zometa) is used to treat high levels of calcium in the blood that may be caused by certain types of cancer. Zoledronic acid (Zometa) is also used along with cancer chemotherapy to treat bone damage caused by multiple myeloma [cancer that begins in the plasma cells (white blood cells that produce substances needed to fight infection)] or by cancer that began in another part of the body but has spread to the bones. Zoledronic acid (Zometa) is not cancer chemotherapy, and it will not slow or stop the spread of cancer. However, it can be used to treat bone disease in patients who have cancer. Zoledronic acid is in a class of medications called bisphosphonates. It works by slowing bone breakdown, increasing bone density (thickness), and decreasing the amount of calcium released from the bones into the blood.


Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.


HOW should this medicine be used?

Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.



Zoledronic acid comes as a solution (liquid) to inject into a vein over at least 15 minutes. It is usually injected by a health care provider in a doctor's office, hospital, or clinic. When zoledronic acid injection is used to treat high blood levels of calcium caused by cancer it is usually given as a single dose. A second dose may be given at least 7 days after the first dose if blood calcium does not drop to normal levels or does not remain at normal levels. When zoledronic acid injection is used to treat bone damage caused by multiple myeloma or cancer that has spread to the bones, it is usually given once every 3-4 weeks. When zoledronic acid injection is used to treat osteoporosis, it is usually given once a year. When zoledronic acid is used to treat Paget's disease of bone, it is usually given as as a single dose, but additional doses may be given after some time has passed.



Your doctor may prescribe or recommend a calcium supplement and a multivitamin containing vitamin D to take during your treatment. You should take these supplements every day as directed by your doctor.Tell your doctor if there is any reason that you will not be able to take these supplements during your treatment.



You may experience a reaction during the first few days after you receive a dose of zoledronic acid injection. Symptoms of this reaction may include flu-like symptoms, fever, headache, and bone or muscle pain. These symptoms may begin during the first 3 days after you receive a dose of zoledronic acid injection and may last 3-14 days. Your doctor may recommend that you take a nonprescription pain reliever/fever reducer after you receive zoledronic acid injection to prevent or treat these symptoms.

******TO BE CONTINUED************

[TommyGun548]

Thanks for the info. I just got an e-mail from her and she said she is taking an IV once a month called Zometa ? Not sure if I got the name correct. She just seems to feel that are at least act like this is a bump in the road for her. While I know she is concerned she seems to think this is beatable. She did say her Dr. mentioned some drug that is like a cement so this must be what you shared. She did say that it wasn't needed yet so she wasn't going to worry about it for now. All the signs point to her being in a very bad way even the info you shared about this med. being used for people who have a short life expectancy. Now while this isn't being used on her yet the Dr. has told her about it as an option. Sounds like more bad news.

[bluebutterfly2222]

I understand how distressing it must be for you to see your friend appearing so ill. It requires a great deal of love--not to mention strength of character--to stand by her, rather than distancing yourself to lessen your own pain.

I don't know if it is widely available yet, but I read recently that there is a procedure, called osteoplasty, that can sometimes relieve the pain of metastatic bone disease. I am going to insert the information below:

"Many cancers--including those of the breast, bladder, kidney, and lung--impact on bone health when cancer metastasizes to the bones (bones are the third most common location to which cancer cells spread).The resulting tumors eat away at the bones, creating holes that make them thin and weak. The condition, called metastatic bone disease, is painful and renders daily activities and sleep difficult.

A study presented at the Society of Interventional Radiology's annual scientific meeting in March 2009  suggests that osteoplasty could be a solution. Osteoplasry is a minimally invasive procedure that involves injecting semi-liquid bone cement into the bone lesions, to support weakened bones in patients who have short life expectancies and aren't responding to conventional pain medications. Of the 81 patients included in the study, 64 (79%) were able to stop taking narcotic drugs for their pain, and 43 (53%) could stop taking other pain medication. Researchers say the resullts should encourage more wide spread applicatiohn of this palliative interventional radiology treatment."

Warm regards...

[TommyGun548]

Kat, She mentioned to me yesterday that she does feel nausea a lot as well as fatigue/foggy and her legs have a constant tingling in them. She is trying to regain the lost weight which is very noticeable. She looks like a very ill woman. I just wonder since bone mets are very treatable is this just a down time for her and she will make some kind of rebound for the future or is she really failing. Her comment about her hips looking like swiss cheese hit me hard as well as her saying that they could break at anytime if she isn't careful. Yet she says she will continue to work as long as she can.  I just wonder about her odds at surviving this for a few more months or a year etc. etc. AS of now her Dr. has not given her any prognosis which I assume is good news ?

[katarina777]

The way narcotics work is not so much that they get rid of pain but rather that the pain does not bother you any longer. They also work this way on psychological pain for those people who do well with narcotics. (not all people do, and they can cause many side effects like nausea and/or fatigue, and breathing problems, and more) For others they actually provide energy, especially vicodin, whereas methodone is more numbing and foggy making.

[katarina777]

With all the other things you are keeping in the back of your mind, you may also keep there the possibility that your friend is an addict.  This only crosses my mind in relation to other potentially helpful treatments she may be avoiding. It's just a thought, not something I know.

[japdip]

It is a well known fact that bone mets is the most manageable of all metastatic cancers. As far as her specific case, her Oncologist would be the best person to answser the question about her prognosis; IF there is an answer. A positive attitude and fighting spirit is definitly an asset.  Regards ...

[katarina777]

There is an IV medication that works very well for strengthening the bones but I do not know much about it and not even the name right now. (I am sure someone else here will know)

I am surprised she is using Vicodin on top of the Methadone; these are not usually combined at all. Methadone alone is dangerous enough and it just does not make any sense to me.

This bone infusion also works very well for the bone pain and I remember your saying before that the radiation was not effective for pain relief.

The 'swiss cheese' bones are very fragile and they easily break.
Femara does not help with the bones at all but it is otherwise often very effective systemic treatment/prevention for hormone positive cancers, and which she must have.

This is all I know and I hope you get some more responses.

Best,

KATRIN