bone mets pain

[43lady]

One year ago I had recurrence to my adominal liner. I went through Herceptin with Abraxane and Carboplatin from Aug through Dec. My CA27.29 markers were normal until around Jan a year ago, then went up to around 80 in Jul. Cancer was undetected through all imagery tests including PET. It was only confirmed with a lapascopy. The markers continued to stay around 80 for the six months I was taking chemo. I went off all meds in Jan. Since mid Feb to mid Apr my markers went to 180. I started Femara in early Apr. After one month, marker went down to 170. About the same time I started Femara, I have constant sever pain in my right rib area and now pain in my lower right skull. Bone scan was negative. I know this is likely to be bone mets, but is it possible this could caused by Femara, since the bone scan was negative?


This discussion is related to Bone metastasis rise in CA2729.

[43lady]

Just an update. My CA27.29 marker went down from 120 to 51 in one month! I on Femara only. The pain described in the earlier post remains the same. At this rate, It appears the marker will be in the "normal" zone in less than a month. Is this decrease typical? Is the steep decrease a good thing? If it gets in the "normal" zone, should I continue to take the same 2.5 daily dosage or a reduced dosage? I know it will someday stop working, I have heard typically 9 months up to two years. If I do get the window of opportunity, are there suggestions for preventing recurrance or extending the Femara's usefullness.?  Are there specific articles I could read on this.

[PaulMD]

The pain may continue as long as you are taking the drug.  Other options to prevent the side effect of femara, though not yet fully proven is the use of drugs called bisphosphonates (pamidronate, zoledronate, etc).

[43lady]

Thanks for your reply. Just got my results from my second month on Femara: 120
This is a decrease of 50 points in four weeks. It looks like the Femara is working great!  I continue to have sever pain constantly, mainly in my right rib area. I have been on Femara nine weeks now. Are there any estimates how long this pain may continue?

[PaulMD]

Hi there.

Bone pains can indeed be a side effect of Femara, and what you are experiencing may really be due to this especially in the presence of a negative bone scan.  If you want to be really sure, a PET Scan is much more accurate in detecting bone metastases than the usual bone scan and you may want to discuss this option with your doctor.  Also, you may also discuss with your doctors regarding short term withdrawal of the drug (about 2-3 weeks) to check if the pain would go away (but this may be risky for your cancer).  Make sure you receive adequate pain medications and I hope your future markers will be normal.

Regards and God bless.