plz,your opinion!!!!!!

[bigbossy79]

My mother has BC from june-2005 and after two years she has bone metastatic and now

as CT


"Widespread bony metastasis involving nearly the whole spine.
In particular at D8,D9 & D10 there is a large bony lytic lesion with some surrounding soft tissue component. The soft tissue component is indenting the thecal sac and its content which may need MRI for proper assessment of the spinal cord compression.
There is significant collapse of D8 with minimal anterior displacement of the spine above this level in relation to the lower lumber spine but I believe the central canal is still roomy.
The mentioned lytic lesion is more towards to the right side and likely infiltrating and compressing the right nerve root at this level. "



and as MRI



"Diffuse abnormal signal involving the whole spine appearing hypo-intense in T1 and T2W images and showing enhancement after contrast.
Pathological compressed fracture involving the D8 verteba associated with intraspinal enhancing component extending one level above and below compressing the subarachnoid space and the nerve roots but not causing spinal cord compression.It results in thoracic kyphosis.
No evidence of spinal cord compression.
The conus medullaris appears normal.
No evidence of intra medullary cord lession."

Plus that she has

"Osteoporosis" in her spine...

Now , there is a lot of opinions...
1)
talk about the surgery with metal component and something called smint to make bone strong to hold the mental.
2)
talk about baloon and something called smint..
3)
said just wear some thing to fix all without any medication..

4)
talk about that we must make the bone strong using zometa and after that we can talk..

Really,I dont know what must i do...

Please give your opinion and who is the right person...

If you have any question about her case I'll answer you very quickly...

thx in advanced

[japdip]

Radiation is the usual recommended treatment for bone metastises .... it helps to relieve the pain. To put your Mother thru spinal surgery would be a great risk .... the anesthesia might be too much for her comprimised system. I would never take that risk with a member of my own family.  The Radiation would not cause her any additional discomfort and could help ease her pain.  

[bigbossy79]

Dear japdip,

Our fault that we try to ask a proffessor and here start the troubles...

My mother's oncologiest is hate this prof. and hate us because we trying to ask another one...

however,the Prof. said that mom is not in a bad situation and there is a lot to do for her..but he will not do anything because her doctor...

We ask her Anesthesiology if she is ready to any operation,he said yes but with risk..
the risk here contain 6 level;level one less risk level 6 very high risk...

Mom got level 3...

We asked many of Doctors and most of them said we must hurry up and doing the surgery..

her onclogiest said we can give her some radiation to disappear the pain..but there is no one agree with him because the radiation will solve the problem and they fear for her spinal cord...

So we hesitate surgery and her oncolgiest and some times thinking that some doctors here working for a money not for relief the patient  ...



Thanks alot fo your reply...

[japdip]

I was unable to access the CT thru our system. So, you haven't seen any type of Physician other than your Mother's Oncologist ?? I was thinking you might have seen a Neurosurgeon based on the suggestions that you mentioned. I have re-read the reports and I know all about the pt.s side of these compression fractures of the spine. My own mother had many along her thoracic spine and suffered severe pain. Although my Mother didn't have cancer the pain is the same when your vertebrae collapse. I don't know your Mother's present condition (quality of life) but I hope the Dr. has offered some sort of pain relief and if she is indeed in the terminal stage of cancer she should be kept as comfortable as possible and with today's methods it's VERY possible. If she is not able to be up and around I would hesitate to traumatize her further with any type of surgical procedure. There is a point where we have to concentrate on making our loved ones as comfortable as we can when no other treatment is available. If you wish and your Mother is able you could seek a second opinion from another Oncologist but remember that sometimes there just aren't any more answers. It's not fair but unfortunately it's life and we have to deal with it the best way we can.   Kindest regards ...

[bigbossy79]

Dear japdip,

please take a look on her CT

http://gocybertech.com/mom/

and give me ur opinion here...

her Oncologist doesn't want to do anything before 2 years a go..

and we asked for her back before this bad situation but no answer..just he said she will die very soon and nothing to do...it's not in a bad situation like his mentioned but he dosn't want to make anything for her...

So I think we can't question him to anything..we are trying to fix what we can..

So please take a look on the CT and answer me...

No bone on D8...the report they gave us wrote D8...I know there is nothing called D8 but it's T8...You are right...

waiting ur reply...

thanks once again...

[japdip]

With the limited information it's impossible to offer a suggestion but actually all 4 that you listed are good and a combination might be even better. This is something that should be discussed in depth between your Mother, her Oncologist and You. Treatment at this stage would depend on many factors. I'm a little confused by your description of the areas of involvement; I think you meant T rather than D when noting the vertebrae. It is in the Thoracic area (upper back), isn't it ?? There are no vertebrae described with the letter D. The balloon procedure is when a balloon type device is inflated between the vertebrae and then a cement is injected to return them to their normal position. It's considered the more NON-invasive type of procedure. The drugs mentioned are used to strengthen the bone but this doesn't produce immediate results. A brace that would be tailored especially for her might help but it would depend on how willing she was to wear it and how much pain relief it would actually give her. At this point pain relief seems to be the main objective so your main question to the Oncologist or the Neurosurgeon should be "which one / or two would give me mother the most relief and be the least traumatic to her?" Hope this has helped somewhat.