Compression fracture on T 10

[Brightman]

My recent Whole body scan and CT scan for PCa ( diagnosed in 2016 with T3N0M1, after which I had radiation,chemotherapy and have been on hormone therapy since), showed a compression fracture on my T10 where I had SBRT radiation 2 years ago. My scans earlier in the year also showed a small fracture on my T9, which has shown to be healing in the latest scans. I am on fentanyl patches for pain. I will have an MRI this afternoon which will include T8-T11. My questions are these:

1. If my MRI shows cancer in my T10, can it be radiated again ? Would this radiation impact on my compression fracture?

2. Will my compression fracture eventually heal and pain reduce so that I can discontinue Fentanyl?

The tumour on my 6th rib has also grown in size, so will also have to be radiated at some time. Is it possible to have radiation on the T10 and on the rib at the same time? I meet again with my RO on Thursday. Thank you for any information. I learn so much from this site. Cheers from Adelaide South Australia.

[Seasid]

What is your PSA now and which medication (treatments) did you had until now and what is your medication now?

Did you have bone strengthening medication and when?

[Brightman in reply to Seasid]

My PSA is now 0.04. It was 0.02 in January and last November it was <0.01, which it has been for most of my journey (except when first diagnosed in 2016 it had jumped from 1.8 to 5.3). So the radiation, chemotherapy and hormone therapy have generally controlled it. I started Xgeva at the beginning of this year when the fracture on my T9 was found after a whole body bone scan and since then have an injection every 3 months.

[Seasid in reply to Brightman]

Did you have a bone density scan?

What is the hormone therapy you are on?

Did you have a compression fraction as a result of the visible cancer met? As result of osteoporosis, or just a weakened bone as a result of radiation and previous met?

I am not an expert but myself trying to understand these things.

It looks to me that if you are hormone sensitive than the mets stop healing if you are on bone strengthening medication. But you are now crpc? Therefore good that you are on bone strengthening medication.

What I still don't understand but maybe someone will know and comment is if the bone strengthening medication interferes with broken bone healing?

[Brightman in reply to Seasid]

Thanks. Yes I have a bone density scan every 2 years so last one was at beginning of 2022, which showed osteopenia only. Compression fracture they think was due to weakened bone, possibly due to cancer there. But because I had SBRT on that T10 vertebrae in 2021, I wonder if radiation has weakened it? I Have just returned home from an MRI on my T8-T11 vertebrae ( yes strange on a Saturday afternoon but that was the next one available). Will see RO on Thursday to see if fracture is due to mechanical or cancer processes and treatment will be decided then. I am on Eligard every 6 months.

Yes your question about the impact of XGeva on broken bone healing is one I have too.

[Seasid in reply to Brightman]

And if you are still in a hormone sensitive phase than it could stop the healing of your mets.

[Seasid in reply to Brightman]

And if you are still in a hormone sensitive phase than it could stop the healing of your mets.

[Blue-Mockingbird]

My husband has a compression fracture of his T7 vertebrae making mobility difficult for him. He was told by the neurosurgeon that the usual spinal surgery was out of the question due to multiple spinal mets. I have a question in for him regarding Vertebroplasty to see if that’s an option.

You asked about simultaneous radiation on spine and rib. My husband had right pelvis and left rib radiated but they were done separately.

[Brightman in reply to Blue-Mockingbird]

Thanks for that. I see the radiation Oncologist on Thursday. Will see what she says then when she views my MRI from Saturday. From what she said the last time I saw her about a week ago, she will treat the two areas separately.

[Brightman]

Just an update on my progress. My psa is back to <0.01 thank goodness. SBRT Radiation on my 6th rib seems to have been successful according to my recent whole body bone scan & CT scan. However the associated increased pain has led to an increase in my fentanyl patch relief to 25um/h. However over the last week the compression fracture on my T10 has increased significantly, especially in the mornings when I get out of bed. I am considering getting a back brace to overcome this pain.

Has anyone else used a back brace? How successful has it been? My oncologist says that they can be uncomfortable but suggested that I try one out. Would appreciate some feedback on this.