please advise on treatment for bone mets

[Arkait]

I have MBC since 2013, stage four as of 2019. I'm on Letrozole only Have lymph nodes enlarged,and malignant pleural

effusion in one lung New bone met on sacrum. should I be taking

something besides Letrozole for bone mets?

[Hidden]

I have bone Mets and take Ibrance and anastrazole. My understanding is Ibrance is the standard of care so you should ask why it’s not offered. Some folks here have side effects. I’ve been fortunate. All I noticed was serous fatigue. We reduced my dosage from 125 mg to 100 mg and I’m doing well. Low tumor markers. Good luck.

[Fighteragain18]

I thought mbc was stage 4 to begin with ??

[Albert23 in reply to Fighteragain18]

I do t know thought the same as u

[blms in reply to Albert23]

Yes

[Hidden]

Hi Mary,

I have two spots on my spine, so was also put on zometa infusions every 12 weeks to help strengthen my bones, and my oncologist prescribed Adcal D3 (calcium carbonate and vitamin D3). I would have a word with your oncologist and find out what else can be done for you personally, as we are all so different. But I would not let anyone fob you off because of your age. I get really upset when I hear that elderly patients are not receiving the same level of care as younger patients. Doctors have a duty of care to all their patients, regardless of their age.

You have mentioned before that you have a heart condition, so I imagine that must feature into your doctor's plan of action. If possible, I would take someone along with you to your next appointment who can advocate for you if you feel you need the support in speaking up.

Sophie

[Arkait in reply to Hidden]

Dear Sophie, I much appreciate your answering my question. I believe Zometa is not

to fight cancer but instead to strengthen bones. I was wondering if Letrozole is adequate for

bone mets as it would seem some patients are given a different drug for bone, or liver mets,

for example..?

[Hidden in reply to Arkait]

Hi Mary,

Yes, you're right that zometa is intended as a bone strengthener. I thought that's what you were asking about. Sorry for the misunderstanding. I know that herceptin is given to some patients with liver metastases or if they are HER2+, but I don't know of another drug specifically for bone metastases.

Sophie

[Godbeforme in reply to Arkait]

Hello! I was put on letrozole and I have bone mets. I was just in here checking on you and I see it's been a month since you've posted. I hope you are doing well, Mary, please give me a shout when you have time. Miss seeing you and sending hugs! God bless you and heal us all in Jesus name, amen! <3 xo

[Hidden]

This would be a decision for you and your oncologist. I was diagnosed with stage 4 breast cancer with Mets to my bones only after an mri on my hip showed cancer. Before that no diagnosis for breast cancer. I take letrozole and Ibrance

[Purple60]

I can’t answer for policy by NHS or other government run healthcare but denusomab (Xgeva) is quite standard to help treat bone mets. It also seems to me if the bone mets is new then the letrozole alone may be starting to fail you. You may need other medications.

[Arkait in reply to Purple60]

Dear Purple60, Thanks for taking the time to answer my question about bone mets.

I get confused between bone strengthening agents (calcium added to bones) versus

bone cancer oppositional agents/drugs. Which is Xgeva?

[Southside25]

I have bone mets on my spine and sternum and have been getting Xgeva shots every three months. The mets haven't improved, but they are stable and haven't gotten any worse.

[Arkait in reply to Southside25]

I get confused between bone strengthening agents (calcium added to bones) versus

bone cancer oppositional agents/drugs. Which is Xgeva?

[Southside25 in reply to Arkait]

Hi. My understanding is that if you take Xgeva like once or twice a year, it's just for bone-strengthening, like for osteoarthritis. If you take it more often, like monthly, it's to help heal, reverse or stabilize bone mets. I got the shots every other month in the beginning of my treatment - maybe the first six months, now quarterly.

[NPmary]

There is evidence that adding a CD4/6 inhibitor like Ibrance (There are 2 others) will lengthen progression free time. Radiation can possibly treat effusion steroid medicine like prednisone or dexamethasone can treat the effusion. Good luck!

[Hidden]

I have bone Mets and take Letrozole and Ibrance. Are you taking other drugs for your lung? If you are that may treat the bone also. Ask your oncologist as they would know all of your medical issues.