Radiation for oligometastatic bone cancer?

[Jac-genova]

Hi everyone. My mom was diagnosed with metastatic breast cancer in her bones (2 tumors - one in her T2 region and one in her L4 region) about 2 years ago. She went to see a radiation oncologist who said that she is a candidate for radiation. She is nervous about the possible side effects from it and I just wanted to ask if any women in this group had radiation and what you thought of it. Can it potentially be a curative treatment?

[Hidden]

Hi Jac-genova -

Wow, good for you mom, to be oligo/doing so well!

I'm hoping that people with more direct and recent experience weigh in but in the meantime let me say that I would do the rads in a heartbeat.

I've gone through rads twice...First after my initial earlier stage dx and then again when I was dx w/ mets and had just one tumor. The first time was harder for me, maybe because they were radiating a pretty large area? When the were doing just the one tumor it was much easier...and they were trying to obliterate it, so full blown rads, not reduce pain or similar.

My understanding of oligometastatic (sp?) disease is that many docs do treat this for a "cure". With this as the goal, I would think that any side-effects like fatigue, etc., would seem reasonable. But, again from what I understand, depending on the location of the mets there can be some risk of the rads causing real damage. E.g.when they were radiating my T12, the doc mentioned a risk of paralysis - very small risk, but still present.

I've tried to score some rads but apparently I have too many mets to qualify for radiation for anything other than pain or risk of like fractures. If I were in your mom's shoes, I'd leap at the chance...

Good luck with it!

Lynn

[Jac-genova in reply to Hidden]

Thank you Lynn I'm praying for you!

[jersey-jazz in reply to Jac-genova]

I am supposedly oligometastatic also, but only until I go for tests in a month because there is "thickening of the uterus walls". The oncologist told me that at my age, it should be a thinning the uterus wall. This is news to me. I had been hoping for some ablation of the liver metastasis but with this latest complication, it appears that they have taken it off the menu.

The point is (and it only one woman's opinion) that if your mother is really oligometastatic, she should be looking forward to having that other cancer removed before it grows, again. This advice is from a cancer patient who knows very little, is reading as fast as she can with a pretty sharp learning curve and who still knows very little about the situation we are all in.

[Jac-genova in reply to Hidden]

Lynn was the radiation SBRT?

[AvidBooklover]

Hi, I am oligometastatic too with a tumor in my hip/pelvis area. I did three sessions of very targeted radiation and they helped enormously. With drug therapy (Ibrance and Fasolodex) and that I have been NED for a while, so I do recommend it. I did get what is called pain flare after the second treatment. You can read up on that and ask about it. But it was gone quickly and nothing happened after the third one the following day. I had 25 rounds of radiation for my original breast cancer and that was a lot worse...my skin was in bad shape. This was nothing like that. I had no fatigue at all, just the pain flare that one afternoon/night. I had bone damage to the hip since the tumor hairline fractured the bone (if only we had figured this out sooner...we thought I had sciatica for 9 months!), that may not have happened. More questions, let me know. Had it done at Sloan Kettering in NYC. One more thing...I did stop Ibrance while I was being treated with radiation...I think a week before and a week after.

[Jac-genova in reply to AvidBooklover]

Thank you! Are you still on ibrance now? Once someone goes through radiation and there is NED would they still keep you on medication? My mom is currently taking letrozole

[AvidBooklover in reply to Jac-genova]

Yes, I am on Ibrance and Fasolodex shots. I was on Letrozole for 7 years after my 2012 surgery. There are questions as to how long this one tumor in my hip was there. I feel there has to be better testing, let's say at the magical five-year point to say...yep, you are all clear. Five years and clear is a myth!

[Red71 in reply to AvidBooklover]

I agree with you about testing. I think we should be tested every two years after we hit 5. Mine was pretty advanced when it was discovered at year 8.

Elaine

[hopenowandtomorrow]

I had the exact situation & experience described by AvidBooklover on this post. I highly recommend SBRT. 🙏❤️🙏

[Jac-genova in reply to hopenowandtomorrow]

do you know the stats/risks for paralysis, nerve damage, etc?

[Hidden]

Hi Jac,

I am planning to have stereotactic radiotherapy on two spots on my spine. I'm having a PET CT scan on Monday and taking it from there. The doctor told me this could be curative, but he didn't want to get my hopes up. I was also reading a medical report last night and even if it isn't curative it can increase progression free survival. One patient lived for an additional 23 years! I would gladly take that!

So if your mum has been told that she is a candidate for this treatment I would take it. Side effects can vary, so it's important she is well informed before she goes ahead.

When I had radiotherapy in 2018 I was in a lot of pain for 5 days afterwards. I lived on paracetamol, ibuprofen and codeine when the pain got too much. But I have been stable ever since and now just want to get rid of those spots altogether. So I feel that it is worth it when you weigh the benefits versus the side effects.

Sophie

[Jac-genova in reply to Hidden]

Thank you Sophie, I am praying for you!

[Hidden in reply to Jac-genova]

Hi Jac,

I didn't end up having stereotactic radiotherapy in the end.

Sophie

[Jac-genova in reply to Hidden]

Thanks for letting me know Sophie, my mom just wrapped up her last session last week and is having kyphoplasty next week. Hope you are well!

[Hidden in reply to Jac-genova]

Thank you. I am doing very well.

[JustmeMary]

Hello - I had 5 treatments of radiation in August this year to treat 2 areas (T8 and a spot on my sternum). The only side effect I had was some fatigue. I’m taking Ibrance and Letrozole now and have my first scan next Friday. 🤞🏽 Good luck to your mom 🙂

[Hidden in reply to JustmeMary]

Hi Mary,

I have a question for you. Do you think the stereotactic radiotherapy got rid of the spots on your T8 and sternum? Or do you have to wait for your scan results to know more? I wish you all the best with your scan results!

Sophie

[JustmeMary in reply to Hidden]

I guess I won’t know for sure until they look at the CT but my radiation oncologist told me the treatments were supposed to stop the growth. He said the spots will still be there but hopefully just remain stable and not grow or change. If that makes sense. 🙂

[Hidden in reply to JustmeMary]

Yes, that does make sense. Thank you! The doctor I spoke to said this treatment could be curative, but he didn't want to get my hopes up. I did read that it can increase progression free survival. I hope it has been effective for you.

Sophie

[Jac-genova in reply to JustmeMary]

After radiation then are you expected to still stay on the medication that you were taking before (e.g. ibrance/letrozole?)

[JustmeMary in reply to Jac-genova]

I didn’t start taking the Ibrance and Letrozole until after the radiation treatments. Before it had spread to my bones, I was on Exemestane only which apparently wasn’t working. My oncologist told me I will most likely be on some type of treatment for the rest of my life.

[Kaylane123]

I had breast cancer which spread to my lower spine, left hip and my neck. Lucky for me they were sm tumors. The Radiation has zapped it all. I had no problem with the radiation . My Breast was slightly red but that was the only problem I had. The last 2.5 years I have been on Letrozole which the side affects are sore bone and muscles in my leg and very tired. My Oncologist wants me to keep taking Letrozole as he is happy with my progress.

[Jac-genova in reply to Kaylane123]

So even though the radiation completely zapped the tumors why does he still want you on letrozole?

[Kaylane123 in reply to Jac-genova]

To help it from coming back I guess. They do not like to tell you it is gone completely as there is always a change of it coming back. I guess they call it remission for now. My tumor markers have been in the 20's since I have been on the medication. It was 99 when first diagnosed.

[AvidBooklover in reply to Kaylane123]

The radiation zaps it and creates a barrier around the area. But...you need continued drug therapy. Here is my lay explanation. Letrozole continues to lessen the estrogen which makes a tumor grow. Ibrance works to bracket tumor growth. Others may explain it far better than me!

[Jac-genova in reply to Kaylane123]

Huh interesting. My mom's have been in the 40s- 60s range and have been steady in the 60s the past several months. Haven't noticed any significant decline.

[blms in reply to Jac-genova]

estrogen has to be stopped that is the approach with letrozole which steps one of the pathways. Ibrance and letrozole together look in synergy to attempt to stop that estrogen all together but only works until your body figures ways around it.

[mariootsi]

She is extremely lucky to be oglio. Radiation is considered a very viable treatment.