Pathologic fracture of Iliac crest

[Dragonfly2]

Such a complicated journey...but essentially after successful spinal stenosis surgery in March,Ienjoyed a few weeks of good health and mobility. I continued Piqray and had to start metformin. In May, I began experiencing increasing pain in my right hp where the cancer is located. Scans were ordered. The bone scan did not show any developments other than metastatic disease. Today's ct scan revealed a pathologic fracture in my right iliac crest. Now what? I suppose things will start to percolate next week as the docs get calls and reports about this. I already notified my APRN who coordinates care for porthopedic oncology. This is new and unexpected. I had just restarted zometa infusions and I hope they would help but my limp, pain, and limited mobility continued. Interestingly, my golf swing is fine an dI can do that...but I can't walk. I suspect the doctor will nix the golf.

Has anyone experienced this kind of pathologic fracture? What did they do for you? How long was recovery? Can I hope to get better?

Such a complicated journey...

[hopenowandtomorrow]

Dear Dragonfly: I’m so sorry for this to have happened to you! I had a pathological fracture in my sacrum due to radiation weakening the bone (occurred a year after the radiation). It would not heal on its own because the bone was too compromised from radiation. After bone cement failed 1 month post surgery, I had orthopedic surgery that placed large screws in my iliac bones to secur the sacrum.

After years of pain and struggling to walk, I healed from that surgery & walk & function without pain.

In your case they will obviously need to assess the integrity/strength of your bones.

Praying for a good outcome for you!

🙏❤️🙏

[nonna70 in reply to hopenowandtomorrow]

God bless you as you deal with your fracture. It was 12 years before I had a met. in my arm. However, it was almost broken so I have a plate and screw in it. I had already had a hip replacement. I was told this week that I had NED. I'm glad of course but rather hesitant to assume no more MBC. As you said, '"such a journey!"

[Dragonfly2 in reply to nonna70]

Yes, who knows how long the bone was eroding before I got diagnosed. I guess I’ve been doing fairly well until this. Thank you for your reply and good wishes. And I’m so glad that you have achieved NED. so lucky and blessed!

[Dragonfly2 in reply to hopenowandtomorrow]

Oh thank you…I needed to hear that others have recovered. After my first dx for mbc, the ortho.onc thought I’d need cement and screws too but therapy regrew the bone and I was fine…I hope I can get good news from him this time. I’m feeling so defeated that this disease continues to erode me bit by bit. But I glad to hear it’s still gonna be ok…how long was your surgical recovery?

[hopenowandtomorrow in reply to Dragonfly2]

I had lumbar sacral fusion surgery L4-S1 (bone graft takes about 6 months to solidify) plus the stabilization screws in the iliac wings. My surgery may be more involved than yours would be. I could walk the next day but I was in the hospital 3 days then started basic home PT. I was going to outside PT & walking 2000 + steps a day at 2 weeks. The healing process takes longer if you have a bone graft. You may not need that. I felt much better & more confident at the 2week mark but not allowed to bend, lift over 10lbs or twist (BLT) until the 6 month mark…post X-ray which the neurosurgeon will confirm the healing has occurred.

🙏❤️🙏

[Dragonfly2 in reply to hopenowandtomorrow]

your post op sounds familiar .. I just had spinal stenosis surgery in march so I know all those restrictions. I’m glad you are recovering well and on to living comfortably. Thank you for your kind input. It’s not knowing on a Friday night that is squeezing my heart. ❤️‍🩹❤️‍🩹

[Granny333]

I am sorry for the pain you are going through. I do hope for you that some type of therapy will give you relief. I will pray for you because I care.

[Dragonfly2]

thank you !

[13plus]

Dragonfly, what an unfortunate situation to follow your successful surgery! I can only imagine your frustration and concern. Please keep us posted on what the next steps will be. Hoping they can come up with a good plan to deal with this for you. Keeping you in my thoughts and wishing the best for you!

[Dragonfly2 in reply to 13plus]

Thank you…getting results on a Friday evening is so frustrating…can’t call anyone for advice! I will be sure to let you all know what comes next. I’m eager to get this resolved …like playing whackamole🤷🏼‍♀️. Stay tuned 🙏

[13plus in reply to Dragonfly2]

Definitely keeps us playing whack-a-mole. No better description! Hang in there, tomorrow is Monday

[Lana7788]

Stay strong! I’ll pray for you!

[Dragonfly2 in reply to Lana7788]

Thank yiu

[TwithBC]

so sorry; yes, complicated journey…wishing for you the strength to endure, and a successful (even if dofficult) road to recovery!! Prayinf your swing doesn’t suffer while you are out for a bit taking care of business!!

[Dragonfly2 in reply to TwithBC]

Yes…want to play as long as I can ! 🙏🙏🙏

[mariootsi]

Sending prayers

[Dragonfly2 in reply to mariootsi]

Thank you !

[love2golfwell]

I am so very sorry that you are dealing with this. I was really hoping you would do well after your other surgery and not have any other complications. I am really sorry about golf, too, as I know you really enjoy that. I hope you get some good answers when you speak with your doctors and they can fix this new issues. Sending you hugs and prayers.

[Dragonfly2 in reply to love2golfwell]

Bummer isn’t it? Feeling better after the spinal surgery probably triggered the fracture…can’t win for trying 🤷🏼‍♀️ but thank you for the well wishes!

[rubyc1234]

Interesting! My right hip has been bothering me for 5 months and I have a known met in the right trochanter. Bone scan was stable but the leg/ hip certainly hurts. I am wondering if I have the same condition as you.

[Dragonfly2 in reply to rubyc1234]

Yes I can see why you’re concerned based on symptoms. Interestingly the bone scan did not suggest a fracture even though I was clearly feeling symptoms. But the bone scan just highlights areas of disease and uptake of the injected meds . It had showed increased uptake but no indication of a fracture. Three weeks later the ct scan told the tale. If I were you, I would squawk to get someone to look at this. Too often they just shake their heads and offer more pain killers. A complete fracture in the trochanter can be very difficult and would require surgery to stabilize. Better to see now what you’re dealing with. Don’t take no for an answer. 🙏❤️‍🩹❤️‍🩹

[HopefulB]

Hi Dragonfly2, I am experiencing / have experienced something close to what you describe. And, sadly, misery likes company as I thought I was alone in finding walking to be so hard. I had to be off XGeva for a time due to mouth surgery (bone had grown in my mouth...) and as soon as the XGeva was out of my system, my bones started to have problems. Radiation has been helpful but new pain seems to appear as soon as one spot is resolved. So I am still on painkillers(that help somewhat but again - not everything I had hoped) and scheduled for a new round of radiation.

But back in February I had terrible pain in my right hip/groin area. It was so bad that I was briefly hospitalized for it. Ultimately it was a small fracture in my right hip socket. The Ortho Onc said they don't operate on the hip socket (because it's too delicate) but that chances were good the fracture would start to heal on it's own. And to my surprise - that is what happened. It took a few months and I have new and different bone pains (after reading all of the comments here I am wondering if I need some kind of surgery!) but the right hip spot which was KILLING me back in February doesn't hurt at all anymore. And the imaging corroborates my experience as it seems the bone has grown in where the fracture used to be.

All to say, I really hope your iliac pathologic bone fracture can be fully resolved whether it heals slowly on its own or through surgery. Thinking of you. Clarisse

[Dragonfly2 in reply to HopefulB]

So glad to hear your news…looks like there is a great similarity in the way MBC manifests itself in the bones. I am still limping from the fracture but I feel I have longer endurance while walking. I will be having an X-ray today to see if there’s any improvement. It’s so debilitating to struggle walking..both physically and mentally. Coupled with the gut issues caused by Piqray and metformin, I often truly feel “sick” and fatigued. I am hoping to get some encouraging news…it’s been a lousy year so far, interspersed with moments of happy news and then clipped at the knees by side effects. Yeah, the fracture was an impressive break from the top of the ilium right into the hip socket…and that explains so much. Well, no point whining…thank you for your best wishes! It’s really encouraging to hear success stores that give us hope and comfort. Best wishes on your own journey..and to every person walking this path. ❤️‍🩹❤️‍🩹