Secondary bone cancer prognosis?

Question

My mom is 55 and had breast cancer 17yrs ago. She has just been diagnosed with secondary bone cancer- it is something "positive" (ER or PR??) Her treatment will be a pill everyday a monthly IV and possibly radiation for pain management.

It is "extremely widespread"- her skull, all down her spine and tailbone, ribs, arms, legs- basically everywhere but hands and feet.

6 yrs ago my dad died of pancreatic cancer- he was diagnosed in Jan and died May 5th. We knew nothing about pancreatic cancer and were completely taken off guard. I'm afraid the same is going to happen with my mom.

Her onc told her only that "50% of people with secondary bone cancer don't live longer than 4 years"

I don't know what to make of that- 4 years from when? diagnosis or when the cancer began to spread? Her's is so wide spread what does that mean for her prognosis?

She has lost about 40 pounds and looks like a skeleton- she's still working. I want her to quit but is that premature or should I encourage her to stop working and enjoy life while she still can?

Anyone have any knowledgeable information to give me? I realize no one knows for sure but certainly there is a basic idea out there about her prognosis.

Please- give it to me straight don't try to be a politican about it. I wish someone would have looked me in the eye and told me it was time to say goodbye to my dad I don't want the same thing to happen again but I also don't want to over react.

Thanks

Answer 1

Be grateful they're not doing chemo--that's h**l on earth and would probably kill her--my sister went through that with breast cancer.  Do whatever you can to convince her to quit work--whether she has 1 year, 5 years or 10 years left, she might as well start living each day as her last--I don't say that to be cruel:  it's the way we should all live everyday but often don't consider..  It's difficult to estimate how long she might have because it's very much dependent on her state of mind, how far the cancer has progressed, and her health otherwise.

My Dad was diagnosed with malignant melanoma 15 years ago and given 6 months to live.  Since then he's had 4 melanomas removed, and over the years it's metastasized to his prostate and his bones.  He has refused all treatments including radiation, chemo etc. because he believes the cure is worse than the disease.  It's hard to argue with someone still alive years after he's supposed to have croaked--he jokes that the only reason people come to visit him is to see if he's still around.  He has mostly good days (goes for walks and meeting him you'd never know) and occasional bad days (rests in bed) but overall he's amazing--he's 81.

I mention this to let you know your Mom may be in the 50% who beats the odds and is here with us into her 80s.  Hope and faith are amazing tonics.

I wish you and your Mom hope and faith, and pray for both of you.  Good luck!

Answer 2

The problem is that nobody really knows when the cancer started to spread. The "4 years" is likely from the time of diagnosis.

Unfortunately, some cancers are more aggressive than others. There's no way to tell which patients have more time and which don't.

Having said that, it's probably best to prepare for your mom to not last the 4 years. That way, you'll have the chance to spend time with her. If she does well and lives longer, consider that a "bonus".

It sounds like her cancer is "HER2" positive. The treatment is actually more targeted to the cancer than regular chemo.

Best of luck.

Answer 3

I know this a distressing time for you, but your mother’s doctor is doing exactly what the best treatment is for someone in her situation.

The ER/PR thing stands for estrogen receptor and progesterone receptor we have found these hormones can stimulate proliferation of cells in the breast and can lead to breast cancer. We now check all breast cancers to see if the tumor reacts to these hormones and apparently your mother’s does. The pill your mother was given is prevent the cancer from getting the hormone(s) they love so much making them less able to thrive and multiply. This treatment is much more targeted to doing this than chemo is and without the nasty side affects. Chemo is reserved for patients with life threatening mets. As painful as bone mets are they are not life threatening.

The monthly IV is a drug designed to reduce pain and fractures due to bone mets therefore reducing the need for radiation. Radiation really is not an option for treating bone mets as widespread as your mothers, but may be used in the most painful areas later on if needed. If you would like to look these drugs up they are Aredia and Zometa.

Regarding the 4-year thing. This would be from the time the bone mets were discovered and she became a stage 4 breast cancer. At this point her doctor is doing what he can to buy her some more time and is hoping to make that time as pain free as possible. From what I know and he knows far better than I, his estimate is pretty accurate, but may change for the better depending on how well she responds to therapy.

My personal opinion about her continuing to work is I think you should take your cues from your mom. Everyone has their own way of dealing with this situation and it would be normal for her to go through several stages. She will likely start feeling much better before she feels bad again so let her live a “normal” life while everything sinks in. Just let her know you love her and you want her to do whatever it is that makes her happy. Best wishes to you both.

Answer 4

I'm sorry to hear this.

Secondary cancer is not curable; but it can often be managed, sometimes for years. I know two people whose bone secondaries are less widespread than they were when they were diagnosed, so their treatment has been successful in managing their cancer.

There are no guarantees of course - but you of all people know that.

I realise this isn't a lot of help; there are a few doctors who answer questions on this board who will be honest with you and give good advice - I hope at least one of them sees your question.

In the meantime I suggest you ask your questions on one or both of  these sites, if you haven't already - you are likely to get answers from people who are or have been in a similar situation, and in my experience nobody will sugar-coat it. Both sites also have loads of information, especially the first one:

http://www.breastcancer.org

http://www.breastcancercare.org.uk

My best wishes to you and your mother