Bone mets - articles sent to 2nd Sis-in-law

[Jackie07]

Hi,

Just heard from my 2nd Sister that our 2nd Sister-in-law (wife of 2nd Brother) is going to have a hip surgery for bone mets. She's just two years younger than me (49?).

I think 2nd Sister-in-law was diagnosed right after my recurrence in 2007 (2008?). Being the only one living in the States, plus having had a couple of major illnesses, I'm usually kept in the dark of any 'bad' news of my family. The Chinese has a tradition not to bring bad news to a person who's recuperating. A person who's just attended a funeral is not supposed to visit anyone in the hospital... etc.

Found a couple of articles on the subject and thought I would share them here with my Her2 sisters:

Breast cancer bone metastasis:
Clin Calcium. 2011;21(3):429-438.
[Encounter of cancer cells with bone. Treatment of bone metastases from breast cancer.]
[Article in Japanese]
Taguchi T.
Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine.
Abstract
In metastatic breast cancer the most common metastatic site is bone. Skeletal-related events (SREs) as well as bone pain are well-known characteristics of bone metastasis. Activation of osteoclast is the most important mechanism for the progression of bone metastasis. To treat bone metastasis, not only administration of antitumor drug but also inhibition of osteoclast activity should be required. Bisphosphonates, as potent inhibitors of osteoclast function, reduce the morbidity of metastatic bone disease, decrease the prevalence of SREs, and improve control of bone pain. Molecular targeted agents which inhibit maturity and activity of osteoclast are under development, and some effectiveness has been proved in clinical trials. Long-term survival just like good control of a symptom is expected in future by using new drugs specific to bone metastasis as part of multidisciplinary approach.

J Clin Oncol. 2011 Feb 22. [Epub ahead of print]
American Society of Clinical Oncology Executive Summary of the Clinical Practice Guideline Update on the Role of Bone-Modifying Agents in Metastatic Breast Cancer.
Van Poznak CH, Temin S, Yee GC, Janjan NA, Barlow WE, Biermann JS, Bosserman LD, Geoghegan C, Hillner BE, Theriault RL, Zuckerman DS, Von Roenn JH.
University of Michigan, Ann Arbor, MI; American Society of Clinical Oncology, Alexandria; Virginia Commonwealth University, Richmond, VA; University of Nebraska Medical Center, Omaha, NE; Cancer Research and Biostatistics, Seattle, WA; Wilshire Oncology Medical Group, Rancho Cucamonga, CA; Y-ME National Breast Cancer Organization; Lurie Comp Cancer Center of Northwestern University, Chicago, IL; National Center for Policy Analysis, Dallas; The University of Texas MD Anderson Cancer Center, Houston, TX; and Mountain States Tumor Institute, Boise, ID.
Abstract
PURPOSE To update the recommendations on the role of bone-modifying agents in the prevention and treatment of skeletal-related events (SREs) for patients with metastatic breast cancer with bone metastases. METHODS A literature search using MEDLINE and the Cochrane Collaboration Library identified relevant studies published between January 2003 and November 2010. The primary outcomes of interest were SREs and time to SRE. Secondary outcomes included adverse events and pain. An Update Committee reviewed the literature and re-evaluated previous recommendations. Results Recommendations were modified to include a new agent. A recommendation regarding osteonecrosis of the jaw was added. Recommendations Bone-modifying agent therapy is only recommended for patients with breast cancer with evidence of bone metastases; denosumab 120 mg subcutaneously every 4 weeks, intravenous pamidronate 90 mg over no less than 2 hours, or zoledronic acid 4 mg over no less than 15 minutes every 3 to 4 weeks is recommended. There is insufficient evidence to demonstrate greater efficacy of one bone-modifying agent over another. In patients with a calculated serum creatinine clearance of more than 60 mg/min, no change in dosage, infusion time, or interval of bisphosphonate administration is required. Serum creatinine should be monitored before each dose. All patients should receive a dental examination and appropriate preventive dentistry before bone-modifying agent therapy and maintain optimal oral health. Current standards of care for cancer bone pain management should be applied at the onset of pain, in concert with the initiation of bone-modifying agent therapy. The use of biochemical markers to monitor bone-modifying agent use is not recommended.