"WE are confident vaccine prevents bc by preventing her2+ DCIS shows efficacy

[Lani]

It may not be possible to do the vertebroplasty at any site that was already irradiated (radiation makes wound healing very slow) but it is unclear how wide the radiation field was (do you know?)

Also, if your mother's kidney function is not tip-top they may feel bisphosphonates are too risky;

Here is an article recommending radiating less times with a higher radiation dose:

ABSTRACT: Prospective randomised multicenter trial on single fraction radiotherapy (8 Gy X 1) versus multiple fractions (3 Gy X 10) in the treatment of painful bone metastases [Radiotherapy & Oncology]
Background and purpose: To investigate whether single-fraction radiotherapy is equal to multiple fractions in the treatment of painful metastases.

Patients and methods: The study planned to recruit 1000 patients with painful bone metastases from four Norwegian and six Swedish hospitals. Patients were randomized to single-fraction (8 Gy x 1) or multiple-fraction (3 Gy x 10) radiotherapy. The primary endpoint of the study was pain relief, with fatigue and global quality of life as the secondary endpoints.

Results: The data monitoring committee recommended closure of the study after 376 patients had been recruited because interim analyses indicated that, as in two other recently published trials, the treatment groups had similar outcomes. Both groups experienced similar pain relief within the first 4 months, and this was maintained throughout the 28-week follow-up. No differences were found for fatigue and global quality of life. Survival was similar in both groups, with median survival of 8-9 months.

Conclusions: Single-fraction 8 Gy and multiple-fraction radiotherapy provide similar pain benefit. These results, confirming those of other studies, indicate that single-fraction 8 Gy should be standard management policy for these patients.

[Lani]

especially since she lives in Florida

One thought: Get her in a pool. If it is above shoulder height it will mostly likely greatly reduce the force of gravity on her spine and relieve that part of her pain that is from the bone being too weak or the nerves being pinched. If there is something from the metastasis itself causing her pain (chemical rather than mechanical) this may not relieve her pain, but warm water is quite soothing and may give her some emotional relief.

Press her doctor on what pain relief methods may be available--I read about people abusing "fentanyl patches" which were meant for cancer patients. Many of these may be too strong for people of her age, especially if her liver or kidney function are not optimal.

If nothing else, you might ask to try a TENS machine. It works on the principal that, if you stub your toe AND THEN bite your finger, the latter relieves some of the pain of the former, as the brain cannot process two signals approaching it simultaneously from two places very well--it dampens the pain. The electrodes need to be placed between "the pain and the brain" so I guess up below her neck??? A pain specialist or physical therapist may be able to help you.

Again, I am just sharing information not making recommendations. I do
not claim ANY expertise. Just trying to pick my brain to see if I can impart any helpful information.

[Nguyen]

Many thanks for taking the time to share your knowledge!!!

- Nguyen

[skibunny]

Lani, thank you so much. Zometa was something my mom's Dr. had mentioned. I will pursue this further.

Skibunny

[Bev]

SkiB, My mom had the cement injection for OsteoP and it did not do the trick. I'm sure there are a ton of variables. It just doesn't always work. I'm glad I came upon this topic and wish I had more to offer. BB

[Lani]

The Lancet Oncology
Volume 7 • Number 11 • November 2006
Copyright © 2006 Elsevier






Newsdesk
Zoledronic acid palliation in bone-metastatic breast cancer


Bryant Furlow



PII S1470-2045(06)70927-5


Women with painful skeletal-related events (SRE) benefit from second-line zoledronic acid, report researchers (J Clin Oncol, published online Sept 25, 2006; DOI: 10.1200/JCO.2006.05.9212).

Bone is the most common site of metastatic disease in women with breast cancer, frequently causing SRE. A phase II trial of 31 women with SRE and bone disease progression who had received first-line bisphosphonate treatments, showed palliative benefits from zoledronic acid. Women had improved pain control and decreased urinary N-telopeptides, a biomarker of bone turnover, compared with baseline measures.



Appropriate bisphosphonate treatment could save costs

“This study shows that patients with progressive bone metastases or SREs while on clodronate or pamidronate can have palliative benefits with a switch to the more potent bisphosphonate zoledronic acid”, says lead author Mark Clemons (Princess Margaret Hospital, Toronto, Ontario, Canada). “If confirmed in randomised trials, these findings have major implications [for] the use of bisphosphonates.”

“The authors should be commended for giving us information on what to do in a frequent clinical situation”, says Peter Barrett-Lee (Cardiff University, Wales, UK). “Now we have some evidence that switching to a newer, more potent agent might help patients failing on first-line bisphosphonates.”

Many centres already use zoledronic acid as first-line treatment, Barrett-Lee points out. “The new results will not be relevant in such cases”, he notes. “But quite a few [clinicians] still use pamidronate first line.”

“It is too early to draw conclusions about complications, which usually occur later. Physicians should not administer second-line bisphosphonates indefinitely”, comments Meletios Dimopoulos (University of Athens, Greece). Zoledronic acid costs five times more than pamidronate, Clemons notes. “We can use less expensive agents first line and save more costly drugs for patients with progression. Appropriately targeting bisphosphonate therapy to those most likely to benefit could save billions of dollars globally.”