Metastatis in Spine a decade after BC and remission

[PeppermintTea2021]

A close relative has been experiencing back pain for around 9 months and has now been diagnosed as having metastatic cancer in the spine. She had breast cancer about10 years ago and although it was comparatively low grade she very bravely and sensibly went for a full mastectomy and made what we thought was a full recovery so it's a terrible shock for her to see that it's come back, or that it never left.

We are all reeling a bit - I was just wondering if anyone had experienced something similar themselves or in the family and what we can expect to happen and any advice really. I appreciate everyone is different and we all accept that this is a very serious diagnosis.

I was diagnosed with spine mets at the same time as my primary diagnosis two and a half years ago and while they were painful at the start, as soon as they were radiated and I was started on targeted therapy drugs, the pain went away.

The main risks the team will be watching for are spinal cord compression (losing feeling in extremities, loss of urine/bowel control) which are critical issues and must be addressed immediately, and vertebrae fracture. Depending on how many, where, and their impact on her quality of life, a short, targeted radiation series (usually 5-10 sessions) on specific mets may be warranted.

Her treatment course will likely be pills if the cancer is hormone positive - they will need to biopsy the new lesions to determine if its the same cancer as before or if it has mutated. The targeted therapies today (palbo/letrozole or palbo/fulvestrant) are very good and will have her living a more or less normal life. Bone only mets are easier to manage and stats show longer life expectancy than those with visceral (i.e. liver, lung) involvement - I know of more than a few women on this combo for longer than 4 years. She will also receive bone strengthening drugs (denosumab) once a month to both help the bones repair and repel the cancer. And once those drugs fail then there is another line of drugs and another line, so while yes, it is serious, there is hope that your relative will be able to function like a "normal" person for many years yet and without IV chemo. Mets is almost like a completely different disease but one that can be effectively managed for quite some time.

Thank you @HerbalRefreshment for that very detailed and informative reply. I hope you are faring ok after what must have been a bloody difficult time not least during lockdown... (also our usernames suggest we have more than one thing in common)..

That's all so useful to know. It sounds like a huge regime to face but at least its not just tramadol and codeine that she's had whilst she's waited for her MRI. As I understand it it won't necessarily go away but you can keep it at bay.

Again thanks and hoping you are doing alright xxx