Mom is resistant to treatment

BossyB

Hello, My mother was diagnosed today with bone mets after HER2+ BC. She is 81 years old and is facing this after completing chemo, surgery and radiation in December of 2016. She is very resistant to doing the suggested Ibrance and an aromatase inhibitor because she can't bear to have the side effects like she had with the chemo. She has pelvic spine and rib involvement and has a good bit of pain. Her oncologist suggested that she might receive radiation to help with the pelvic pain.

Can anyone advise me of the real effects of these drugs? She says she doesn't care if she lives long if she has to feel miserable in her last year(s). I am encouraging her to accept the treatment because I am told it can extend her life and also help her pain. (Hence my name BossyB...because she says I keep telling her what to do.) I don't want her to suffer, she is a tiny woman and very frail and I just want to know other people's experiences with this treatment. Is it too much for an 81 year old to take?

I am torn because I want to support her decision and respect her wishes but I want her around (without suffering). At this point she said she would try it but as soon as it makes her sick she is stopping treatment. What is the right thing to do here? Please help me.

Icietla

Welcome, BossyB. We are so sorry about your Mother's disease progression and her suffering. You have come to the best place for information and support. She is very blessed to have you to encourage her, watch out for her, and help her otherwise.

I think the right thing for you to do is present her with information as to what she can fairly expect with the recommended medicines.

I have been on the aromatase inhibitor Letrozole (generic Femara) for nearly two years. I am required to take daily at least certain minimums of Calcium and Vitamin D also. If my bones thin substantially on AI treatment, I will have other medicine to help with their endurance so I can stay on the AI treatment.

My AI treatment has been pretty easy. I am informed that my tumor marker test results have been stable throughout my Letrozole treatment. My side effects from the medicine have been only temporary. Some of us surmise that, generally speaking, the longer since one's menopause, the easier one's AI treatment seems to be. [N.B.: Some AI patients who have recently had Chemotherapy and/or Radiation Treatment have complained of worse side effects after starting AI treatment; it is not clear whether their side effects are fairly attributable to their AI treatment, or whether those patients are experiencing (even increasing) aftereffects of their prior treatment/s.]

Here is a discussion thread for our members doing well on AI treatment. You can read about our (tolerable) AI side effects on this thread. Please read through it for your Mother.

https://community.breastcancer.org/forum/78/topics/854403?page=1

I have no experience with Ibrance, but many of our members have, and many are on the same type medicine combination recommended for your Mother. Here is the thread where you can ask our Stage IV members for information and inputs for your Mother's case.

https://community.breastcancer.org/forum/8/topics/783594?page=1

Bestbird

I am sorry to hear about your mother. If her cancer is HER2+ then there are HER2 targeted drugs she can try, and she can always stop if she wishes to.

BossyB

Thank you for your responses Bestbird and Icietla . Unfortunately my mom has been on Letrozole for over a year and that wasn't enough. They will need to be more aggressive and I'm not sure what she can tolerate. That Ibrance looks like it can have some nasty side effects as well as the Denosumab (Xgeva). If anyone out there has used these drugs please let me know what to expect. I wish you both peace as you go through your treatments.

Hopeful82014

She can always try the treatment and stop if it's too uncomfortable for her. She might also ask her MO about faslodex.

KBeee

I have been on denosunab and have had no side effects at all.

I am so sorry your mom is dealing with this

pajim

Hi BossyB, denosumab is generally easy. Some people have some bones aches, others don't. I had no troubles at all. But remember it's not an anti-cancer drug.

The side-effects of Ibrance are low white blood cell counts, and some people have a lot of fatigue. It can be a more difficult to take.

As your Mom is resistant to letrozole and doesn't want chemo side-effects I would recommend Faslodex (fulvestrant). With or without Ibrance. Though Ibrance does have some of those chemo side-effects.

FYI I've been on all these drugs. letrozole and faslodex were easy peasy. Ibrance was a little more difficult. Your (or your Mom's) experience may vary.

Do tell her (and remember yourself) that just because she agrees to start a treatment doesn't mean she has to continue it. She can stop at any time if she doesn't like the side-effects of the drugs.

BossyB

Thanks for all the input. She has agreed to beginning treatment starting tomorrow. It's great having advise from all you brave people who are going through this. God bless you all.