Question on Triple Negative Stage 4 Bone Mets

BoneMetsDIL

Hello,

My mother in law is 71 with triple negative bone metastasis. She was just diagnosed in October at stage 4. She has many many areas of bone Mets and fractures with spinal and hip involvement primarily. She has been wheelchair bound for a few months, She has had two rounds of chemo. First round, some cancer went away but new cancer showed up in other areas. She had a second round of chemo and recently got a UTI. She had fever etc and ended up in teh hospital again with horrific pain in legs. They did PET scan again (since she just finished round 2 anyways) and no progression, but also the cancer is the same (no reduction) so stable I guess. However, doc said she now needs to remain bed bound because her fractures aren’t healing and that is causing awful pain. She is on tons of pain meds, somewhat delusional, and hallucinating. Doc said mix of meds, age etc. Anyways, she is now bed bound and delusional. She is supposed to start oral chemo next week.

My MIL is in India. They do NOT tell you prognosis and timeline there. So no one knows what to expect. Over here, my oncologist friends have said anywhere from 3 months to 2 years.

I am so lost. Since her cancer is stable, is she now just stuck in bed with pain and just basically in a vegetated state due to pain meds? How long does she realistically have? Surgery right now with so many areas of bone Mets and weakened bones is likely not a good idea! We just dont know what to expect and want a realistic view of the situation.

Anyone please help? We live here and my MIL is living with my SIL right now in India. They are in one of the best cancer hospitals around...

exbrnxgrl

Hello DIL,

I am sorry to hear of you MIL’s diagnosis. In my opinion, it’s difficult for anyone to predict how long a stage IV patient might live. I think your oncologist friend can be a source of information but is hardly in a position to predict your MIL’s future unless she has complete access to all of your mother’s medical records. I am very pragmatic so I am not filling you with false hope but I have seen quite a few new treatments for mbc over the last 10 years. Yes, though not as extensive as your MIL’s, I have been living with mbc, bone only, for almost 10 years. I am well aware of the fact that I’m an outlier but that doesn’t negate the fact that there have been some advances in treatment.

As for pain, is a pain management/palliative care team available to her? Regardless of other treatments, managing her pain will greatly enhance her quality of life.

Since I am not a doctor I can’t really offer anything more definitive but I hope that no one is putting an expiration date on your MIL (unless she truly is that critical). Take good care.

BoneMetsDIL

Yes, her pain is being managed with lots of pain meds. However, she is absolutely miserable with the thought of being confined to a bed for the remainder of her life. Her bones are too weak for any surgical intervention... FOr us, as a family, it is awful to see her confined and in so much mental and physical pain..

Moderators

Welcome BoneMetsDIL

We're so very sorry to hear of your mother-in-law's diagnosis, but we're so glad you've found us. As you can already see, there are so many members here always willing to offer their advice, information, encouragement, and support -- we're all here for you and your MIL!

While you wait for some more responses, we want to point you to the main Breastcancer.org site's section on Treatments for Pain, which can offer some options for you MIL to keep her comfortable.

Please keep us posted on how she's doing and how we can help further.

--The Mods

BevJen

BoneMetsDIL,

I am so sorry to hear about your MIL.

I have stage IV ER/PR+, HER2- breast cancer and diffuse skeletal mets. I also have extensive degenerative disease throughout my back. I just turned 69, so not too much younger than your MIL.

Just to offer some suggestions that I think would happen here in your mom's situation. You say repeatedly that surgery is not an option. Have you actually talked to a surgeon, or just to the oncologist? Here, I think that perhaps surgery might be considered. If not surgery, then I think that targeted radiation would also be discussed to the areas that are providing pain to her. Techniques such as SBRT (a specific type of radiation) might be considered. And also, I think before any of those, a doctor here would recommend physical therapy to isolate and strengthen areas of her back that could perhaps be helped.

I would be most irritated that your oncologist is basically giving up on your MIL. 71, in this day and age, is really not that old (said by someone who is 2 years younger than that). So I would probably find another oncologist as a first step here, and get a second opinion. Of course your MIL is depressed -- she's been made a prisoner of her bed.

Please look into at least getting a second opinion. Also, look into some consults on PT, surgery, and radiation. Good luck.

BoneMetsDIL

Hello,

So MIL suffered quite a setback this weekend. She was completely delirious. And also, has another fracture in her femur to add to many other fractures in her body. She is basically confined to her bed. Had fever as well. We spoke with the team of docs. They are saying that they think she has a few months... I have checked with a few here and that seems to be the consensus... She is still in hospital. Docs say much too frail for any surgery.