Thread for Stage IV Oligometastatic Folks

@AP3 that is wonderful news! I am so happy to hear that for your wife. I have invasive ductal carcinoma, with Mets to my sternum. I am on carboplatin, Gemcitabine, and keytruda. I'm also triple negative, with no genetic mutations. I was diagnosed as stage 4 from the beginning. My left breast tumor was 14cm, several lymph nodes involved on my left side as well.

hi, I only have mediastinAl lymph nodes lighting up. But now I’m getting pleural effusion. Anybody get this?

I was told that there is no way to say for sure if we are truly oligmetastic just that if we meet the definition that we might be. My radiation oncologist believed me to be an oligmetastic and went after my tumor very aggressively as she thought it was the one chance to possibly keep my cancer from returning. That being said my MO told me that he thought I could be an oligo but that I still needed to be on standard treatment for someone with bone met because if it turned out that I was not an oligo than my cancer could come back and spread. I am on XGEVA, Ibrance and Faslodex.

Here is an interesting article about oligmetastic breast cancer: https://apm.amegroups.com/article/view/51420/html

exbrnxgrl - thank you for your input. i appreciate it. i assume most people have much more to lose (children, family) than i do and i totally understand and respect that. i'll keep searching for someone who has/is treating bone mets with rads only & no meds, which really does sound like a long shot.

Hello all, This is about my wife Anca:

Diagnosis in February: Oligometastatic breast cancer ER/PR+, HER2-, multiple tumors in left breast (two of them larger than 4cm), 4 sub-centimetrical lesions in different bones.
Had 1 round of ACT chemotherapy(5months), PET scan shows significantly reduced breast tumors, but one bone tumor growth. They are the same bone tumors, no new sites are affected.

She is getting treatment at Northwestern Hospital Chicago.
We are concerned that because of that 1 bone tumor that grew less than 1 cm, they will not do surgery.
Any thoughts? Thanks!!!

Silas, many doctors don’t recommend surgery at all but if it’s an option, I wouldn’t think they’d need to get all tumors under control first, especially if your wife would have to be off treatment for the surgery itself. Have the doctors talked about the plan yet?

silas102, my surgeon was hesitant about doing my BMX as well. I think her reasoning was that the cancer had already spread to both breasts, lymph nodes and my spine and thus the cancer was now systemic. A BMX is major surgery and there can be complications like I had, so I think the surgeon wanted to spare me of that. My oncologist felt differently. He wanted to treat me like a Stage 3/oligometastatic patient. I had also read a medical study that indicated slightly better survival and time to progression for oligometastatic patients who had surgery, so I talked to the surgeon and she agreed to do what my MO recommended.

My tumors were different from Anca’s, so maybe her MO and surgeon will recommend a different strategy.

It’s been a little over three years since I was diagnosed and it has certainly been a rough road, but I think I’m starting to become accustomed to the bumps. Some people think that everything goes back to normal after treatment ends, but life will never be the same again. I think accepting that fact is helpful. I’ll be thinking of you and Anca. I hope that you and she can talk through the pros and cons of surgery and that you can have peace with whatever decision is made

HI,

I saw this article published December 2021 about Ogliometastic and how they are categorizing it. Interesting is also if you have responded to treatment and have limited mets as a result it is considered medically induced.

5. Surgical intervention of oligometastatic breast cancer

Several trials have reported on the surgical approach to eradicate discrete metastasis with resistant subclones. These trials have yielded varied results but have shown enough promise to warrant further consideration of a more integrated approach to treatment of oligometastatic disease.

https://www.sciencedirect.com/science/article/pii/...

I completely understand that.

Hi all, thanks for your answers. After 5 months of ACT chemo, the breast and ganglions tumors reduced greatly. However the bone ones about same size, 2 small increase. Next treatment: hormonal (letrazole, ribociclib, zoladex), no surgery until the bone tumors are in control. No radiation unless there is pain.
We are getting a second opinion today from University of Chicago hospital, they have a program for Stage 4 breast cancer.

silas102, I’m happy to hear there was a reduction after the ACT. I would also echo exbrnxgrl that you should ask whether rads would be helpful in extending the time to progression.

My T11 lesion was zapped twice and it has been stable with no signs of progression for three years. My MO thinks there is a good chance that I will be like exbrnxgrl and get at least a decade without progression. Every case is different, of course, but I’m very encouraged by the anecdotes of longer survival for oligometastatic people

silas102,

I live in the Santa Clara Valley, aka Silicon Valley. My medical arrangements, though very common in CA, are a bit different than most. I belong to a completely self contained HMO, Kaiser Permanente. This means that everyone and everything is a Kaiser employee or service. Yup, everything from pharmacies to labs to scans are part of Kaiser and the patients are considered members. That being said, I do not know if they do second opinions for non-members. If this is the case you might want to consider a major teaching facility or NCI facility for a second opinion. While not all areas can be radiated, I continue to be surprised when an mo says they only use rads for pain relief. While this was common in the past, it is becoming more common and I believe (no concrete proof) that having rads to my bone met significantly contributed to my longevity. We are all a bit different so I don't know if there are other circumstances that would contradict rads for you however it may be worth pursuing.

BTW, as a Kaiser member I can only use Kaiser doctors and facilities but I did self pay for a second opinion at Stanford and they agreed with my MO's treatment plan including rads. Take care and feel free to keep in contact.

PS: Curative attempt is a bit odd to me as there is no cure for bc and was never mentioned by my docs, particularly not 11 years ago. I certainly do not consider myself cured. I am just very lucky.