Monday, May 12, 2008

The "M" word

I'm eating lunch at my desk, and there are a number of items on the board in front of me.

  • There's a picture of my Finnish daughter and other women, all in corporate-sponsored pirate outfits.

  • I have a mailing label for the same Finnish daughter. However, the address won't be accurate by this fall.

  • I also have a 2008 telephone area code map. Not for Finland; for the United States and Canada. (Trivia fact: American Samoa's area coee is 684.)

  • There's a Burger King coupon for a shake that expired almost a year ago. (The coupon, not the shake.)

  • There is a picture showing the senior leadership team for one of the major divisions in my company. Many of the people are still working for the company. I think.

  • There's an 8th grade graduation invitation from my daughter. She's almost in 11th grade now.

  • There's a picture that my daughter drew in the 20th century.
And there's a card, the left side of which contains Psalm 121, the right side of which starts with the words "In Loving Memory."

My mother in law died on September 14, 2004, and I blogged about it at the time.

My mother in law died yesterday afternoon of breast cancer that had spread to the brain.

I believe that it was in June that we learned that her breast cancer had spread to her brain. She went through another round of chemotherapy, and she was at Plott Nursing Home for a while, but eventually she was moved back home to hospice care.

After thinking about this, I realized why I had such a negative reaction when I read this Susan Reynolds post over the weekend.

Turns out that two area of bone are either deteriorating (some of that could be age) or the breast cancer has metastasized and started growing in one or both areas. That sounds like a bad news / worse news option. For some reason the bone has some areas significant enough to warrant concern....

Unfortunately I'm stuck not knowing more until I can get an MRI. That can't happen until the chest wall expanders come out. They contain metal and that's a no-no for going through the MRI machine unless I want to chance them being magnetized right through my chest wall. No one wants blood on the MRI machine apparently.

Read more of Reynolds' post here.

I said it on FriendFeed; words like "metastatic" scare me. But at this point, you start researching your options. Susan did, and found this item from 2001:

A recent study found that a drug called ibandronate successfully reduced the number of breast cancer cells in the bones of mice. Ibandronate belongs to a class of drugs called bisphosphonates that scientists have been studying to determine whether they can block the progression of breast cancer cells that have spread to the bone....

When breast cancer spreads past the breast and axillary (armpit) lymph nodes, it often spreads first to the bone. These breast cancer tumors in the bone are called "bone metastases." As advanced breast cancer dissolves portions of bone, a variety of problems can occur. Bone metastases can cause pain, decreased activity, and potentially severe problems such as fractures....

According to an expert panel of the American Society of Clinical Oncology (ASCO), bisphosphonates have shown benefits in reducing bone complications. However, bisphosphonates have not had an impact on patient survival (i.e., patients do not live longer if they take bisphosphonates). Thus, bisphosphonates are used to improve a patient’s quality of life rather than cure the disease. While bisphosphonates can be helpful, the ASCO believes they should not replace current standards of treatment for cancer pain, such as local radiation therapy and other medications.

In addition to treating bone metastases, bisphosphonates are also being studied to see if they can play a role in the prevention of metastatic breast cancer (breast cancer that has spread to other organs, such as the bone, liver, lung, etc.).

I found a later article:

Researchers Affiliated with the European MF 4265 Study Group have reported that oral Boniva is effective and safe in the treatment of bone metastasis from breast cancer. This report was published in the March 2004 issue of the British Journal of Cancer. A previous randomized trial published in the September 2003 issue of the Annals of Oncology had demonstrated effectiveness of the IV form in preventing skeletal morbidity in women with metastatic breast cancer.

Ibandronate (Boniva) is a bisphosphonate that can be administered intravenously or orally. It is categorized as a third generation aminobisphosphonate which may have less GI side effects than other oral bisphosphonates.

So, how do you cope with this? Imaginis has some thoughts on this also:

In a survey sponsored by the National Alliance of Breast Cancer Organizations (NABCO), the majority of the 200 women with metastatic breast cancer surveyed said the public perceives them as being "near death—with little or no time to live." However, nearly 20% of women with metastatic breast cancer live five years or longer. It is important for patients and physicians to be realistic about the outcome of advanced breast cancer, but at the same time, the survival rate (16%) is based on statistics. Each woman is unique and her situation will also be unique.

The Imaginis article goes on to suggest several resources.

The National Cancer Institute’s booklet, "Advanced Breast Cancer: Living Each Day." This booklet provides advice on how to deal with the physical and emotional burdens of metastatic breast cancer. A copy of the booklet is available online at Call 1.800.4.CANCER (1.800.422.6237) for information on how to receive a copy of the NCI booklet.
Contact the American Cancer Society for published information and local support groups at 1.800.ACS.2345. (1.800.227.2345).

Advanced Breast Cancer: A Guide to Living With Metastatic Disease (1998) by Musa Mayer offers advice on how to cope with advanced breast cancer. Mayer weaves excerpts from interviews she has conducted with women who have metastatic breast cancer throughout the book.

The Y-ME National Breast Cancer Organization has a 24-hour hot-line women may call for services and support: 1.800.211.2141.

The Susan G. Komen Foundation provides a 24-hour helpline that is answered by trained, caring volunteers whose lives have been personally touched by breast cancer. Helpline volunteers give timely and accurate information to callers with breast health and breast cancer concerns: 1.800.I’M AWARE (1.800.462.9273).

Talk to a counselor, family member, friend, breast cancer survivor, therapist, or clergyman or woman.

Well, people are certainly talking.

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