What can reduce my mother's bone pain in breast cancer?

Question

Hi doctor,

My mother is suffering from breast cancer as the primary, and now there is brain metastasis. The disease has spread to all parts of the body, including the bones. I have attached her PET scan for your reference.

We are taking the treatment for the disease, and her physical condition was very good till last week. Our doctor changed suddenly as he moved to another hospital, and the new doctor is taking care of her now.

Every month, we used to have Ibandronic acid for bone, but we did not receive this medicine last month as the doctor did not include it. Now, my mother is getting severe leg pains and is not able to sit or get up. She is unable to stand for even 2 minutes.

Can you see the PET scan report and suggest good medicine for the bone improvement?
Can you suggest a good medicine for bone metastasis?

Some doctors said that Zoledronic acid is better than Ibandronic acid.

Please suggest.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern about the patient.

As per the scan report you sent (attachment removed to protect patient identity), though the metastasis is widespread, she has relatively improved as far as bone is considered (sclerotic). In the case of cancers, bone quality is largely affected. Bisphosphonates are used to improve the quality of bone, which is a slow process.

Currently, two approved and commonly used IV bisphosphonates are Pamidronate disodium and Zoledronic acid. This will reduce her bone pain relatively. Her kidney function should be normal before taking this injection. This should be taken once a month. You can just request the treating oncologist regarding this.

Regarding your query, though there are a few differences between them, Zoledronic acid is preferred. But that does not mean that the other bisphosphonate should not be taken. Any bisphosphonate works similarly, with each differing in its side effects. She might not be able to get up, meaning that apart from the bony component, the neurological component might be present, and her generalized weakness would also add to it.

The preventive measures you can take are;

Use a walker while walking if she has pain while walking to prevent falling. As her bones are weak, even a trivial fall can cause a fracture.
In the bathroom, use any carpet that does not slip.
Always ask her to take the support of the railing while climbing stairs.

I hope this helps.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Thank you. Hope your mother does her activities of daily living effortlessly. Take care.

Thank you.