What is causing bone pain in a woman, 56, with breast cancer?

Hi,

Welcome to icliniq.com.

I understand your concern.

From what you describe, it is very likely that the bone and lung changes seen on your PET-CT (positron emission tomography–computed tomography), along with the rising alkaline phosphatase and high calcium levels, indicate that the breast cancer is more active in the bones and possibly in the lungs as well. The numbness in your left leg and the difficulty walking are particularly important because they may suggest that a spinal nerve, or even the spinal cord, is being compressed by disease in the spine. This is not something that should be monitored at home; it requires urgent medical attention.

The most important step now is to contact your treating oncologist immediately. If you cannot reach them quickly, you should go to the emergency department. They may need to arrange urgent imaging of your spine and decide on further treatment, including pain control and measures to protect your nerves.

Your blood sugar and blood pressure also need active management alongside your cancer care. Your HbA1c (glycated hemoglobin) indicates that your diabetes is not well-controlled at the moment. In a situation like yours, the goal is not “perfect” blood sugars but safe, reasonably controlled levels without frequent lows, typically fasting readings around 110 to 150 mg/dL and post-meal readings mostly under 200 mg/dL. This helps prevent complications from very high sugars while avoiding weakness or fainting from hypoglycemia.

The simplest and safest approach in your case is often to move toward an insulin-based plan that can be adjusted daily. Practically, this usually means a once-daily background (basal) insulin, with small additional doses before meals if needed, while continuing Metformin if your kidneys and stomach tolerate it. Medicines that cause sudden lows or dehydration may need to be reduced or stopped. You would check your sugars at home with a glucometer, and your doctor would adjust your insulin gradually based on those readings and how well you are eating.

Your blood pressure of 158/96 mmHg also needs better control. High blood pressure adds extra strain on your heart, kidneys, and brain and can worsen headaches and fatigue. In your case, the aim is to bring it down gently into a safer range, usually an upper value between 120 and 140, by adjusting the dose of your current medications and, if needed, adding another medicine such as Amlodipine or Telmisartan, provided your kidney function and potassium levels are appropriate. The goal is to lower your pressure without causing dizziness or unsteadiness, so doses are increased slowly while monitoring how you feel and what your home readings show.

The high calcium level (11.2 mg/dL) is likely related to bone involvement. Elevated calcium can cause nausea, poor appetite, constipation, sleepiness, and confusion. This cannot be managed through diet alone; it usually requires intravenous fluids and medications given in a hospital or day-care setting under your oncologist’s or physician’s supervision. It is important that you inform your team about the missed zoledronic acid dose and your ongoing nausea.

I hope this has helped you.

Please feel free to reach out to me again for further queries.

Thank you.