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stage 4 breast cancer met to the spine
lynnette
Posted: Thursday, September 30, 2010 6:29 AM
Joined: 9/30/2010
Posts: 8


I was wondering if anyone else on this forum has information reguarding what to expect with radiatiion to the spine. My sister just found out in april that she has this dx. She has refused all chemo and radiation up until this point. Her lumpectomy was done 5 yrs ago and surrounding lymph nodes were clear she chose to deny all treatment being the naturalist that she is. She fell in april and fx her lumbar spine 2 places those were repaired and she recovered. Now her thoracic spine has fx due to the invasion of the cancer in the lumbar and thoracic spine. She has been doing natural and holistic therapies including raw diet and juicing. She was walking up to 1/2 mile a day and feeling stronger. All of a sudden she has excrucitating pain between her shoulder blades. I'm sure it is the thoracic vertebrae fx. They are advocating radiation to decrease the pain. If her pain is due to the fractured vertebrae will radiation help? I guess in the long run it might kill cancer cells and stop the rapid degeneration of the vertebrae due to the cancer. Will radiation therapy further weaken her crumbling vertebrae in her spine?
radsrus
Posted: Friday, October 01, 2010 3:22 AM
Joined: 10/10/2008
Posts: 4435


Radiation will usually stop or greatly reduce the pain. Vertebroplasty or kyphoplasty might also be useful after the radiation.

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


lynnette
Posted: Friday, October 01, 2010 7:54 AM
Joined: 9/30/2010
Posts: 8


Thank you for the information I hope she can get the repair done after the radiation therapy.
lynnette
Posted: Saturday, October 02, 2010 8:46 AM
Joined: 9/30/2010
Posts: 8


I was also wondering about having kyphoplasty to the fractured thoracic vertebrae. Why wouldn't the physicians just have advocated that to aleviate the pain as that is obviously why she is in pain? i understand that the radiation is recomended for knocking back the cancer cells but why would\'t they repair the obvious reason for her sudden acute pain the fx vertebrae before they started radiation tx? Won't she have to wait now and heal from the radiation tx who knows how long before she can have the fx vertebrae repaired? This is soooooo frustrating!!!! My sisiter is in excrutiating pain while they do radiation tx to her spine knowing that she has a fx vertebrae that is CAUSING the pain and now i'm assuming she cant have kyphoplasty done till she heals from the radiation tx? Please let me know how all this works. Thanks
radsrus
Posted: Sunday, October 03, 2010 4:17 AM
Joined: 10/10/2008
Posts: 4435


1. It is not at all clear that kyphoplasty is better than vertebroplasty 2. There is some concern that doing either might track cancer cells out along the needle tracks. 3. The pain is probably multifactorial, and simply stabilizing the vertebra without also treating the cancer is not always effective. I think you can make a legitimate argument as to which you do first (see #1) 4. RT frequently alleviates the pain without need for invasive intervention, although not always 5. We are willing to do vertebroplasty immediately after RT, and particularly after CK where the skin does not get sigfnificant doses

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


lynnette
Posted: Sunday, October 03, 2010 9:25 AM
Joined: 9/30/2010
Posts: 8


what is the difference bt kyphoplasty and vertebrplasty? Do you just strenghthen the vertebrae somehow without doing bone replacement? A very concerning development is that her hands are now numb and tingling. I am sure it is due to tissue damage and swelling around the spinal cord. She is on steroid doses. Po now not IV. She is scheduled for 10 more raditation tx to thoracic spine. What is the protocol for this. Apparently the physicians have expected the numbness and tingling and told her about it because she called it neuropathy but this is not true neuropathy just swelling to the tissues around the cord and placing pressure on the cord. Please advise me as soon as possible what you would do about this latest development and I am praying the ones in charge will do something FAST. Cord damage is nothing to PLAY AROUND WITH!!!!! She has only had 2 radiation tx so far thurs and friday this wk. The whole place shuts down on the wk end so I presume they will get on with it on Monday. I hate all this I wish she wasn't in pain and I wish I didn't know so much about spinal cord injury as I am a RN who has worked extensivly with those type pts.
radsrus
Posted: Sunday, October 03, 2010 6:19 PM
Joined: 10/10/2008
Posts: 4435


Vertebroplasty simply pumps the vertebra full of glue that hardens and stabilizes the bone. Kyphoplasty first puts in a balloon and tries to pump it up to restore the height of the vertebra. As I read the data, neither approach is clearly superior. She needs to keep in close touch with the treating team. They should be available all the time

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


lynnette
Posted: Monday, October 04, 2010 11:13 AM
Joined: 9/30/2010
Posts: 8


Thanks for the info. She is being treated today at the hospital on outpt basis. She is telling her team about the tingling and numbness in the each hand last 3 digits. I hope they increase the steroids or give her some IV for edema. I guess she will have to get through these last 7 radiation tx's before we can talk vertebrae repair. Where are you located? She is being treated in Tampa florida at Moffit cancer hospital. I did find it strange that they shut down on the week-end with the raditation txs. You would think being a cancer center they wouldn't resemble the VA hospitals so much. At least her cord had a break for 2 days. Thanks for the info.
radsrus
Posted: Monday, October 04, 2010 8:40 PM
Joined: 10/10/2008
Posts: 4435


I don't know of ANY radiation centers that treat through the weekend on a regular basis. It is simply not a supportable endeavor because of the expense.

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


lynnette
Posted: Tuesday, October 05, 2010 8:42 AM
Joined: 9/30/2010
Posts: 8


I wasn't aware that it was common place to close down for week-end as we are new to radiation txs. Are you familiar with Moffit Cancer center? Just curious. Also had a question about cyberknife therapy. I guess she wouldn't be a candidate because there is no tumor to remove. The cells from the cancerous cyst in her breast 5 yrs ago have invaded her bone and are destroying bone tissue at a very rapid rate so I assume radiation therapy to the obvious sites that show up on cat scan and pet scans is the best route of attacking the cancer now.
radsrus
Posted: Tuesday, October 05, 2010 9:14 AM
Joined: 10/10/2008
Posts: 4435


Moffitt Is a good center. She would be a good candidate for CK for various things if needed, including spine

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


lynnette
Posted: Tuesday, October 05, 2010 9:23 AM
Joined: 9/30/2010
Posts: 8


what type of therapy with cyberknife would benifit her? I want to let her know and is there a place in Tampa Florida that has cyberknife therapy?
radsrus
Posted: Tuesday, October 05, 2010 11:53 AM
Joined: 10/10/2008
Posts: 4435


If you go to Accuray.com you can find a list of CK centers nearest your zip code. What she would be a candidate for would depend on the exact circumstances so would require review of scans etc at the time treatment is being considered.

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


gregmarg
Posted: Tuesday, October 19, 2010 8:02 AM
Joined: 10/19/2010
Posts: 2



gregmarg
Posted: Tuesday, October 19, 2010 8:06 AM
Joined: 10/19/2010
Posts: 2


My fiance was recently diagnosed with Stage 4 breast cancer. It appears as though the cancer cells have spread to 4-5 vertabrae, the doctors decided not to do a biopsy because of the location and proximity to the spine. She is due to start chemo in 2 days, my question is would she be a good candidate for the cyber knife, not sure how it works, what would be the benefits if any or the risks.  Thanks
radsrus
Posted: Tuesday, October 19, 2010 8:29 AM
Joined: 10/10/2008
Posts: 4435


That many vertebral bodies are best treated with standard radiation if radiation is needed at all.

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


lynnette
Posted: Sunday, October 24, 2010 6:54 PM
Joined: 9/30/2010
Posts: 8


My sister just underwent 10 raditation tx to the thoracic spine. It didn't help her pain at all. I ask again would she be a candidtate for vertebrae plasty after she heal from the radiation tx? Her pain and numbness were not helped at all. Would a needle insertion be a risk to spread the cancer? It seems that the process of inserting the substance to fix the fracture it would also seal in the cancer cells not let them out.
radsrus
Posted: Monday, October 25, 2010 3:24 AM
Joined: 10/10/2008
Posts: 4435


Vertebroplasty or kyphoplasty might help. I have not searched the medical literature, but I have not seen any reports of cancer cells tracking along the needle tracks, and that would be highly unlikely after radiation treatment anyway. The glue also does not seal them in. It just stabilizes the bone.

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


 

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