› Forums › General Melanoma Community › Cyber Knife for bone met?
- This topic has 30 replies, 5 voices, and was last updated 8 years, 9 months ago by
Momofjake.
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- May 22, 2014 at 11:37 pm
After receiving the devastating news about the head of the humerus met. I went today and met with the radiation oncologist and they will decide if they will treat the met with cyber knife of with regular radiation.
This is completely new to me and I don't know what to expect from either of them. Did anyone have similar experiences?
Also they scheduled me for a PET CT next week, and I'm terrified what that will might show!!! It's just plain horror movie, going from almost NED to having this big tumor in a matter of weeks. I strongly believe that this monster was hiding in my shoulder for a longer time and the CT just failed to detect it.
Prayers
Dana
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- May 22, 2014 at 11:40 pm
I did not intend to post Anonymous! Sorry it's Sofistef
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- May 23, 2014 at 12:05 am
My husband's original diagnosis was mucosal melanoma of the sinus in April 2013. It has spread and he is stage 4 and is currently on the Merck PD1 expanded access trial. Among his many treatments, he has had Cyberknife twice. Once for "clean up" of original sinus surgeries and recently for a tumor that was pushing down on his eye. Great success both times. For a tumor that was in his hip bone, they used traditional radiation – a one time dose. That too was successful. We go to Dr. O'Day at Beverly Hills Cancer Center.
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- May 23, 2014 at 12:05 am
My husband's original diagnosis was mucosal melanoma of the sinus in April 2013. It has spread and he is stage 4 and is currently on the Merck PD1 expanded access trial. Among his many treatments, he has had Cyberknife twice. Once for "clean up" of original sinus surgeries and recently for a tumor that was pushing down on his eye. Great success both times. For a tumor that was in his hip bone, they used traditional radiation – a one time dose. That too was successful. We go to Dr. O'Day at Beverly Hills Cancer Center.
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- May 23, 2014 at 12:05 am
My husband's original diagnosis was mucosal melanoma of the sinus in April 2013. It has spread and he is stage 4 and is currently on the Merck PD1 expanded access trial. Among his many treatments, he has had Cyberknife twice. Once for "clean up" of original sinus surgeries and recently for a tumor that was pushing down on his eye. Great success both times. For a tumor that was in his hip bone, they used traditional radiation – a one time dose. That too was successful. We go to Dr. O'Day at Beverly Hills Cancer Center.
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- May 23, 2014 at 1:50 am
Artie (Arthusjed007) has a number of bone mets including one very serious one in the T-10 vertebra. He had traditional radiation which helped for a while and then stereotactic radiation which I think worked even better. You can read his profile here: http://www.melanoma.org/community/profiles/arthurjedi007 and then you might want to Private Message him with specific questions.
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- May 23, 2014 at 1:50 am
Artie (Arthusjed007) has a number of bone mets including one very serious one in the T-10 vertebra. He had traditional radiation which helped for a while and then stereotactic radiation which I think worked even better. You can read his profile here: http://www.melanoma.org/community/profiles/arthurjedi007 and then you might want to Private Message him with specific questions.
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- May 23, 2014 at 1:50 am
Artie (Arthusjed007) has a number of bone mets including one very serious one in the T-10 vertebra. He had traditional radiation which helped for a while and then stereotactic radiation which I think worked even better. You can read his profile here: http://www.melanoma.org/community/profiles/arthurjedi007 and then you might want to Private Message him with specific questions.
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- May 24, 2014 at 2:48 am
Sorry to hear about your bone met. And apologies, I'm new here so haven't had the chance to fill in my profile and treatment history (it will take awhile), but I wanted to respond to your message because I have experience with bone mets and radiation. I've been Stage IV since my diagnosis in July 2010 and have had 6 bone mets, including one in my left humeral head, along with 5 in the “long bones” of my legs (one in both the left and right femurs and 3 in the left tibia).The one in my humerus was discovered on PET two weeks after my original diagnosis; unfortunately it didn't respond to the original trial I was in and rapidly went from “something to watch” to being at major risk of fracture. My shoulder was mostly asymptomatic until maybe a month or so before the scan that found that it had progressed, at which point it had started to be a dull ache. By that point, it was beyond any sort of radiation being an option, so I had to see an orthopedic oncologist and had a radical resection of the entire proximal humerus (including the head) which was entirely replaced with a titanium implant. I have limited range of motion and strength in my arm, but I still have it and it's functional.All 5 of my leg bone mets were treated with radiation. Keep in mind that CyberKnife is more about branding and less about the actual kind of radiation you’ll receive. CyberKnife is a form of stereotactic radiation, where stereotactic is how the radiation is targeted at the tumor. But stereotactic radiotherapy can be delivered using a more traditional linear accelerator, both are the same “kind” of radiation.Melanoma used to be considered to be “radio-resistive”, i.e. not responsive to radiation therapy. More recently however, it’s been found that melanoma will respond to radiation using fewer sessions at much higher fractions per session, but the same overall dose. Most people think of radiation as a daily treatment regimen over many weeks. For example, and your mileage may vary, a “traditional” dosing schedule might be 30 grays (Gy) given in 1-Gy fractions, every weekday for 6 weeks (5 days per week x 6 weeks x 1 gray per session). Melanoma is more likely to respond to the same 30-Gy, but instead every other weekday (Mon-Wed-Fri) for 5 sessions in 6-Gy fractions, or even something more aggressive like 3 sessions of 10-Gy fractions. And again, the actual machine used isn't really important, that's more marketing-speak for how the system targets the tumor. For example, CyberKnife is capable of following the movement of a lung and adjusting on the fly, which probably isn’t necessary for a bone met (I had CyberKnife following surgery for a brain met in 2012). So my experience was that radiation therapy was much less disruptive over a shorter period of time than I was expecting. It was also painless, with the biggest side effect being some fatigue. For a couple of the bone mets I also had some hair loss on the skin and what appears to be long-term but mild skin discoloration. Fatigue was very mild for the bone mets and a little more (but manageable) for a lung met this past February.My first leg bone mets were in my left tibia and I noticed them before they showed up on a scan. I had gone for a light jog on the treadmill and noticed that something just wasn't right. Not really pain, just a feeling I hadn't ever experienced that seemed like it was in the bone. After an x-ray and MRI, two lesions very close to each other were found. Both of them and the one in my left femur were eventually treated with two different radiation treatments. Each was 5 fractions of 6-Gy each. Another one in my left tibia and my right femur were subsequently treated with 3 fractions of 10-Gy each. The first tibial lesions responded to radiation and had been stable for almost three years, but recently started becoming more active so the same orthopedic oncologist who performed my shoulder surgery also resected it (just a few days ago) by drilling into the bone, scooping the malignancy, and filling it with bone cement. The first femoral lesion was radiated about two years ago, but didn't respond to radiation quickly enough, so it was resected the same way. The other tibial and femoral lesions have been stable for about three years and don't even earn mention on my scan reports any more.I hope that helps and I'll try to answer any other questions you might have. Try not to get too hung up on the “kinds” of radiation, they're all basically external beam radiation therapy. I was glad to have radiation oncologists and an orthopedic oncologist who work well together and help guide us when radiation or surgery is appropriate.Joe -
- May 24, 2014 at 2:48 am
Sorry to hear about your bone met. And apologies, I'm new here so haven't had the chance to fill in my profile and treatment history (it will take awhile), but I wanted to respond to your message because I have experience with bone mets and radiation. I've been Stage IV since my diagnosis in July 2010 and have had 6 bone mets, including one in my left humeral head, along with 5 in the “long bones” of my legs (one in both the left and right femurs and 3 in the left tibia).The one in my humerus was discovered on PET two weeks after my original diagnosis; unfortunately it didn't respond to the original trial I was in and rapidly went from “something to watch” to being at major risk of fracture. My shoulder was mostly asymptomatic until maybe a month or so before the scan that found that it had progressed, at which point it had started to be a dull ache. By that point, it was beyond any sort of radiation being an option, so I had to see an orthopedic oncologist and had a radical resection of the entire proximal humerus (including the head) which was entirely replaced with a titanium implant. I have limited range of motion and strength in my arm, but I still have it and it's functional.All 5 of my leg bone mets were treated with radiation. Keep in mind that CyberKnife is more about branding and less about the actual kind of radiation you’ll receive. CyberKnife is a form of stereotactic radiation, where stereotactic is how the radiation is targeted at the tumor. But stereotactic radiotherapy can be delivered using a more traditional linear accelerator, both are the same “kind” of radiation.Melanoma used to be considered to be “radio-resistive”, i.e. not responsive to radiation therapy. More recently however, it’s been found that melanoma will respond to radiation using fewer sessions at much higher fractions per session, but the same overall dose. Most people think of radiation as a daily treatment regimen over many weeks. For example, and your mileage may vary, a “traditional” dosing schedule might be 30 grays (Gy) given in 1-Gy fractions, every weekday for 6 weeks (5 days per week x 6 weeks x 1 gray per session). Melanoma is more likely to respond to the same 30-Gy, but instead every other weekday (Mon-Wed-Fri) for 5 sessions in 6-Gy fractions, or even something more aggressive like 3 sessions of 10-Gy fractions. And again, the actual machine used isn't really important, that's more marketing-speak for how the system targets the tumor. For example, CyberKnife is capable of following the movement of a lung and adjusting on the fly, which probably isn’t necessary for a bone met (I had CyberKnife following surgery for a brain met in 2012). So my experience was that radiation therapy was much less disruptive over a shorter period of time than I was expecting. It was also painless, with the biggest side effect being some fatigue. For a couple of the bone mets I also had some hair loss on the skin and what appears to be long-term but mild skin discoloration. Fatigue was very mild for the bone mets and a little more (but manageable) for a lung met this past February.My first leg bone mets were in my left tibia and I noticed them before they showed up on a scan. I had gone for a light jog on the treadmill and noticed that something just wasn't right. Not really pain, just a feeling I hadn't ever experienced that seemed like it was in the bone. After an x-ray and MRI, two lesions very close to each other were found. Both of them and the one in my left femur were eventually treated with two different radiation treatments. Each was 5 fractions of 6-Gy each. Another one in my left tibia and my right femur were subsequently treated with 3 fractions of 10-Gy each. The first tibial lesions responded to radiation and had been stable for almost three years, but recently started becoming more active so the same orthopedic oncologist who performed my shoulder surgery also resected it (just a few days ago) by drilling into the bone, scooping the malignancy, and filling it with bone cement. The first femoral lesion was radiated about two years ago, but didn't respond to radiation quickly enough, so it was resected the same way. The other tibial and femoral lesions have been stable for about three years and don't even earn mention on my scan reports any more.I hope that helps and I'll try to answer any other questions you might have. Try not to get too hung up on the “kinds” of radiation, they're all basically external beam radiation therapy. I was glad to have radiation oncologists and an orthopedic oncologist who work well together and help guide us when radiation or surgery is appropriate.Joe-
- May 24, 2014 at 1:52 pm
Thank you everybody for your responses!
I appreciate every single word .
Joe, can I ask where you are treated? Your story is so encuraging, I'm gathering all the strenght to keep fighting. I'm just numbed by the news I received, how fast things can change , from almost NED to this in a matter of weeks. Tonight I will have a brain MRI, tuesday the PET CT , an soon they will unblind me to find out what meds I received.hopeluly soon I will have a plan. Last weeks bloodwork was normal, for what it matters !
Dana
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- May 24, 2014 at 1:52 pm
Thank you everybody for your responses!
I appreciate every single word .
Joe, can I ask where you are treated? Your story is so encuraging, I'm gathering all the strenght to keep fighting. I'm just numbed by the news I received, how fast things can change , from almost NED to this in a matter of weeks. Tonight I will have a brain MRI, tuesday the PET CT , an soon they will unblind me to find out what meds I received.hopeluly soon I will have a plan. Last weeks bloodwork was normal, for what it matters !
Dana
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- May 24, 2014 at 6:51 pm
I'm glad the Information is helpful, I'm at Fox Chase Cancer Center in Philadelphia. I started there after my diagnosis; my surgeon there had done a fellowship at NIH in Bethesda, MD, several years prior, so recommended I look into one of their TIL cell trials. Within about six weeks, I started a TIL and IL-2 trial at NIH that I was in for about nine months. It's a long story by itself, I'll save that for another post, but ultimately I went through several rounds of IL-2 and eventually TIL. I had several tumors literally melt away but a few months after receiving the TIL cells, I found the bone mets in my tibia. They were probably there from early in my trial participation, but since standard scanning was a chest to pelvis CT scan (neck to mid-thigh, really), they were never picked up until I noticed the odd sensation. So while I did have a good response to TIL, for purposes of the trial it was considered “progressive disease” and we went straight to treating the bone tumors directly with radiation back at Fox Chase. Before starting my TIL treatments, specifically the chemotherapy portion, I also had to have the humeral met treated because of the significant fracture risk (when your immune system has been wiped out by chemotherapy, the last thing you need is a fracture and the significant risk of infection), so partway through the trial at NIH, we paused and saw my orthopedic oncologist at Fox Chase and he performed the arthroplasty of my shoulder. I've been fortunate to have a good team of doctors at both NIH and Fox Chase; I clearly had a response to the TIL that has played a major role in slowing the progression of disease to a point where we’ve been able to address later metastases as they've occurred. I've had 14 different tumors: the original lesion on my back, left humerus, lymph nodes in the left axilla, small intestine, soft tissue of the right temple, internal mediastinum (chest well), three in the left tibia, left femur, right femur, brain, and right lung. In addition to TIL and IL-2, I've also had ipi, along with seven surgeries and six rounds of radiation.Dana, I saw another of your posts where you mention that there is a fracture at the site of the humeral met. Have you or your radiation oncologist consulted with an orthopedic oncologist? It's something you might want to consider, just to hear their opinion on radiation vs. perhaps surgery. You mentioned in that same post that you were surprised how fast it progressed. Mine went from “something to keep an eye on” to being very significant in just about six weeks. In October 2010, it was scanned with CT and mostly stable compared to the prior scan six weeks earlier, with the hope that it would respond to IL-2. Went back to NIH six weeks later, in early December, to start another round of IL-2, but the CT showed significant progression of the tumor. I had noticed some discomfort there in the weeks prior. Before I left NIH that day, they had me wearing a sling and told me to wear it 24×7 until I could see a surgeon — they were worried I could even fracture it in my sleep if I rolled on it the wrong way. We came back to Philadelphia and I saw the orthopedic oncologist at Fox Chase, whose first comment to me on seeing the CT and MRI was, “Wear the sling.” I had the surgery about 10 days later. -
- May 24, 2014 at 6:51 pm
I'm glad the Information is helpful, I'm at Fox Chase Cancer Center in Philadelphia. I started there after my diagnosis; my surgeon there had done a fellowship at NIH in Bethesda, MD, several years prior, so recommended I look into one of their TIL cell trials. Within about six weeks, I started a TIL and IL-2 trial at NIH that I was in for about nine months. It's a long story by itself, I'll save that for another post, but ultimately I went through several rounds of IL-2 and eventually TIL. I had several tumors literally melt away but a few months after receiving the TIL cells, I found the bone mets in my tibia. They were probably there from early in my trial participation, but since standard scanning was a chest to pelvis CT scan (neck to mid-thigh, really), they were never picked up until I noticed the odd sensation. So while I did have a good response to TIL, for purposes of the trial it was considered “progressive disease” and we went straight to treating the bone tumors directly with radiation back at Fox Chase. Before starting my TIL treatments, specifically the chemotherapy portion, I also had to have the humeral met treated because of the significant fracture risk (when your immune system has been wiped out by chemotherapy, the last thing you need is a fracture and the significant risk of infection), so partway through the trial at NIH, we paused and saw my orthopedic oncologist at Fox Chase and he performed the arthroplasty of my shoulder. I've been fortunate to have a good team of doctors at both NIH and Fox Chase; I clearly had a response to the TIL that has played a major role in slowing the progression of disease to a point where we’ve been able to address later metastases as they've occurred. I've had 14 different tumors: the original lesion on my back, left humerus, lymph nodes in the left axilla, small intestine, soft tissue of the right temple, internal mediastinum (chest well), three in the left tibia, left femur, right femur, brain, and right lung. In addition to TIL and IL-2, I've also had ipi, along with seven surgeries and six rounds of radiation.Dana, I saw another of your posts where you mention that there is a fracture at the site of the humeral met. Have you or your radiation oncologist consulted with an orthopedic oncologist? It's something you might want to consider, just to hear their opinion on radiation vs. perhaps surgery. You mentioned in that same post that you were surprised how fast it progressed. Mine went from “something to keep an eye on” to being very significant in just about six weeks. In October 2010, it was scanned with CT and mostly stable compared to the prior scan six weeks earlier, with the hope that it would respond to IL-2. Went back to NIH six weeks later, in early December, to start another round of IL-2, but the CT showed significant progression of the tumor. I had noticed some discomfort there in the weeks prior. Before I left NIH that day, they had me wearing a sling and told me to wear it 24×7 until I could see a surgeon — they were worried I could even fracture it in my sleep if I rolled on it the wrong way. We came back to Philadelphia and I saw the orthopedic oncologist at Fox Chase, whose first comment to me on seeing the CT and MRI was, “Wear the sling.” I had the surgery about 10 days later. -
- May 24, 2014 at 6:51 pm
I'm glad the Information is helpful, I'm at Fox Chase Cancer Center in Philadelphia. I started there after my diagnosis; my surgeon there had done a fellowship at NIH in Bethesda, MD, several years prior, so recommended I look into one of their TIL cell trials. Within about six weeks, I started a TIL and IL-2 trial at NIH that I was in for about nine months. It's a long story by itself, I'll save that for another post, but ultimately I went through several rounds of IL-2 and eventually TIL. I had several tumors literally melt away but a few months after receiving the TIL cells, I found the bone mets in my tibia. They were probably there from early in my trial participation, but since standard scanning was a chest to pelvis CT scan (neck to mid-thigh, really), they were never picked up until I noticed the odd sensation. So while I did have a good response to TIL, for purposes of the trial it was considered “progressive disease” and we went straight to treating the bone tumors directly with radiation back at Fox Chase. Before starting my TIL treatments, specifically the chemotherapy portion, I also had to have the humeral met treated because of the significant fracture risk (when your immune system has been wiped out by chemotherapy, the last thing you need is a fracture and the significant risk of infection), so partway through the trial at NIH, we paused and saw my orthopedic oncologist at Fox Chase and he performed the arthroplasty of my shoulder. I've been fortunate to have a good team of doctors at both NIH and Fox Chase; I clearly had a response to the TIL that has played a major role in slowing the progression of disease to a point where we’ve been able to address later metastases as they've occurred. I've had 14 different tumors: the original lesion on my back, left humerus, lymph nodes in the left axilla, small intestine, soft tissue of the right temple, internal mediastinum (chest well), three in the left tibia, left femur, right femur, brain, and right lung. In addition to TIL and IL-2, I've also had ipi, along with seven surgeries and six rounds of radiation.Dana, I saw another of your posts where you mention that there is a fracture at the site of the humeral met. Have you or your radiation oncologist consulted with an orthopedic oncologist? It's something you might want to consider, just to hear their opinion on radiation vs. perhaps surgery. You mentioned in that same post that you were surprised how fast it progressed. Mine went from “something to keep an eye on” to being very significant in just about six weeks. In October 2010, it was scanned with CT and mostly stable compared to the prior scan six weeks earlier, with the hope that it would respond to IL-2. Went back to NIH six weeks later, in early December, to start another round of IL-2, but the CT showed significant progression of the tumor. I had noticed some discomfort there in the weeks prior. Before I left NIH that day, they had me wearing a sling and told me to wear it 24×7 until I could see a surgeon — they were worried I could even fracture it in my sleep if I rolled on it the wrong way. We came back to Philadelphia and I saw the orthopedic oncologist at Fox Chase, whose first comment to me on seeing the CT and MRI was, “Wear the sling.” I had the surgery about 10 days later. -
- May 24, 2014 at 1:52 pm
Thank you everybody for your responses!
I appreciate every single word .
Joe, can I ask where you are treated? Your story is so encuraging, I'm gathering all the strenght to keep fighting. I'm just numbed by the news I received, how fast things can change , from almost NED to this in a matter of weeks. Tonight I will have a brain MRI, tuesday the PET CT , an soon they will unblind me to find out what meds I received.hopeluly soon I will have a plan. Last weeks bloodwork was normal, for what it matters !
Dana
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- July 30, 2015 at 2:11 pm
Joe,
how are you? My 18yr old son is stage 4 w bone mets on his spine, femurs, ribs etc. He also has it in his liver, lungs, muscles and skin. He started keytruda 5 weeks ago and feels way better this week! Last weeks MRI on his lower back showed sizable tumors. I don't know how the femurs are doing. He is very active!! Too active probably but at 18 it's the deal. He was diagnosed just 11 mo ago. He has gone thru biochemo w low dose IL-2 and radiation on his head and neck plus multiple surgeries. It's been rough for sure.
Now I am very worried about spine and femurs! His doc has never mentioned surgery and we had to push for the recent MRI and now they are suggesting radiation. He is 18!! Can't have spine fractures w a chance of the anti pd1 working long term for him!
Just wanted to see how you are and thank you!
Prayers,
Momofjake(kerri)
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- July 30, 2015 at 2:11 pm
Joe,
how are you? My 18yr old son is stage 4 w bone mets on his spine, femurs, ribs etc. He also has it in his liver, lungs, muscles and skin. He started keytruda 5 weeks ago and feels way better this week! Last weeks MRI on his lower back showed sizable tumors. I don't know how the femurs are doing. He is very active!! Too active probably but at 18 it's the deal. He was diagnosed just 11 mo ago. He has gone thru biochemo w low dose IL-2 and radiation on his head and neck plus multiple surgeries. It's been rough for sure.
Now I am very worried about spine and femurs! His doc has never mentioned surgery and we had to push for the recent MRI and now they are suggesting radiation. He is 18!! Can't have spine fractures w a chance of the anti pd1 working long term for him!
Just wanted to see how you are and thank you!
Prayers,
Momofjake(kerri)
-
- July 30, 2015 at 2:11 pm
Joe,
how are you? My 18yr old son is stage 4 w bone mets on his spine, femurs, ribs etc. He also has it in his liver, lungs, muscles and skin. He started keytruda 5 weeks ago and feels way better this week! Last weeks MRI on his lower back showed sizable tumors. I don't know how the femurs are doing. He is very active!! Too active probably but at 18 it's the deal. He was diagnosed just 11 mo ago. He has gone thru biochemo w low dose IL-2 and radiation on his head and neck plus multiple surgeries. It's been rough for sure.
Now I am very worried about spine and femurs! His doc has never mentioned surgery and we had to push for the recent MRI and now they are suggesting radiation. He is 18!! Can't have spine fractures w a chance of the anti pd1 working long term for him!
Just wanted to see how you are and thank you!
Prayers,
Momofjake(kerri)
-
- May 24, 2014 at 2:48 am
Sorry to hear about your bone met. And apologies, I'm new here so haven't had the chance to fill in my profile and treatment history (it will take awhile), but I wanted to respond to your message because I have experience with bone mets and radiation. I've been Stage IV since my diagnosis in July 2010 and have had 6 bone mets, including one in my left humeral head, along with 5 in the “long bones” of my legs (one in both the left and right femurs and 3 in the left tibia).The one in my humerus was discovered on PET two weeks after my original diagnosis; unfortunately it didn't respond to the original trial I was in and rapidly went from “something to watch” to being at major risk of fracture. My shoulder was mostly asymptomatic until maybe a month or so before the scan that found that it had progressed, at which point it had started to be a dull ache. By that point, it was beyond any sort of radiation being an option, so I had to see an orthopedic oncologist and had a radical resection of the entire proximal humerus (including the head) which was entirely replaced with a titanium implant. I have limited range of motion and strength in my arm, but I still have it and it's functional.All 5 of my leg bone mets were treated with radiation. Keep in mind that CyberKnife is more about branding and less about the actual kind of radiation you’ll receive. CyberKnife is a form of stereotactic radiation, where stereotactic is how the radiation is targeted at the tumor. But stereotactic radiotherapy can be delivered using a more traditional linear accelerator, both are the same “kind” of radiation.Melanoma used to be considered to be “radio-resistive”, i.e. not responsive to radiation therapy. More recently however, it’s been found that melanoma will respond to radiation using fewer sessions at much higher fractions per session, but the same overall dose. Most people think of radiation as a daily treatment regimen over many weeks. For example, and your mileage may vary, a “traditional” dosing schedule might be 30 grays (Gy) given in 1-Gy fractions, every weekday for 6 weeks (5 days per week x 6 weeks x 1 gray per session). Melanoma is more likely to respond to the same 30-Gy, but instead every other weekday (Mon-Wed-Fri) for 5 sessions in 6-Gy fractions, or even something more aggressive like 3 sessions of 10-Gy fractions. And again, the actual machine used isn't really important, that's more marketing-speak for how the system targets the tumor. For example, CyberKnife is capable of following the movement of a lung and adjusting on the fly, which probably isn’t necessary for a bone met (I had CyberKnife following surgery for a brain met in 2012). So my experience was that radiation therapy was much less disruptive over a shorter period of time than I was expecting. It was also painless, with the biggest side effect being some fatigue. For a couple of the bone mets I also had some hair loss on the skin and what appears to be long-term but mild skin discoloration. Fatigue was very mild for the bone mets and a little more (but manageable) for a lung met this past February.My first leg bone mets were in my left tibia and I noticed them before they showed up on a scan. I had gone for a light jog on the treadmill and noticed that something just wasn't right. Not really pain, just a feeling I hadn't ever experienced that seemed like it was in the bone. After an x-ray and MRI, two lesions very close to each other were found. Both of them and the one in my left femur were eventually treated with two different radiation treatments. Each was 5 fractions of 6-Gy each. Another one in my left tibia and my right femur were subsequently treated with 3 fractions of 10-Gy each. The first tibial lesions responded to radiation and had been stable for almost three years, but recently started becoming more active so the same orthopedic oncologist who performed my shoulder surgery also resected it (just a few days ago) by drilling into the bone, scooping the malignancy, and filling it with bone cement. The first femoral lesion was radiated about two years ago, but didn't respond to radiation quickly enough, so it was resected the same way. The other tibial and femoral lesions have been stable for about three years and don't even earn mention on my scan reports any more.I hope that helps and I'll try to answer any other questions you might have. Try not to get too hung up on the “kinds” of radiation, they're all basically external beam radiation therapy. I was glad to have radiation oncologists and an orthopedic oncologist who work well together and help guide us when radiation or surgery is appropriate.Joe
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