Coping with Bone Issues in Ca... Video Transcript

Participants

Roger Waltzman MD, Jessica Wing

Summary

Life isn't easy for people living with cancer and especially for young patients like filmmaker Jessica Wing whose illness and complications had restricted not only her movements, but also her life. After radiation and surgery, Jessica was thankful when her doctor suggested a medical treatment that has helped Jessica resume her routine.

Webcast Transcript

JESSICA WING: It was very difficult. I mean it's still difficult, but I think living with it for so long has made me become a little more blasé.

ANNOUNCER: What Jessica has had to live with is colon cancer. The 31-year-old filmmaker and composer had been having bowel problems when she went to the doctor. Nothing could have been more shocking than hearing her diagnosis

JESSICA WING: It was so completely unexpected. I was 30. There was no history of cancer in my family. There was absolutely nothing that-I had been a vegetarian for ten years. So there is nothing to think that you're suddenly going to find out that you have stage 4 colon cancer.

ANNOUNCER: Jessica's cancer was treated with chemotherapy and then surgery. But after her initial treatments, new problems arose.

JESSICA WING: I had a lot of neck pain. I went in for a bone scan where they basically can see any metastases that would be anywhere in your bones. And they discovered at that point that there were metastases sort of scattered through my spine and also in my hips. But the worst one was in my neck where I was having a lot of pain.

ROGER WALTZMAN, MD: Bone complications from cancer can occur in really a wide variety of diseases, but the ones that are most commonly affected by bone complications are multiple myeloma, which is like a leukemia of white cells. Also the solid tumors that are most likely to spread to the bone are breast cancer, prostate cancer, lung cancer.

Colorectal cancer is, in addition, a disease that can spread to the bone.

ANNOUNCER: Bone complications happen when cancer interferes with the ability of the body to form new bone.

ROGER WALTZMAN, MD: There are two different cells at work. One called the osteoblast and one called the osteoclast; laying down new bone versus removing old bone. And as the cancer takes up more of the bone, there is less ability for the normal osteoblast to form normal bone. And instead there is increased osteoclastic activity to remove the abnormal bone. Unfortunately, in the process of removing the abnormal bone, what might result is just weakened thin bones. Because you don't have normal bone tissue being laid down.

JESSICA WING: I couldn't really look at the computer for any extended period of time. I could watch television, which is not one of my favorite activities, but I couldn't really walk around a lot because I could not turn my head to look and see if a car was coming. It was really hard to be confined to the house and not have a lot to do. And also being in pain is hard. That was the worst.

ANNOUNCER: When bone complications do occur there are several treatment options including surgery to stabilize bones, radiation for pain control, and bisphosphonate therapy, specifically aimed at strengthening bone. Initially, Jessica had radiation on her neck, but soon after her doctors suggested bisphosphonates.

ROGER WALTZMAN, MD: Bisphosphonates are drugs that act to prevent a particular cell in the body, the osteoclast, from resorbing bone. So basically it's stopping what is an accelerated, albeit normal, process when it's at a low level. And it stops this accelerated process from leaching away the normal bone, so to speak. It's not effective in all patients; it's not universally effective, I guess we could say. But it does seem to demonstrate in large trials, in large clinical trials, that there is a decrease in the incidence of further skeletal involvement of disease when using bisphosphonates. And an improvement in pain control for patients-the reduction in the complications, such as fractures or the need for radiation therapy.