Chances of AROMATASE INHIBITOR in stopping METASTASIS.

Hello. Thank you for posting your query at DoctorSpring.com
1. These cancers are slow growing ones. Like you say, I can't be sure and I really don't know if it had not gone to other places. Based on the investigations available with you, YOU DONT HAVE DISSEMINATED DISEASE RIGHT NOW. If you have your medical report, I am sure your doctors would have staged you as M0 (zero).
2. Possibly YES. AI can act on all cells which are ER positive.
3. Most commonly ER positive cancers spread to bones due to molecular affinity. I don't deny that other sites will not be affected. But preferentially bones are most common site of metastatic deposit in this condition.
Feel free to discuss further,
Regards.

Thank you for your answer. I'm worried about the pain in my buttocks and upper thighs. I am afraid it is bone cancer. I read that bone cancer can hurt from pressure--and that's what happens. I wake up and I'm sort of o.k. But, then, by the end of the day when I've been sitting a lot, my buttocks hurts so much. This morning was actually the first time I woke up and the buttocks was already a bit sore.
Here is the problem. I know my white count is very low right now. I am NOT taking neupogen. But, even if the white count is trying to grow, it's so low, that the neutrophils couldn't be making pain by pushing on the bones. There just can't be enough white cells for that.
You know I am worried that all 3 scans are false negatives (because of my dense bones hiding things). Do you think I am wrong about that?
I don't see how it can be the taxol, because it only affects my buttocks and sometimes my legs. It doesn't affect the top of my body at all.
Do you think what I am feeling is bone cancer? If it were bone cancer, it would be fairly extensive through the lower part of the pelvis, because both sides hurt. I guess, actually it is more of a soreness than actual pain.
I really am looking for an explanation for this pain. My upper femur area hurts too, sometimes. And sometimes there is a pinching feeling which is I think almost between the femur and the pelvis. I also sometimes, at the very end of the day have a soreness in my coccyx.
The only time I am pain free, all day long, is the 2 days after chemo when I have had decadron.
I also worry that the pain in the femurs/legs is separate from the pain in the pelvis. In other words, maybe the leg pain is from chemo, but the pelvis/buttocks pain is from bone cancer.
I feel as though I have had so many tests done--scans AND blood tests that I shouldn't worry about bone cancer. But, to me the symptoms sound like it--the soreness in the buttocks/pelvis especially.

Hello. Thank you for writing to us again.
I hope we have discussed the same issue of pain, decadron and marrow expansion a few times before. I really don't know how to answer your anxious concern on something which commonly happens in post chemo period. I DO COMPLETELY UNDERSTAND YOUR ANXIETY FROM YOUR SIDE. you are definitely correlating it in a wrong way.
When we have a certain and definite cause of pain / soreness (as you describe), I really don't know how to confirm it to you that it is not caused by cancer.
I would suggest you to undergo a complete repeat of all the investigations after a set period of time to affirm you that you do not have dissemination at this point of time. BUT THIS IS NOT NECESSARY FROM TREATMENT POINT OF VIEW. THIS MAY BE REPEATED ONLY TO CONVINCE YOU.
Please understand that any doctor does not have a necessity to hide the truth and treat you. It is obvious from all your previous investigations that you are free of disease right now.
This is the reason why your doctors are treating you with CURATIVE INTENT.
Kind regards.

1. I need a clarification. I have not taken neupogen in 7 days. I suspect my white count is VERY low right now. You told me that I could get bone pain just from having the white cells grow on their own (no need for neupogen to cause the pain) But, I don't understand how that can be--because the cells aren't putting pressure on anything when the white count is very low. They may be trying to grow extra fast--but they aren't "pushing" on anything to cause pain. I really want to believe that the buttocks can have bone pain, even without the neupogen, I think I just need a bit more detailed explanation.
2. Would it be likely for bone cancer pain to suddenly start, right in the middle of chemo? It seems like the chemo should keep everything constant. Because when I started the A/C chemo in February, I had no pain. It seems like the pain started in May, when I switched to Taxol. So is it bone cancer, starting to hurt more during chemo, or is it the taxol (the problem is that taxol isn't supposed to cause BONE pain, and that's what I have)?? Thank you!!!

It is the hematopoietic progenitor stem cells in the marrow which try to multiply to replenish the cells in blood. This is because of various cytokines which gets released after exposure to chemotherapy. This is a usual body mechanism in response to any insult to bone marrow cells.

Additionally myalgia (muscle pain) is also caused by Taxol. It will be difficult to differentiate myalgia from bone pain with symptoms. Both get relieved with Decadron and Tylenol. Since it is a short duration pain, symptomatic therapy is usually advised.

Regards.

Thank you so much for the answer
Can these pains last maybe 2 weeks after a treatment?

Yes, it is possible.
During later courses of chemo it may last longer but subsequently comes down by itself.