Spinal metastases

I don't even know where to start. My dad had surgery for colon cancer five years ago, and everything was going great... until two months ago. Now, it’s spread through his entire spine, and he actually has a spinal fracture from the metastases.
He's been on morphine for three weeks now, plus they've got an epidural catheter in him.
The doctors are basically saying radiation isn't "worth it" anymore, but we're fighting just to get him that treatment.
Does anyone here know what the actual survival odds look like with a diagnosis like this?
Thanks in advance.

dustyjackal33 said:I don't even know where to start. Five years ago, my dad had surgery for colon cancer, and everything was going great—until two months ago. Now, the cancer has spread throughout his spine, causing a spinal fracture from the metastases.
He's been on morphine for three weeks now and has an epidural catheter in his spine.
The doctors are basically saying radiation isn't "worth it," but we're fighting to get him that treatment.
Does anyone know what the survival odds actually look like with a diagnosis like this?
Thanks in advance.

Radiation for the spine is palliative care, meaning the goal is to halt the progression of the metastasis and manage the pain. That said, you haven't given me the full picture of his condition. Are there metastases elsewhere? What is his overall physical state?
There are certainly chances for survival, but the real question is the quality of life he'll have.
Hang in there and try to be his rock.

Hey there—it really depends on where exactly the metastases are located along the spine. If they're hitting the vertebrae and causing painful fractures, things like vertebroplasty or kyphoplasty could definitely help out.

The doctor checked his spine and said a metastasis has actually eaten through one of the vertebrae!
He’s been up and down lately. This morning was actually pretty good, but by evening he was in agony, even with heavy doses of morphine and Norco!
He's losing his appetite too... we have to practically bribe him just to get a few bites in. He's weak on his feet, but that's mostly from the pain. He still has this huge will to live—it's like he's fighting hard—but when the pain hits peak levels, it feels like he's just giving up for a bit. He gets a little out of it if he takes too much morphine, though I think it's just the meds hitting him...
Ronald Green31: Sorry, I honestly don't have the energy to Google this right now, so could you explain what vertebroplasty and kyphoplasty actually are?
Thanks for the help!

If you're dealing with painful vertebral compression fractures, there are a couple of options:
1. Vertebroplasty — this involves injecting bone cement into the vertebra—provided the posterior wall is still intact and enough height has been preserved.
2. Kyphoplasty — used when the vertebra has actually collapsed; a tiny balloon is inflated to restore the lost height before the cement is applied.

Hall & Oates - that iconic 80s duo:

http://www.youtube.com/watch?v=cRScWseLXSg

http://www.youtube.com/watch?v=WPmy2fCuTjs

The woman on the right is Mel.

Back in '85, she beat a liver tumor and everyone thought she was totally in the clear.

But then, late in '87, the damn thing came back—this time as a metastasis in her spine. She was in massive pain, and everyone just assumed it was a slipped disc until an imaging scan showed a shadow where it shouldn't be. Her music career was basically over right then. She started chemo, but honestly, those treatments absolutely trashed her immune system. She ended up passing away on January 18, 1990, from pneumonia.

Ronald Green31: They told us surgery was out of the question... since it spread through the whole spine, they said an operation could be fatal.
I'm wondering if some kind of radiation therapy—maybe once a month—could at least take the edge off the pain?
I remember when my grandma had metastases, she went into the hospital for radiation every month, and then things would actually feel a bit better for the following month...

If we’re looking at widespread metastases stretching along the entire length of the spine, I’m worried that surgery just isn't on the table anymore. The real danger with these kinds of tumors is that if you try to cut into them, they can go absolutely haywire. At that stage, you might be looking at nothing more than palliative care or targeted radiation to manage the worst spots.
Radiation therapy has to be administered in very specific, precise doses.
My advice? Get a second opinion. You also have to account for a certain level of clinical pragmatism here; with the massive backlogs and waiting lists for radiation centers across the US, doctors often don't want to burn through precious time or resources on cases that are purely palliative.😢

They told us there was zero chance he’d even make it to surgery!!
Yesterday was brutal. He was in so much pain we actually had to call 911. They gave him a cocktail of shots—some Ketoral, Normabel, and something to relax his muscles—and man, he was fine after that! He was talking some total nonsense, but hey, that’s just the meds kicking in...
He felt great today too. Slept straight through until 3 PM, and said he finally got some actual rest, all while sleeping on his back!! He even hopped out of bed without any trouble at all so I could head to the bathroom to get cleaned up!
The doctor said this is totally normal and that these ups and downs are part of the deal!!

As for radiation, we aren't 100% sure yet, but it looks like he'll be going through with it!! He's getting these patches that release morphine slowly over three days, so hopefully that keeps him comfortable too!

I'm just praying things get easier. Maybe I'm being selfish, but I want him home with me for as long as possible

P.S. He was telling me today that he's heading to the beach tomorrow, haha!!

dustyjackal33 said:They told us there was absolutely zero chance he’d go under for surgery!!
Yesterday was a total nightmare; his pain levels spiked so hard we actually had to call 911. They pumped him full of a cocktail of injections—think Toradol, Norflex, and something to relax his muscles—and after that, he was doing great! He was talking some total nonsense, but honestly, that was just the drugs talking!
He’s actually feeling good today, too. He slept straight through until 3 PM and said he finally caught up on rest, all while sleeping on his back!! He even got out of bed without any issues while I went to the bathroom to get ready for the day!
The doctor mentioned this is pretty standard and that these kinds of ups and downs are expected!!

As for radiation therapy, we aren't 100% certain yet, but it looks like he’ll be going for it!! He’s also getting those patches that release morphine slowly over three days, so hopefully, that provides some extra relief!

I’m praying things get easier for him. Maybe I'm being selfish, but part of me just wants him to stay here with us for as long as possible.

P.S. He was joking today that he’s heading to the beach tomorrow, haha!!

He’ll be using Duragesic patches.
It isn't selfish to want him by your side for as long as you can, but at the end of the day, it's quality of life that really matters. I truly hope he gets to experience what time he has left without being in agony.
Wishing you all the strength in the world to hang in there and stay by his side.

I just stumbled upon this thread. My father is also going through a series of tests due to severe back pain.

The MRI of the lumbar segment suggests "probable" metastatic lesions involving osteolytic changes in the L1 vertebral body and the right pedicle of the T12 vertebra. There is initial spinal canal obstruction at the L1 level. Vertebral body height is preserved. He has been fitted with a Milwaukee brace.

It’s been two weeks since we started seeing specialists. We’ve already done a PET/CT and are currently waiting on those results. A bone marrow biopsy confirmed there is no connection to CLL—which is what the hematologists claimed—but get this: a neurosurgeon (!) wrote on the MRI report that these changes are part of a primary CLL malignancy. Can you believe that? We still don't have any clear answers. We haven't been referred to an oncologist yet, so we're essentially flying blind. I'm heading in today for blood markers; either we'll discover a cancer we didn't know about, or the source will remain a mystery.

It is difficult to process whether my father is facing the end very soon. If the source remains unknown, is there any chance these metastases could be partially treated to improve his mobility, or is he stuck in this brace indefinitely?

I feel like I'm hitting a wall. Every time I ask a question, they just pass me off to another department. I haven't received a straight answer; we are constantly playing catch-up with various test results. He is on medication and has a high pain tolerance, but I am truly lost. Should I push for a vertebral biopsy, or would that be a mistake that causes these lesions to spread further? They have already performed a bone marrow puncture and a bone biopsy via the hip, and we are still waiting on that specific result.

Will the PET/CT results finally give us some clarity? I would appreciate any advice if anyone has it.