In this second of three episodes on managing bone metastases in MBC, we bring you a broad review of the major interventions to treat and manage bone mets. We explain the differences among the specialties of Radiology (think x-rays and PET/CT scans) vs. Radiation Oncology (external beam, Stereotactic Radiation Surgery (SRS) or Stereotactic Body Radiation Therapy (SBRT) and Interventional Radiology (Biopsies, Cryoablation, Radiofrequency Ablation among others). The majority of patients with MBC have bone metastases and may have been treated with some form of radiation. For patients with "oligometastatic" disease, where the number of distant sites of metastatic spread is generally considered to be 5 or less, radiation treatment may be “curative”. It gets a little less clear in those of us with heavier tumor burden and more widespread disease. In that case, radiation is often offered for pain and neurologic considerations, such as preventing a tumor from pressing on the spinal cord, possibly resulting in serious spinal cord compression. But, can different radiation strategies be helpful in disease management, beyond pain management? We ask these questions of both experts here – the first Dr. Shalom Kalnicki, Professor of Radiation Oncology and Associate Director of the Montefiore Einstein Comprehensive Cancer Center in New York City. Our second expert clinician is Dr. Rory Goodwin, who leads the Duke Center for Brain and Spine Metastasis in Durham, North Carolina. He’ll talk about this innovative Center’s approach to managing bone mets, including offering some lesser-known treatment approaches like Cryoablation (freezing the tumor), and Radiofrequency Ablation (heating the tumor). We also address an emerging therapy called “Theranostics” which is when a radioactive tracer (like the ones used in PET/CT scans) is bound to a radiation treatment that can deliver a lethal dose directly to the bound cancer cell. So listen here and learn with us, and check out the more detailed show notes on our website for the links to what’s covered in the episode.

Today’s episode is the first in a three part series covering all things related to bone metastasis. In our first episode, we’re covering the basics starting with some bone education. We’re joined by Dr. Azeez Farooki, an endocrinologist at MSK, who discusses his role on treatment for bone disease stemming from breast cancer. We’re also joined by Dr. Monica Fornier, a breast medical oncologist also at MSK, who treats people living with metastatic breast cancer. Both doctors will be diving into bone disease & the latest in breast cancer bone metastasis research. Topics include theories on why breast cancer spreads to the bones, as well as the future of bone metastasis research and treatment. We unlock the wisdom of these top experts as they bridge the gaps between advancing research and patient care in a thought provoking conversation.

Even though breast cancer research is comparatively well-funded, researchers still don't fully understand the many different ways metastatic cancer eventually evades currently available treatments. Just like a detective can learn much from studying the scene of a crime, researchers need to understand how breast cancer causes death to better understand how to stop it from doing so. One of the quickest ways for them to do that is through something called a tissue donation program.

Many of us are familiar with organ donation programs, but as metastatic patients, we are no longer eligible to donate our organs to another person. We can, however, donate tissue while we're still alive and tissues, including organs, soon after we die to aid thousands of future patients by helping researchers better understand the process of metastasis. Understanding the way cancer evades current treatments is key to developing more effective and more targeted treatments that let us live longer (and with a better quality of life) with the hope that one day we can stop MBC from prematurely ending our lives.

To learn more about tissue donation programs and why they are so essential to scientific discoveries, we talk with patient advocates, Stephanie Walker and Christine Hodgdon, along with breast cancer researcher Dr. Steffi Oesterreich and clinical coordinator Lori Miller about the topic of tissue donation in general and the specific program they're all involved with called Hope for Others at the University of Pittsburgh.