Skull Bone Metastasis: Treatment Options?

Hi Naz, I had disease progression to my skull. I think they were about 10 spots. So they radiated most of my skull. They made me a special helmet, first. That took about 15 hours. I had 15-20 sessions of radiation. I lost all my hair very quickly except for about 1.5 inches at the base of my skull. I was fortunate to get most of my hair back just not as thick. Then, my oncologist changed my meds to Ibrance/fluvestrant. I had been on Ibrance/letrolzole.

Hi Virginia, Thank you for sharing your experience. I have my appt with rad onc next week. Was your cognition effected at all? I am worried about that.

Hi Naz, I have extensive Mets to my skull with breakdown showing on the parietal calvarium. I have been on Ibrance, anastrozole and Xgeva. Which seemed to work for about a year, I am due for another pet scan in 2 weeks so I do not know my present status but as of 3 months ago according to my last pet scan , the medicine was working. Best of luck to you! You will be in my thoughts and prayers. Melissa

Naz, no cognitive issues. They were very careful that they only hit my skull. My helmet had some kind of thick skin on it. They also rotated the machine about 30 times.

My disease metastasis is to my bones and liver. Diagnosis a year ago. It is in my skull, my spine, most of my ribs, my pelvic bones and was really fast moving. My oncologist put me on Verzenio. Within 3 months the cancer in all locations was reduced by 1/2. My side effects were exhaustion, and serious diarrhea. I was just learning to manage it when my blood counts started dropping. I kept needing transfusions every three weeks. Turns out, the Verzenio was attacking my bone marrow system to the point of a complete bone marrow system failure. I had to be taken off the Verzenio in October. I wish they could have left me on it and just dealt with transfusions as needed(, but they were concerned I could be thrown into acute leukemia. So now it’s a waiting game. I just had CTscans and bone scans; no change from the previous scans in September.,Bone marrow is slowly resuming functioning without help. I really want to be able to go back on the Verzenio. Naz I did radiation first, but only to part of my pelvic bone to help with pain. None to my skull. Good luck.

Thank you everyone for your replies. Virginia so glad they could treat urs and u did not have any cognitive issues. Melissa so glad your mets have been responsive to systemic treatment. Kathleen, its so wonderful that your lesions were reduced by 1/2 and am glad your imaging doesnt show growth. That is hopeful.I met with my rad onc who suggested MRI another 3 months to see progression and suggested hold off radiation since I am not very symptomatic ( I do have occasional localized pain/burning sensation/tenderness to touch, and a bit of indentation on the skull in that area) and have not taken pain meds for it. Apparently they can't do radiation to one area more than once and want to see if systemic targeted therapy will help or not. I only started that 2 months ago so will have my next imaging CT in March. My medical oncologist wasn't very concerned which made me more worried as I am hoping the lesion doesn't get into my brain. He says it could happen but it's rare. He wants to order the MRI in March which in Canada means another 2 months wait so likely May. Your comments have been helpful as no cognitive issues happened with radiation and some didn't have radiation and the area responded to systemic therapy. Thank you again. 🩷🩷🩷

This sounds like a challenging situation, and it's completely understandable to want to explore all available treatment options for skull bone metastases. Both targeted therapy combinations and radiation treatments like SBRT can be effective approaches, though the best choice depends on many individual factors that only your oncology team can fully evaluate. Consider discussing both options with your medical team - they can review your specific case details, current health status, and treatment history to help guide the decision that's right for your situation.