Oncologist Questions Leptomeningeal Disease

Leptomeningeals disease- help me get more time?

I am a 62 year old stage 4 breast cancer patient who has been on treatment for bone mets for the last 6 years which have been relatively stable. I recently was told in my last scan and confirmed in cytology that the cancer has spread to the leptomenigeal space on my spine around t1-t4. I know that this is very bad, and does not leave me with many options or much time. This last week I started having difficulty standing and am losing feeling in my legs. I am exhausted from treatments, but my son's wedding is in six months and I want more than anything to be there and be standing for our mother son dance before I leave this earth. While I am exhausted from treatments, I will do what it takes to get me to his wedding. What do you think is my best treatment option?

8 Answers

Your symptoms sound like you have cord compression in those level. The doctor may be able to give you radiation treatment to relieve your symptoms and regain the motor function. In some patients, decompressive laminectomy may be helpful to prevent you from paralysis. The treatment may not prolong your life, but at least it will prevent you from losing control of your leg.
I would consider radiation therapy to the T-spine if you did not have this part of spine radiated previously. It may help to reverse your symptoms.
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You should have immediate Radiation Therapy to the spine & possibly have intraspinal Chemotherapy.
If you can tolerate whole brain and spine radiation therapy, it may help you control disease. If not, radiation to T1-4 may help relieve some symptoms too. I hope that you can dance with your son at his wedding.
Radiation should help palliate your symptoms.
Chemotherapy and Radiation to the spine.
Please discuss this with your personal oncologist. Treatment options for leptomeningeal disease include chemotherapy delivered directly to the spinal fluid, radiation therapy for some patients, and systemic therapy for some patients. For some patients, the best treatment option is supportive care with transition to hospice. The doctors taking care of you who have access to the details of your case are best equipped to help you make the right decision.
Sorry to hear about the progression of your disease. I would recommend radiation therapy to the area, to prevent further deterioration of your leg function, with possible improvement.