JESSICA WING: It was very difficult. I mean it's still difficult, but I think living with it for so long has made me become a little more blasé.
ANNOUNCER: What Jessica has had to live with is colon cancer. The 31-year-old filmmaker and composer had been having bowel problems when she went to the doctor. Nothing could have been more shocking than hearing her diagnosis
JESSICA WING: It was so completely unexpected. I was 30. There was no history of cancer in my family. There was absolutely nothing that-I had been a vegetarian for ten years. So there is nothing to think that you're suddenly going to find out that you have stage 4 colon cancer.
ANNOUNCER: Jessica's cancer was treated with chemotherapy and then surgery. But after her initial treatments, new problems arose.
JESSICA WING: I had a lot of neck pain. I went in for a bone scan where they basically can see any metastases that would be anywhere in your bones. And they discovered at that point that there were metastases sort of scattered through my spine and also in my hips. But the worst one was in my neck where I was having a lot of pain.
ROGER WALTZMAN, MD: Bone complications from cancer can occur in really a wide variety of diseases, but the ones that are most commonly affected by bone complications are multiple myeloma, which is like a leukemia of white cells. Also the solid tumors that are most likely to spread to the bone are breast cancer, prostate cancer, lung cancer.
Colorectal cancer is, in addition, a disease that can spread to the bone.
ANNOUNCER: Bone complications happen when cancer interferes with the ability of the body to form new bone.
ROGER WALTZMAN, MD: There are two different cells at work. One called the osteoblast and one called the osteoclast; laying down new bone versus removing old bone. And as the cancer takes up more of the bone, there is less ability for the normal osteoblast to form normal bone. And instead there is increased osteoclastic activity to remove the abnormal bone. Unfortunately, in the process of removing the abnormal bone, what might result is just weakened thin bones. Because you don't have normal bone tissue being laid down.
JESSICA WING: I couldn't really look at the computer for any extended period of time. I could watch television, which is not one of my favorite activities, but I couldn't really walk around a lot because I could not turn my head to look and see if a car was coming. It was really hard to be confined to the house and not have a lot to do. And also being in pain is hard. That was the worst.
ANNOUNCER: When bone complications do occur there are several treatment options including surgery to stabilize bones, radiation for pain control, and bisphosphonate therapy, specifically aimed at strengthening bone. Initially, Jessica had radiation on her neck, but soon after her doctors suggested bisphosphonates.
ROGER WALTZMAN, MD: Bisphosphonates are drugs that act to prevent a particular cell in the body, the osteoclast, from resorbing bone. So basically it's stopping what is an accelerated, albeit normal, process when it's at a low level. And it stops this accelerated process from leaching away the normal bone, so to speak. It's not effective in all patients; it's not universally effective, I guess we could say. But it does seem to demonstrate in large trials, in large clinical trials, that there is a decrease in the incidence of further skeletal involvement of disease when using bisphosphonates. And an improvement in pain control for patients-the reduction in the complications, such as fractures or the need for radiation therapy.
The bisphosphonates that we use typically these days are intravenous bisphosphonates, and they're called Zometa and Aredia, and they're given about every three or four weeks, so not particularly often, over anywhere between 15 minutes for Zometa and a couple of hours for Aredia. The bulk of the data in the cancer literature is for Aredia, and there's emerging data for Zometa as well which, at least in the laboratory, appears to be significantly more active than Aredia, and so potentially more beneficial, and hopefully just as safe.
ANNOUNCER: Side effects appear to be minimal.
ROGER WALTZMAN, MD: Sometimes people can have a flu-like symptom the day after the infusion: a fever and chills and that sort of thing. But it's almost always resolving within a day or so.
ANNOUNCER: Once bone complications are stablized, patients are often encouraged to re-establish an exercise routine.
ROGER WALTZMAN, MD: It does not need to be a very hard-paced, rapid, aerobic activity; it can really be simple walking or fast walking or something along that line. The importance of this is really critical, because we can do so much with medications, but maintaining physical health by exercise is really important as well.
JESSICA WING: I do yoga sometimes, and there are positions that I can't do that put pressure on the neck because although the disease has been eliminated by the radiation, there still could be some weakness in the bone. So I just have to be more aware, especially of my neck and my spine.
ANNOUNCER: But for Jessica, alleviating the painful and debilitating symptoms of bone complications meant being able to return to her normal routine.
JESSICA WING: Now that my bone disease seems to be stable, I'm back to exercising. I swim. I do yoga. I hike. I'm going to go scuba diving. So it's nice.
Being physically sound and being able to do the things that somebody my age should do makes me feel really good. And it makes it a lot easier for me not to obsess about my illness or be afraid for the future.
ANNOUNCER: What Jessica has had to live with is colon cancer. The 31-year-old filmmaker and composer had been having bowel problems when she went to the doctor. Nothing could have been more shocking than hearing her diagnosis
JESSICA WING: It was so completely unexpected. I was 30. There was no history of cancer in my family. There was absolutely nothing that-I had been a vegetarian for ten years. So there is nothing to think that you're suddenly going to find out that you have stage 4 colon cancer.
ANNOUNCER: Jessica's cancer was treated with chemotherapy and then surgery. But after her initial treatments, new problems arose.
JESSICA WING: I had a lot of neck pain. I went in for a bone scan where they basically can see any metastases that would be anywhere in your bones. And they discovered at that point that there were metastases sort of scattered through my spine and also in my hips. But the worst one was in my neck where I was having a lot of pain.
ROGER WALTZMAN, MD: Bone complications from cancer can occur in really a wide variety of diseases, but the ones that are most commonly affected by bone complications are multiple myeloma, which is like a leukemia of white cells. Also the solid tumors that are most likely to spread to the bone are breast cancer, prostate cancer, lung cancer.
Colorectal cancer is, in addition, a disease that can spread to the bone.
ANNOUNCER: Bone complications happen when cancer interferes with the ability of the body to form new bone.
ROGER WALTZMAN, MD: There are two different cells at work. One called the osteoblast and one called the osteoclast; laying down new bone versus removing old bone. And as the cancer takes up more of the bone, there is less ability for the normal osteoblast to form normal bone. And instead there is increased osteoclastic activity to remove the abnormal bone. Unfortunately, in the process of removing the abnormal bone, what might result is just weakened thin bones. Because you don't have normal bone tissue being laid down.
JESSICA WING: I couldn't really look at the computer for any extended period of time. I could watch television, which is not one of my favorite activities, but I couldn't really walk around a lot because I could not turn my head to look and see if a car was coming. It was really hard to be confined to the house and not have a lot to do. And also being in pain is hard. That was the worst.
ANNOUNCER: When bone complications do occur there are several treatment options including surgery to stabilize bones, radiation for pain control, and bisphosphonate therapy, specifically aimed at strengthening bone. Initially, Jessica had radiation on her neck, but soon after her doctors suggested bisphosphonates.
ROGER WALTZMAN, MD: Bisphosphonates are drugs that act to prevent a particular cell in the body, the osteoclast, from resorbing bone. So basically it's stopping what is an accelerated, albeit normal, process when it's at a low level. And it stops this accelerated process from leaching away the normal bone, so to speak. It's not effective in all patients; it's not universally effective, I guess we could say. But it does seem to demonstrate in large trials, in large clinical trials, that there is a decrease in the incidence of further skeletal involvement of disease when using bisphosphonates. And an improvement in pain control for patients-the reduction in the complications, such as fractures or the need for radiation therapy.
The bisphosphonates that we use typically these days are intravenous bisphosphonates, and they're called Zometa and Aredia, and they're given about every three or four weeks, so not particularly often, over anywhere between 15 minutes for Zometa and a couple of hours for Aredia. The bulk of the data in the cancer literature is for Aredia, and there's emerging data for Zometa as well which, at least in the laboratory, appears to be significantly more active than Aredia, and so potentially more beneficial, and hopefully just as safe.
ANNOUNCER: Side effects appear to be minimal.
ROGER WALTZMAN, MD: Sometimes people can have a flu-like symptom the day after the infusion: a fever and chills and that sort of thing. But it's almost always resolving within a day or so.
ANNOUNCER: Once bone complications are stablized, patients are often encouraged to re-establish an exercise routine.
ROGER WALTZMAN, MD: It does not need to be a very hard-paced, rapid, aerobic activity; it can really be simple walking or fast walking or something along that line. The importance of this is really critical, because we can do so much with medications, but maintaining physical health by exercise is really important as well.
JESSICA WING: I do yoga sometimes, and there are positions that I can't do that put pressure on the neck because although the disease has been eliminated by the radiation, there still could be some weakness in the bone. So I just have to be more aware, especially of my neck and my spine.
ANNOUNCER: But for Jessica, alleviating the painful and debilitating symptoms of bone complications meant being able to return to her normal routine.
JESSICA WING: Now that my bone disease seems to be stable, I'm back to exercising. I swim. I do yoga. I hike. I'm going to go scuba diving. So it's nice.
Being physically sound and being able to do the things that somebody my age should do makes me feel really good. And it makes it a lot easier for me not to obsess about my illness or be afraid for the future.