Mini TED Talk: Bone Cancer Staging & Symptoms

Added: 2026-05-13

[00:00:00]I am not going to play around with you, mister.

[00:00:03]Sir.

[00:00:05]He ate his medicine but doesn't want to eat lunch cuz it's too early. Huh? Too early?

[00:00:11]Going to He knows I want to change him.

[00:00:15]He'll come over here and as soon as I go to stand up, he runs away. Okay.

[00:00:22]Let's go. Let's go.

[00:00:24]Well, thank you very much for letting me change you. Thank you very much, sir.

[00:00:28]You were full diapy. I knew it, too.

[00:00:31]I knew it. I know you don't want your lunch, but I know we're going to go out in a second. Let Let me tell our friends this mini Ted. Okay. So, we did the liver, right? So, let's have a little chitchat about another scenario.

[00:00:48]What if we had origin throat to bone?

[00:00:53]What would the symptoms be? What would it look like? What What What would be going on? Mind you, I spoke to two hospice nurses about this whole thing last night. And they said I'm not off at all.

[00:01:10]Again, I want to put it in layman's terms so anybody out there can do this themselves. So, type in stage four throat to bone cancer symptoms.

[00:01:23]>> [sighs] >> So, that means it has metastasized to the bone.

[00:01:30]AKA bone metastases.

[00:01:33]Causes severe symptoms. Persistent worsening bone pain.

[00:01:39]Unexplained fractures. Significant fatigue.

[00:01:46]To say the word significant in medical jargon means it is severe.

[00:01:55]When throat cancer spreads to the bones, it typically affects the spine, the pelvis, the ribs.

[00:02:06]We will go over that. There's a big reason for it.

[00:02:10]Fractures, the bones become brittle and they break with little or no trauma.

[00:02:18]Got a story about that.

[00:02:20]>> [snorts] >> Reduced mobility, difficulty moving, particularly if the cancer affects weight-bearing bones, like legs or spine.

[00:02:33]Swelling at the site of the tumors.

[00:02:38]Anemia and fatigue, high levels of fatigue, dizziness, pale skin due to reduced red blood cell production.

[00:02:54]This is from onccarecancer.com.

[00:03:00]There you go. O N carecancer.com.

[00:03:05]Stage four bone cancer.

[00:03:08]Bone Some diseases start slowly, but stage four bone cancer is not one of them.

[00:03:16]The most advanced stage of bone cancer is stage four. At this point, the cancer has spread to other parts of the body.

[00:03:24]Symptoms get worse, more common as cancer cells spread. Pain is worse, moving around is hard, and doing everyday things is harder than before.

[00:03:36]The cancer weakens the bones, which causes the pain.

[00:03:43]Swelling around the affected bone becomes more obvious.

[00:03:48]The area may look bigger, firmer, a little bent. The skin may feel warm or sore.

[00:03:57]Stage four bone cancer makes the bones so weak that they can break with very little pressure. Simple things like bending, walking, picking up something light can break bones.

[00:04:13]Pathological fractures are those that happen because of the disease, not an accident. It is one of the most common signs of stage four.

[00:04:25]Hardship walking or moving.

[00:04:29]Problems breathing when the cancer moves to the lungs, because it often spreads to the lungs.

[00:04:39]And then to the brain, because it generally invades the spine.

[00:04:44]You definitely don't want a plate of food.

[00:04:48]Night sweats, having fevers. Bone cancer typically affects people with breast cancer, prostate cancer, and lung cancer.

[00:04:59]This is how the cancer travels.

[00:05:02]And this is how the bone tumors grow.

[00:05:06]What are the symptoms?

[00:05:08]Bone fractures, we've already gone over that. Hypercalcemia, which causes confusion.

[00:05:18]On top of what did we say? Liver.

[00:05:22]Secondary liver cancer causes confusion.

[00:05:28]Constipation, loss of appetite, nausea, and vomiting.

[00:05:34]Spinal cord compression.

[00:05:37]What is the treatment for bone metastases?

[00:05:44]There you go.

[00:05:49]From Ortho Info, here is a lovely x-ray.

[00:05:54]Not lovely. I I not joking about it.

[00:05:58]This is what's called a pathological fracture.

[00:06:02]>> [snorts] >> This did not happen because of trauma.

[00:06:07]It did not happen for any reason except cancer.

[00:06:12]As you can see, do you see the darkened area here, the grayer area? And do you see how there are little pits and holes?

[00:06:23]That's the cancer.

[00:06:26]And it weakened that bone so that the person didn't have to do anything. Maybe they picked up the newspaper.

[00:06:35]Maybe they picked up a fly swatter.

[00:06:38]I am not kidding you. They could pick up a pen and break their bone.

[00:06:44]So, here's an interesting story from 30 years ago.

[00:06:51]When I first got hired up here. No, it was '90s. '90 Oh, wait. Hold on. Hold on.

[00:07:01]'91.

[00:07:03]Late '91, '92, early '92, spring '92.

[00:07:09]Okay, spring '92-ish.

[00:07:12]We did not have AMR yet. Okay? Our ambulances were privately owned by private company or by hospital base. So, each hospital had their own ambulances.

[00:07:24]My ex-husband worked on our ambulance before the hep- hecalopter came.

[00:07:29]And then there was a private company that the rest of us went to, North Valley Ambulance.

[00:07:39]They later got bought out by AMR.

[00:07:42]Like so many ambulances across the country.

[00:07:46]AMR I think is taking over the world.

[00:07:48]But, I digress.

[00:07:52]The owners of AMR were a lovely couple, older couple. They wanted to retire, hence why they wanted to sell to AMR.

[00:08:03]And they had a passion for golfing, which is a big thing up here. We have a million golf courses. We have golf courses that I don't know anything about this but I have one three blocks away, designed by the biggest designers in the world.

[00:08:23]We have like nationally and internationally ranked golf courses, or have had before the drought.

[00:08:33]So, their passion was golfing.

[00:08:38]And they would take off days from work.

[00:08:41]They still were working in their early 60s. But they would take days off as the merger, the takeover, whatever you'd sell out to AMR was approaching.

[00:08:52]And their dream, they used to have property in Alaska, and they would go up there to go fishing for salmon, and then they would come back home, and they would their hobby would be golfing.

[00:09:05]So, they just foresaw themselves with the grandkids living between Alaska and here and participating in their hobbies.

[00:09:16]So, one day the ambulance is coming in, and my charge looks at me and she says, "Oh, We're in This is big. This is big." And I'm like, "What?"

[00:09:27]And they said, "Pat's coming in. She busted her arm."

[00:09:32]And I'm like, "She did? What were they doing?" I mean, they didn't they weren't redoing the house.

[00:09:39]They didn't participate in thrill-seeking activities. I'm like, what wow. So, here comes the LSU beep beep beep. We all go out. Poor Pat is in excruciating pain even though the medic on board had given her morphine.

[00:09:59]No sign of trauma.

[00:10:02]No mechanism of injury that would indicate a trauma.

[00:10:07]You know what she was doing?

[00:10:10]She shattered the head of her humerus clean off.

[00:10:16]By swinging her golf club.

[00:10:20]And when we got her x-rays, we all stood around the x-ray board in x-ray, not in the ER cuz we didn't want Conrad to see it, her husband.

[00:10:32]We actually began crying silently. Even our doc did.

[00:10:39]It still upsets me to this day. I had to stop for a second.

[00:10:45]It was a clean break.

[00:10:49]And it looked worse than this, the pitting.

[00:10:52]It had eaten away at her bone.

[00:10:59]And it was lung cancer.

[00:11:02]So, the bone cancer was secondary.

[00:11:09]And it was something that stuck with me the rest of my life because actually, there's another patient, but I'll get to that. But, it was like the first time I personally was involved with somebody who had just been told, "You're dying of cancer by swinging a golf club.

[00:11:38]She said she heard it.

[00:11:41]She heard it. He heard it.

[00:11:44]The people in their golfing party standing around, they heard it.

[00:11:53]Those people never forgot that.

[00:11:57]Never.

[00:11:58]So, I always mention to you about the pain of bone cancer and how it's the worst.

[00:12:04]And I tell you guys all the time about how the patients can't even have sheets on them because the weight of a sheet is that painful.

[00:12:14]And all the morphine, all the fentanyl doesn't touch it.

[00:12:20]They are in such pain.

[00:12:22]I had a patient.

[00:12:24]I was in their house.

[00:12:27]911 call comes in.

[00:12:30]And this woman is absolutely in excruciating pain. And beside the bed was a bottle with morphine, liquid morphine that they would syringe and they would place it in her mouth because she could still swallow.

[00:12:48]She had breast cancer and it had spread to her bones.

[00:12:52]It was in her spine, her pelvis, her ribs.

[00:12:58]Her spine looked like it had marshmallows under the skin and those were all the bone tumors.

[00:13:05]She couldn't lay on her back.

[00:13:07]She couldn't lay on her side. She couldn't lay on her stomach.

[00:13:11]She couldn't sit up. She had actually gotten compression fractures from sitting up in her recliner because just gravity was crushing her vertebrae.

[00:13:25]And here's this woman screaming in agony and her husband had been given a insulin syringe to draw up the morphine to dispense under her tongue.

[00:13:45]And instead, I saw a 30 cc syringe.

[00:13:50]And he said, "I've been filling those and it's not working."

[00:13:56]Now, her tolerance was so high at that point that even though it would have killed you and I, she was able to still be awake, somewhat oriented, not very much, not just because of the morphine, but because of the pain.

[00:14:17]So, I always roll my eyes when I see these people on Tik Tok or YouTube in the ER going, "I have nine out of 10 pain." No, you don't.

[00:14:28]No, you don't. I have seen amputations.

[00:14:33]I have seen that woman in her bed. I have seen patients that are truly in nine or 10 out of 10 pain.

[00:14:42]So, when you come in with your little headache or your toothache or your tummy ache and you want to say it's nine, people who have gone through cancer, people who have had loved ones who have had cancer, they understand.

[00:15:03]This is secondary.

[00:15:08]This is a metastasis to the bone.

[00:15:16]This is what happens. This is stage four.

[00:15:20]For some people, they can have surgical treatment, and here is the X-ray of somebody who did. Now, the bone cancer will eat away the bone, as we know, and weaken it. So, what they can do is fill it, they call it nicely here, bone cement. It is cadaver paste.

[00:15:43]And the opaque section in there, they have filled, and then they have drilled.

[00:15:49]Here is an intramedullary nail, which goes down the femur, because, as you can see, they have cancer, it's eating away the femur, they don't want everything to fall off, so they installed a titanium nail, they call it, or a rod, and then it goes up into the ball of the hip.

[00:16:11]It is not a cure, but it can keep you from fracturing, so long as you have enough bone to work with.

[00:16:22]Cadaver paste is exactly what you think it is. They take a deceased person's bone, they pulverize their long bone, they then mix it with a glue, and then they install it into your body.

[00:16:39]Fun fact, Hubs has cadaver chips that are like little wedges you'd put in a in tree falling, into his neck. He's got three of them. I always wonder who's in his neck. So, also from Onk Care, on Care Oh my god, would you stop? They're playing.

[00:16:59]Someone's crying because they're playing.

[00:17:03]Yes, I hear you. Stop.

[00:17:05]Stop. They're just playing.

[00:17:08]Can we witness what's going on?

[00:17:11]Oh my gosh. Oh my gosh.

[00:17:21]>> Do you want to go in your bedroom?

[00:17:25]There's going to be a yelp pretty soon.

[00:17:36]Do you guys mind?

[00:17:38]Back to this.

[00:17:41]So, from the the oncare Here it is. Oncare.

[00:17:47]Oncarecancer.com, okay? They do have a lot of lovely things. This is for stage four throat cancers for what patients should know.

[00:17:56]What does stage four throat cancer mean?

[00:18:01]So, there's three stages as we spoke about.

[00:18:04]Stage 4A, the cancer has grown into nearby tissues or spread to nearby lymph nodes. So, still confined to above the collarbone.

[00:18:18]Stage 4B, it has spread extensively in the neck or crucial nearby structures such as blood vessels. Still above the collarbone.

[00:18:34]Stage 4C, cancer has spread to distant parts of the body such as lungs, liver, or bones, aka metastases.

[00:18:49]Why is it important that I'm saying it's above the collarbone?

[00:18:54]>> [snorts] >> Because throat cancer and neck cancer generally want to invade the area they started.

[00:19:09]Okay?

[00:19:10]>> [snorts] >> Most people are going to think, "Oh, it's going to go up there to the brain."

[00:19:16]No, it tends not to. What it generally follows the pathway of is invading circumferentially your neck.

[00:19:26]And what is in your neck near your throat? Well, other than veins and arteries, you have lymph glands all around your neck, under your jaw.

[00:19:40]And that's where it will go most likely.

[00:19:44]Remember, cancer cells need a transport system. Yes, they grow on their own, but they need a transport system in order to spread to distant areas.

[00:19:59]So, if you have throat to bone, bone invading your marrow where your red blood cells are created, throat where your lymph is located, more lymph glands are located, you have two transport systems right there.

[00:20:23]You would need such intensive remedy to fight foresee.

[00:20:35]You would be practically living at the hospital.

[00:20:40]So, what do they do? Here are combinations of cancer therapies.

[00:20:45]Radiation. I have never known anyone who had throat cancer that did not have radiation.

[00:20:52]Um and and beam guided, okay?

[00:20:57]Not seeding.

[00:20:59]Beamed.

[00:21:01]Okay, so going in the machine.

[00:21:04]You have chemotherapy, and then you have target therapy.

[00:21:09]You'll have surgery, especially uh to diminish those lymph nodes.

[00:21:15]You have your surgery and then followed by radiation and chemo. Sometimes they'll irradiate lymph nodes to shrink them or try to shrink the tumor before they do surgery, but it depends. Are you immunocompromised? Are you strong enough? If you're 4C, generally you're not strong enough for surgery right away.

[00:21:38]You have your immunotherapy.

[00:21:42]So, living with stage four throat cancer, you go to speech and swallowing function rehab.

[00:21:51]You need to have psychological support groups.

[00:21:57]And of course, from my friends at the Clevelandclinic.org, my favorite site next to PubMed.

[00:22:04]Always go to the Clevelandclinic.org.

[00:22:07]Here they are.

[00:22:09]Myclevelandclinic.org for any of your health care questions.

[00:22:16]They are awesome. I know a lot of people really like Mayo. I don't know why. I really love Cleveland. I can't say I Hey, Cleveland Clinic, sponsor me. No, I'm kidding. So, not only did they show us this awesome little diagram here about how the metastases happens, the more common types, they tell us what the symptoms and causes are. And the hypercalcemia is very important, plus the uh fatigue and anemia because you have to remember your red blood cells are created in your bone marrow. So, when cancer starts eating at your bones, it invades that marrow canal.

[00:22:58]And then it impedes the the of red blood cells. Hence, you will have paper white mucous membrane linings throughout your body.

[00:23:12]Okay? I mean like glowing white.

[00:23:15]Now, if you have liver involvement on top of that, it's going to be underlying pale, so the yellow is going to really stand out.

[00:23:24]Without your red blood cells, too, you are going to be so fatigued, it isn't funny.

[00:23:31]Cleveland Clinic goes on to also do all the tests that are needed, management and treatment with links to each.

[00:23:42]I love them.

[00:23:44]And what happens if I don't receive treatment? Guess who forgot they told us all they had a cancer appointment on Thursday. I didn't want to say anything until today, because today someone's saying their cancer appointment is chemo, and it's on Monday.

[00:24:03]Wonder what drug it's going to be.

[00:24:06]Because you know what? Cleveland Clinic goes into the types of drugs.

[00:24:10]They even teach you the difference between bone cancer or bone metastases.

[00:24:17]So, remember, the easiest way to think of it is primary, secondary.

[00:24:23]Bone cancer is sarcoma, osteosarcoma, and then you'll have whatever type it is before that word.

[00:24:33]So, say Ludwig's osteosarcoma.

[00:24:38]When it's bone metastases, that is secondary cancer. It is not the place of origin.

[00:24:46]It is spread throughout your body, but you always ask somebody, "What's your origin?"

[00:24:53]Breast cancer, testicle cancer, liver cancer, whatever.

[00:24:59]So, that's the difference.

[00:25:01]I love about Cleveland Clinic is they even teach you osteocytes versus osteoblasts and what their functions in your body are. So, I'm not a big fan of WebMD, but they do have this um metastatic throat cancer, what happens when my throat cancer spreads.

[00:25:22]So, they tell you what throat cancer is and then how is it spread? I'm kind of happy they did this, direct invasion, which is the tumor going into the tissues surrounding the tumor, the very beginning little origin site.

[00:25:40]Um and then it has lymphatic spread and the bloodstream um to go to places like lungs, liver, skin, bones.

[00:25:53]It's interesting for some reason it it throat cancer doesn't you would think it would just immediately go to your head, your brain and I don't understand it. It will wrap around and go to your spine.

[00:26:09]But for some reason and I guess it's based on the fact that our lymphatics and our blood supply they tend to inva- invade where they're on their way down.

[00:26:23]Um that's all I can think of. I'm I'm not an oncology nurse, okay?

[00:26:28]Um that it spreads down.

[00:26:34]So, it's very rare. I looked around to see if there were any cases cuz as you know, my sister died of brain cancer. Her origin was brain cancer, okay? Plain and simple and I don't believe in her 6 years there was ever any spread.

[00:26:54]Uh she had an Astro and Astros tend to go very fast, but she had double double double and then she had gamma knife.

[00:27:04]Which is why she sounded younger than her 9-year-old uh when she was going through it. Do you like to see these different sites to see um if they have anything different and I am not finding anything different. Treating metastatic throat cancer is surgery followed by radiation, systemic therapy, which is you know full body. Uh immunotherapy, chemotherapy, targeted therapy, clinical trials, palliative care. Generally for C, you're palliative at that point.

[00:27:35]What's the survival rate of throat cancer that's spread to your lungs?

[00:27:39]10 to 15 months. And yet some people are still smoking but claiming moist cold air hurts their throats.

[00:27:50]But see in the hospital, we give cooling airway treatments because it takes the inflammation and swelling down. It won't take the tumor size down of a throat tumor.

[00:28:04]But the a surrounding tissues are inflamed.

[00:28:09]And that's what cooling air moist air does.

[00:28:15]But apparently some people are different. Now Sloan Kettering, which is known as a fine medical institution, has um a throat cancer diagnosis types and stages. It's a a guide. Um so here's the thing. Saying throat cancer is kind of a misnomer. That's a very vague term. It is laryngeal, it is tonsillar, it is um you can have oral cancer. It's tracheal cancer. You have to Thyroid cancer is technically a throat cancer. So, usually people will say, "I have laryngeal cancer. I have tonsillar cancer." And yes, tonsils become cancerous more than you expect. Generally, they don't call esophageal cancer throat cancer.

[00:29:14]The vague term of throat cancer tends to be most often laryngeal in my experience.

[00:29:25]So, it's your larynx. So, they take out your voice box.

[00:29:29]So, in their first appointments, you would go in for imaging and then your genetic marker testing. So, here they list the different types of throat cancer.

[00:29:42]And you have your stages 0 1 2 3 and 4, and they explain the TNM, which we went over in the last mini TED. So, let's hit stage 4 because that's what we're hearing about.

[00:29:55]Um let's see, nearby tissues such as the neck, trachea, thyroid, esophagus, jaw, and mouth are now invaded.

[00:30:05]So, from the naked eye observing a patient in four, you would see it. Okay? That's what that's saying.

[00:30:17]One Really?

[00:30:21]Large lymph node more than 3 cm on the same side of the neck as the tumor. Oh, I got that. Okay. Okay.

[00:30:29]So, more than one lymph node of any size on the same side of the neck as the tumor has been invaded. One lymph node of any size on the side of the neck across from the tumor, has been invaded.

[00:30:44]And distant areas beyond the throat, such as lungs.

[00:30:52]The TNM staging system 4C, cancer has spread to distant parts of the body beyond the throat. So, 4C.

[00:31:03]There's no D.

[00:31:05]There's C. That's it.

[00:31:14]Okay.

[00:31:15]Now, their facility, they even do dental cancer care. Because, generally, when you have laryngeal or tonsillar cancers, it invades your mandible, your lower jaw.

[00:31:30]It will make tumors form in the jaw.

[00:31:34]They will take out pieces of your jaw. I have seen entire jaws removed, and I have seen open, it's called a radical necks. And people will have masks that have drapes that hang down below their collarbone, so that the world doesn't have to see it. But, literally, you can look inside their throat. It is exposed.

[00:31:56]Um That is stage 4C. Because they lose their teeth.

[00:32:05]The cancer is eating all their nutrition up.

[00:32:10]And their teeth, the gums recede, the teeth fall out, it invades the jaw, the jaw becomes misshapen, or parts or the entire thing needs to be taken out.

[00:32:25]There is a link to their surgeries for throat cancer, all the different types.

[00:32:31]They have to have your genetic marker, the type, the stage, and the location.

[00:32:37]And then you have your radiation for throat cancer as the only treatment in combination with chemo after surgery or to treat cancers that come back after surgery. So, you can get chemo before your surgery or after.

[00:32:53]And I find it interesting they say there are a few kinds of chemo medicines for throat cancer.

[00:33:01]They are quite specific.

[00:33:04]Then there's targeted therapies. There's immunotherapy. We've been over this. And why the genetic testing improves your treatments.

[00:33:14]So, here are your mutations. They need to know all these things, all your markers, all your genetic plan before they give you chemo.

[00:33:27]And I'm telling you, you you remember every acronym. You remember every single one of these. As an ultra-rare patient myself, I could recite you my acronyms.

[00:33:41]All my genetic markers. Everybody with a serious disease, be it cancer, be it whatever, you have to be your own advocate often times.

[00:33:56]There aren't always people like me helping.

[00:34:00]I have notebooks full of acronyms for my patients. So, in case they come to the hospital unconscious, there is a card they carry with my number.

[00:34:12]And I talk to the doctor and tell them the information and I send it on a flash drive.

[00:34:19]People who have cancer, an advanced cancer, they know all these.

[00:34:26]There's also clinical trials. Now, you can look up online where all the clinical trials are. I used to do it for my disease. Um I don't any longer. I'm at the age I'm in the death zone they call it, but I'm at the age where I'm kind of like I'm okay. I'm okay. Knock on wood.

[00:34:48]Um and if I pop off tomorrow, I'm okay.

[00:34:53]I am okay.

[00:34:55]Here are all the specialists that you will be having appointments with to combat throat cancer.

[00:35:15]Yeah, where's the social worker? And can I just say that if anybody is concerned about anyone in the country, please help that person. Have the American Cancer Society reach out to them. Have their local oncologist team reach out to them.

[00:35:35]There are resources out there.

[00:35:38]And trust me, cancer is one of those things that brings people together.

[00:35:44]It's it's actually beautiful. The disease sucks, but the people that are in the groups are absolutely amazing people.

[00:35:58]The ACS does more for patients. I have seen them hand out gas cards here.

[00:36:05]Um $50 gas cards.

[00:36:08]I have seen them bring home cooked meals.

[00:36:12]I have seen them go over and visit every day with a patient.

[00:36:18]I've seen them taking patients to store or doing their grocery shopping for them.

[00:36:24]The people that are affected by cancer and lose loved ones to cancer are most often times the people who turn around and volunteer.

[00:36:37]Cancer changes lives.

[00:36:41]And so they have a huge network of people across this country that help others with cancer.

[00:36:50]It's like their thing.

[00:36:53]It's their family.

[00:36:56]They have their blood family and they have their cancer family.

[00:37:00]So I hope this helped inform you of certain things.

[00:37:05]This is bone cancer.

[00:37:07]This is throat to bone.

[00:37:11]If I've missed anything, let me know.