Hi all,
My Dad was diagnosed with multiple myeloma due to having a compression fracture last year. Since then, he has been having the induction therapy as well as monthly Zometa. However, for the past four months, he has been infused with Zometa once every two months. The last time he had it was two months ago.
He's been complaining about his back being sore over the past few days. Is it possible for him to have a second lesion due to multiple myeloma? His counts of Kappa was low, about 90. I'm dead worried. He's scheduled for ASCT this coming Monday, hopefully things will go well. Thanks.
Forums
Re: Compression Fracture, Lesion
It is possible to develop more fractures despite effective treatment. Repeat x-ray would be reasonable if he is having more pain. Or if it is the old fracture causing more pain, repair of the fracture with kyphoplasty could be considered if not already done. Something to consider after the transplant.
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Dr. Jason Valent - Name: Jason Valent, M.D.
Beacon Medical Advisor
Re: Compression Fracture, Lesion
My husband gets Zometa at the end of every month. His doctors are Dr. Farat Abonour at IU Simon Cancer Center, Dr. Michael Mak at Columbus Regional Hospital, Indiana, and Dr. Mark Rubin at Florida Cancer Specialists in Bonita Springs, FL.
Martha
Martha
Re: Compression Fracture, Lesion
Thank you for your reply.
When he was diagnosed last year, he had 2 starting-to-collapse vertebraes and 1 totally collapsed vertebrae. The kyphoplasty was done to the 2, while the completely collapsed one was left by the doctor. He said it was impossible to fix that one, and "it looks like it has stabilizes."
4 months ago he visitted the doctor (including x-ray procedures) and thankfully, everything was fine. It was just the last two weeks he's been complaining about stiff and sore back, especially after long sitting.
As for the zometa, he was prescribed once every two months because of the side effects. He had a severe bone pain, and the doctor told him to get it every other months.
I hope this is something we don't have to worry too much..
Thanks again!
When he was diagnosed last year, he had 2 starting-to-collapse vertebraes and 1 totally collapsed vertebrae. The kyphoplasty was done to the 2, while the completely collapsed one was left by the doctor. He said it was impossible to fix that one, and "it looks like it has stabilizes."
4 months ago he visitted the doctor (including x-ray procedures) and thankfully, everything was fine. It was just the last two weeks he's been complaining about stiff and sore back, especially after long sitting.
As for the zometa, he was prescribed once every two months because of the side effects. He had a severe bone pain, and the doctor told him to get it every other months.
I hope this is something we don't have to worry too much..
Thanks again!
Re: Compression Fracture, Lesion
Chronic pain sometimes becomes an issue with the destructive lesions. Adequate pain control is very important.
I echo the thoughts previously stated. If there are new pains, even in controlled myeloma and on Zometa, it is worth having another look with plain X rays or MRI. New fractures (from old myelomatous lesions) can occur. One must also know that it may also be unrelatated to the myeloma or myeloma-induced bone disease -- degenerative changes or the like.
As for Zometa, it is the preferred bisphosphonate and every other month dosing should be adequate. However, if the Zometa-induced symptoms are too significant, pamidronate (Aredia) may be used instead. It tends to have fewer side effects.
I echo the thoughts previously stated. If there are new pains, even in controlled myeloma and on Zometa, it is worth having another look with plain X rays or MRI. New fractures (from old myelomatous lesions) can occur. One must also know that it may also be unrelatated to the myeloma or myeloma-induced bone disease -- degenerative changes or the like.
As for Zometa, it is the preferred bisphosphonate and every other month dosing should be adequate. However, if the Zometa-induced symptoms are too significant, pamidronate (Aredia) may be used instead. It tends to have fewer side effects.
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Dr. Ken Shain - Name: Ken Shain, M.D., Ph.D.
Beacon Medical Advisor
Re: Compression Fracture, Lesion
Hi
I am having lumbar pain from the original lesion,my onc sent me to a pain management dr, he gave me a lumbar root sleeve injection, really did not help, wants to do 2 more. My multiple myeloma specialist at mayo doesn't seem to think this will be effective. He feels the treatment with the cement would be better, the pain mgmt dr does not agree, he says all my fractures are healed that is only good fr new fractures. I would appreciate a response, it is so difficult living with this pain,
Maria
I am having lumbar pain from the original lesion,my onc sent me to a pain management dr, he gave me a lumbar root sleeve injection, really did not help, wants to do 2 more. My multiple myeloma specialist at mayo doesn't seem to think this will be effective. He feels the treatment with the cement would be better, the pain mgmt dr does not agree, he says all my fractures are healed that is only good fr new fractures. I would appreciate a response, it is so difficult living with this pain,
Maria
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Taxm1040 - Name: Maria Oneill
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 08/2011
- Age at diagnosis: 62
Re: Compression Fracture, Lesion
Hi
i am 53 with multple myloma x 8 years. I have multiple copression fractures thoracic and lumbar area. Recent fall li compression. Told i do not have osteoporisis as a result of the myloma no lesions. Plan to have a kyphoplasty due to pain and lack of mobility with increasing pain. On zomita every three months and calcium /vitamin d supplement. When ever a new doctor looks at my xray they say your bones are a mess. "spinal column of a 65-70 year old man." thought's.
i am 53 with multple myloma x 8 years. I have multiple copression fractures thoracic and lumbar area. Recent fall li compression. Told i do not have osteoporisis as a result of the myloma no lesions. Plan to have a kyphoplasty due to pain and lack of mobility with increasing pain. On zomita every three months and calcium /vitamin d supplement. When ever a new doctor looks at my xray they say your bones are a mess. "spinal column of a 65-70 year old man." thought's.
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fred
Re: Compression Fracture, Lesion
I don't have any specifc suggestion but rather have a general question for the advisors that does bear on this issue.
In terms of bone drugs, I think what is missing - and desperately needed - are medications that STIMULATE the GROWTH of bone mass and hence fill in lesions. My understanding is that all conventional drugs, such as Aredia and Zometa - and I am on the latter one - only INHIBIT the LOSS of bone mass.
Is this understanding correct? And if so, are there any drugs on the horizon that will meet this missing gap and stimulate bone growth?
In terms of bone drugs, I think what is missing - and desperately needed - are medications that STIMULATE the GROWTH of bone mass and hence fill in lesions. My understanding is that all conventional drugs, such as Aredia and Zometa - and I am on the latter one - only INHIBIT the LOSS of bone mass.
Is this understanding correct? And if so, are there any drugs on the horizon that will meet this missing gap and stimulate bone growth?
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Dan D
Re: Compression Fracture, Lesion
Hi Dan, I believe carfilzomib has been reported to enhance bone formation in addition to its other anti-myeloma effects.
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terryl1 - Name: Terry
- Who do you know with myeloma?: self
- When were you/they diagnosed?: August 10, 2011
- Age at diagnosis: 49
Re: Compression Fracture, Lesion
If so, that is a big deal. Thanks for the update. I am currently on rev and dex with great results after four cycles, but I wonder whether adding carfilzomib might just give the last push to sCR.
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Dan D
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