Referral to hematologist-oncologist

by **psychprof23** on Wed Feb 25, 2015 7:28 pm

Referral to hematologist-oncologist - what can I expect?

by psychprof23 on Wed Feb 25, 2015 7:28 pm

Hi, all!

I had an MRI in which the radiologist thought she saw myeloma indicators. She said there was a "very heterogeneous marrow signal in the lumbar spine."

This led to a peripheral blood smear, which showed borderline monochromic normocytic anemia, with a "prominent rouleaux formation." The pathologist stated that the rouleaux formation could be due to inflammation, but that I should have a serum protein electrophoresis with immunofixation to determine if monoclonal protein is present.

My CBC showed one hundredth of a point away from anemia, with low normal hemoglobin. My calcium has been trending upwards for a year. The last calcium test was 9.8, with 10 being the high-end limit for the normal range.

I have had low grade fevers, increased pain in my lower back, left hip, and left leg for over a year. The bone pain is usually worse in the evening.

My doctor referred me to a hematology oncologist today for a work up. What should I expect from this appointment? The electrophesis with immunofixation has not been done yet, but I am hoping for a full work up – even though I am not sure what that entails.

Thank you!
Mara

by **Multibilly** on Wed Feb 25, 2015 8:18 pm

Re: Referral to hematologist-oncologist - what can I expect?

by Multibilly on Wed Feb 25, 2015 8:18 pm

Hi Mara,

If there is truly a suspicion of multiple myeloma, the hematologist will likely order up a number of tests. Depending on the results of those lab tests, he/she may then order follow-up imaging, such as a PET/CT (which would identify any "hot spots" in your body where cancerous cells may be accumulating) and a bone marrow biopsy (the definitive "golden test" for multiple myeloma). If they run a bone marrow biopsy, they would certainly also do the genetic testing outlined in the above link.

If your insurance permits it, I'd really encourage you to start off with a hematologist that specializes in multiple myeloma (a hematologist that might occasionally deal with multiple myeloma is not really a multiple myeloma specialist). A multiple myeloma specialist will know the latest test protocols and how best to interpret the lab results.

If you let the forum know approximately where you live, folks on the forum can make some recommendations of facilities to seek out.

by **psychprof23** on Wed Feb 25, 2015 8:43 pm

Re: Referral to hematologist-oncologist - what can I expect?

by psychprof23 on Wed Feb 25, 2015 8:43 pm

Thank you again, Multibilly. I live near Indianapolis, Indiana.

by **Boris Simkovich** on Wed Feb 25, 2015 8:55 pm

Re: Referral to hematologist-oncologist - what can I expect?

by Boris Simkovich on Wed Feb 25, 2015 8:55 pm

Hi Mara,

The Simon Cancer Center at Indiana University has several myeloma specialists. For example, Dr. David Roodman is internationally recognized for his myeloma research, which focuses on myeloma bone disease. Dr. Rafat Abonour also is a myeloma specialist involved in the latest research in the field.

Others here in the forum who live in your area may have additional recommendations, but I think the Simon Cancer Center would be an excellent place to go for an initial consultation with a myeloma specialist.

by **Julie Phillips** on Wed Feb 25, 2015 9:37 pm

Re: Referral to hematologist-oncologist - what can I expect?

by Julie Phillips on Wed Feb 25, 2015 9:37 pm

I am a patient at IU Simon Cancer and Dr. Abonour is my doctor. I had my stem cell transplant done there July 2013. I really like and respect Dr. Abonour and his staff. I highly recommend IU Simon Cancer Center.

by **psychprof23** on Thu Feb 26, 2015 7:07 pm

Re: Referral to hematologist-oncologist - what can I expect?

by psychprof23 on Thu Feb 26, 2015 7:07 pm

Julie, thank you do much! I was tested for monoclonal protein today. I'm glad I will know the answer to that test at least next week, as my hematologist / oncologist appointment is not until March 13 .

I wish you the best as you continue your journey!

Mara