[sandy57]

How fast can bone lesions grow?

by sandy57 on Tue Feb 17, 2015 8:45 pm

If someone had a pelvic x-ray and there were no lesions, then 3 months later have a MRI and have lesions everywhere, is that possible? How fast can lesions grow?

Thanks

[Cheryl G]

Re: How fast can bone lesions grow?

by Cheryl G on Tue Feb 17, 2015 11:05 pm

Hi Sandy57,

Apparently, bone lesions can develop quite quickly. See this posting from Dr. Hoffman from last fall, where he writes "Myeloma lesions can certainly grow rapidly at times."

However, there may be a different explanation for what happened than what it seems at first glance. The imagine that was done 3 months ago was an X-ray. X-rays mainly pick up lesions in the outer, hard bone (lytic lesions).

The lesions that were picked up recently, you said, were picked up by MRI. That sort of imaging, however, is better at picking up focal lesions, which are abnormal areas in the bone marrow. Those lesions could not have been visible, or visible at all, on the x-rays 3 months ago.

Most likely, there is a mix of things going on. There were focal lesions 3 months ago that weren't picked up by the x-rays, and now there are both focal lesions and, perhaps, some lytic lesions.

Hope this helps a bit. If you find out more details after talking with a doctor about the two sets of imaging results, it would be really helpful to everyone here if you could let us know what you find out.

Good luck!

[sandy57]

Re: How fast can bone lesions grow?

by sandy57 on Tue Feb 17, 2015 11:35 pm

Thanks Cheryl.

[Tracy J]

Re: How fast can bone lesions grow?

by Tracy J on Wed Feb 18, 2015 10:21 am

It is important to make sure you are comparing apples and apples, and oranges with oranges as far as imaging tests go. Different kinds of images will show different kinds of things. So, if you are tracking disease progression and response to treatment, try as much as you can to use the same kind of imaging. Sometimes this is not possible, obviously.

Just from my own experience they can grow and resolve very quickly. In August I had a PET CT which showed lesions with metabolic activity (meaning active tumors) all over the places. I started Velcade, Revlimid and dex. A repeat PET CT in November just 3 months later, showed no metabolic activity at all. Now, the damage done to my bones from those tumors was still present and visible, but the tumors themselves were no longer active.

Here's where I ran into trouble - in January I started having bone pain again and this time I had a bone scan - which is a different kind of test. This was done to try to spare me so much radiation from the CT scans. It showed lesions all over the place, but it was a little difficult to know if this represented true relapse, or simply the appearance of relapse because we were comparing different tests. This impacts treatment and prognosis big time, so there was a lot of discussion and debate between my various doctors about this. Eventually they all seemed to agree that it was a true relapse, especially given the change in my symptoms. I was switched to carfilzomib/ Revlimid and dex. I am scheduled for another PET CT at the end of my 2nd cycle. I should probably stick to PET CT from now on just to avoid this uncertainty. I am a little wary of all that radiation, but I think the balance of risks vs benefits weighs on the side of PET CT.

Anyway, assuming that was true relapse, my tumors became metabolically active again from the beginning of November to the beginning of Jan - 2 months.