Hi everyone, would like to get any opinions on my new situation. Last week started getting pain in my right arm , shoulder. Got an X-ray on Friday, showed Lucent lesions on humerous(sp) and shoulder area. Then the next day I discovered I had shingles , so lots of arm pain. Shingles under control but still have arm pain. So my question is, first, I'm on zometa bimonthly, and all my blood work is stable, so how can I have lesions on my arm? Or can they be 'old'? The radiologist report seemed vague to me. I'm going for a full skeletal survey soon. But I'm very concerned because I'm just a worry wart and obsess about these things.
Thanks for any replies.
Forums
Re: Lucent lesions
Well, you seem to already be on Zometa for some bone condition, but you don't mention the condition here.
If your doc is suspicious of the lucencies being related to myeloma, you would want to get several other specific blood and urine tests that are outlined by Dr Shain in the thread below (but you say your blood work is "stable"). You can't diagnose multiple myeloma with just xrays, although a full skeletal xray is one of the key tests that one uses in its diagnosis.
https://myelomabeacon.org/forum/what-are-the-chances-of-me-having-multiple-myeloma-t1666.html
If your doc is suspicious of the lucencies being related to myeloma, you would want to get several other specific blood and urine tests that are outlined by Dr Shain in the thread below (but you say your blood work is "stable"). You can't diagnose multiple myeloma with just xrays, although a full skeletal xray is one of the key tests that one uses in its diagnosis.
https://myelomabeacon.org/forum/what-are-the-chances-of-me-having-multiple-myeloma-t1666.html
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Lucent lesions
Oh, sorry, I was diagnosed almost 8 years ago, SCT, relapsed 2x, been of Rev/Dex for 6 months.
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Christina1952
Re: Lucent lesions
Christina1952 wrote:
> Oh, sorry, I was diagnosed almost 8 years ago, SCT, relapsed 2x, been of
> Rev/Dex for 6 months.
Do you have your earlier radiology reports, and did they show any lesions in this area in the earlier reports? (I assume you must have been xray'd and/or PET/CT'd if you have been dealing with multiple myeloma this long). I have also found that identification of "lucencies" can be quite subjective. Getting a second opinion on interpreting the xray and/or doing a follow-up PET/CT scan to confirm the findings was key in my case. Doing this disproved the existence of bone lesions that were pointed out in a recent skeletal survey that had done when I first got diagnosed.
I will let somebody else comment on what happens to bone lesions over time when one is treated for multiple myeloma. I don't believe they ever really go away completely and that you will always see artifacts of their presence in a radiological exam, regardless of treatment protocols...but I'm not speaking from experience here.
> Oh, sorry, I was diagnosed almost 8 years ago, SCT, relapsed 2x, been of
> Rev/Dex for 6 months.
Do you have your earlier radiology reports, and did they show any lesions in this area in the earlier reports? (I assume you must have been xray'd and/or PET/CT'd if you have been dealing with multiple myeloma this long). I have also found that identification of "lucencies" can be quite subjective. Getting a second opinion on interpreting the xray and/or doing a follow-up PET/CT scan to confirm the findings was key in my case. Doing this disproved the existence of bone lesions that were pointed out in a recent skeletal survey that had done when I first got diagnosed.
I will let somebody else comment on what happens to bone lesions over time when one is treated for multiple myeloma. I don't believe they ever really go away completely and that you will always see artifacts of their presence in a radiological exam, regardless of treatment protocols...but I'm not speaking from experience here.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Lucent lesions
When I get a skeletal survey once a year, the radiologist's report always refers to the previous year's report to note any changes. i still have lots of lesions, which seem to be permanent, but I know that my bones are stronger now. Did have several years of treatment with aredia, another bisphosphonate. At the time of dx, my bones were very weak, but now I seem to be reasonably strong, although I don't overdo any lifting etc. So in my case the lesions seem to be permanent, but from speaking to my doctor I think that they do heal up for many patients. I don't have 'active' myeloma right now, so it doesn't seem to be a cause for concern.
Sorry about the shingles, Christine, I guess that can be very painful! Hope it clears up soon.
Sorry about the shingles, Christine, I guess that can be very painful! Hope it clears up soon.
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: Lucent lesions
Thanks, Nancy and multibilly,
Unfortunately, last years X-rays didn't include my arms, I guess a full skeletal survey is everything but. So unfortunately there isn't a comparison. My myeloma isn't totally sleeping, but my m protein, the marker he uses, is very low .
I haven't had any problem at all with my shoulder till the shingles hit. So it is a mystery. But I'm sure he'll figure it out. Actually, I've had no pain anywhere and have felt great. So again mystery?
I'm not sure what an MRI would show ,any thoughts.?
I haven't a pet scan since diagnosis , I think, maybe that's what we should do.? When I talked about these before with him, he says they are necessary for where I was, not sure his reluctance.
Unfortunately, last years X-rays didn't include my arms, I guess a full skeletal survey is everything but. So unfortunately there isn't a comparison. My myeloma isn't totally sleeping, but my m protein, the marker he uses, is very low .
I haven't had any problem at all with my shoulder till the shingles hit. So it is a mystery. But I'm sure he'll figure it out. Actually, I've had no pain anywhere and have felt great. So again mystery?
I'm not sure what an MRI would show ,any thoughts.?
I haven't a pet scan since diagnosis , I think, maybe that's what we should do.? When I talked about these before with him, he says they are necessary for where I was, not sure his reluctance.
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Christina1952
Re: Lucent lesions
hI Christine...a 'full' skeletal survey doesn't seem to include the section of the legs from the knees to the feet! I was using an elliptical machine in January and of course unused muscles always hurt and I thought maybe I had injured my shins....someone else on the Forum commented on that recently. (The shins are OK again, so I guess it wasn't serious). It did include the arms though...maybe this varies from one centre to the next, as to what is x-rayed.
Hope you can get to the bottom of this pain issue though. If my myeloma flares up on me again I am sure I would be getting closer attention to bone issues since there is actually quite a lot of damage.
Hope you can get to the bottom of this pain issue though. If my myeloma flares up on me again I am sure I would be getting closer attention to bone issues since there is actually quite a lot of damage.
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: Lucent lesions
Nancy and Sandra-
My oncologist said that the skeletal x-rays include the bones of the body that have high concentrations of bone marrow. So, below the knees and below the elbows are not usually included. Shoulder and upper arms should be included because fractures do occur in these areas. I had a pathologic fracture of my left humerus 4 years ago and it was readily visible as were the lesions at the fracture site. They are still visible today even though the fracture healed without any interventions other than starting Revlimid and Dex at the time.
Recently I developed bone pain in my left lower leg. When I mentioned it to my oncologist he ordered a new skeletal survey and told me to tell the radiology tech to include my lower leg. They called the doctor and told him to write orders for x-rays of both of my tibias and fibulas. This x-ray showed that i had a discreet bone lesion in both fibulas, but the one on the left was the one that was causing me severe pain. I just finished a course of radiation to that area and it is feeling a lot better.
So, at the very least ask your doctor to have x-rays done of your shoulder and upper arm.
Nancy in Phila
My oncologist said that the skeletal x-rays include the bones of the body that have high concentrations of bone marrow. So, below the knees and below the elbows are not usually included. Shoulder and upper arms should be included because fractures do occur in these areas. I had a pathologic fracture of my left humerus 4 years ago and it was readily visible as were the lesions at the fracture site. They are still visible today even though the fracture healed without any interventions other than starting Revlimid and Dex at the time.
Recently I developed bone pain in my left lower leg. When I mentioned it to my oncologist he ordered a new skeletal survey and told me to tell the radiology tech to include my lower leg. They called the doctor and told him to write orders for x-rays of both of my tibias and fibulas. This x-ray showed that i had a discreet bone lesion in both fibulas, but the one on the left was the one that was causing me severe pain. I just finished a course of radiation to that area and it is feeling a lot better.
So, at the very least ask your doctor to have x-rays done of your shoulder and upper arm.
Nancy in Phila
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NStewart - Name: Nancy Stewart
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 3/08
- Age at diagnosis: 60
Re: Lucent lesions
Thanks Nancy, that is helpful! i actually called the cancer ctr. before my last skeletal survey after reading your previous post, and asked if the x-rays would include the lower legs. There was some confusion and they told me on the phone that the x-rays would be done there, but when I got there it turned out that they did not take x-rays of that area, and I would have had to have separate x-rays ordered. By that time, I was feeling better, so didn't do that, but another time I will if experiencing a lot of pain! And it is also helpful to know that radiation helped you out with the pain. Hope you are well!
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: Lucent lesions
So N Stewart , so they determined there was a lesion in your leg, did an X-ray and then you did radiation?
Was there an earlier X-ray to compare? And is your myeloma active now?
This has me really perplexed, first, I'm on zometa, I'm in VG partial remission( low m protein)
And if it is new, how does he determine that?
I didn't realize they radiation for lesions, is that the norm? I thought it was get back on rev/ dex.
Thanks I really appreciate you sharing your current similar condition.
Was there an earlier X-ray to compare? And is your myeloma active now?
This has me really perplexed, first, I'm on zometa, I'm in VG partial remission( low m protein)
And if it is new, how does he determine that?
I didn't realize they radiation for lesions, is that the norm? I thought it was get back on rev/ dex.
Thanks I really appreciate you sharing your current similar condition.
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Christina1952
14 posts
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