[chrisbo]

Multiple myeloma & recurring prostate cancer

by chrisbo on Thu Sep 18, 2014 5:41 pm

Has any one been unlucky enough to have multiple myeloma and also have their prostate cancer recur?

My husband had prostate cancer in 2000, moderately aggressive with a Gleason score of 7, he was 57 at the time, now 71. He had eternal beam radiation and high dose temporary brachytherapy. His PSA wasn't that high when his GP caught it at 3, and in 4 months went to 8. He went into remission after treatment.

His PSA very slowly started going up from the lowest at 0.01 in about 2008. The doctors didn't seem to be concerned, even though I knew that meant something was up. In 2011 he was diagnosed with multiple myeloma. He has had a rough road with that these last 3 years. He's very weak, constant diarrhea, in pain all the time and on a lot of medication. He just keeps hanging on, but his quality of life is miserable.

He was on IV Velcade in the first year. It worked, but the side effects were terrible. He went to subcutaneous Velcade and that didn't work at all. He is now back on 25 mg Revlimid for 3 weeks on, 1 week off, and 20 mg dex once a week for 3 weeks. His M-spike was 1 g/dL last month, came down for the last 4 months. He's been back on treatment now after a 7 month break due to side effects and the doctor dragging his feet.

About a year ago, his PSA was climbing faster and STILL the oncologist who is treating him, didn't seem concerned UNTIL it reached 16.8 last month. THEN all of a sudden he sent him to the oncologist radiologist in his office last Friday. He said that, with those numbers, he does feel the prostate cancer is back and he also thinks it's gone to the bone.

This shocked us. We thought the cancer might be just still in the capsule, but with his other cancer showing many lesions in the pelvic area, thought it was that. NOW, they want him to start hormones, but unknown which one or when, still waiting to hear from them to call back (like we are always doing).

The doctor said there are no other tests for someone who has had previous radiation and treatment. No biopsy, so they are strictly going on the rise in PSA and will just treat him like he does have it back.

That seems a little odd to me. The MRI couldn't rule it out, but couldn't confirm it given that he has so many lesions from the multiple myeloma. We don't have the best specialists for his multiple myeloma here in Vegas and it's not feasible to go out of state, so we are stuck with what is here.

Anyone know of anyone with this problem?

We both want to know which cancer will get him first and should be more aggressively treated. His doctors won't give any stats on this.

In the meantime, I got him into our local Cleveland Clinic Urology doctors for next Tuesday and am hoping they will have a little more info.

Any thoughts or suggestions?

Thanks

[Dr. Heather Landau]

Re: Multiple myeloma & recurring prostate cancer

by Dr. Heather Landau on Sun Sep 21, 2014 9:46 pm

Hi Chrisbo,

I am very sorry to hear of your husband's struggles. Indeed, patients with multiple myeloma are at higher risk than the general population of cancer other than multiple myeloma. Therefore it is not infrequent that as doctors we are faced with distinguishing one cancer from another. This is particularly important for your husband given that he is both symptomatic from disease and has had substantial side effects from treatment.

While having prior pelvic radiation can make diagnostic testing more difficult, since biopsies in that area may not show much, I wonder if he has had a PET scan, which can reveal if there is disease outside of the pelvis. If so, that should be biopsied. If it shows prostate cancer rather than multiple myeloma, it would be reasonable to focus on treating the prostate cancer.

If on the other hand, the only disease that is present is in the pelvis, I would (not knowing the details of course) still attempt a biopsy, since we have super sensitive methods for picking up cancer. Again, if informative, treatment can be directed at that.

Best of luck to you and your husband!
Heather Landau

[Ann C]

Re: Multiple myeloma & recurring prostate cancer

by Ann C on Wed Aug 02, 2017 10:00 pm

My husband had prostate cancer in 2012. It was treated with radiation. In November of 2016, he was diagnosed with multiple myeloma after 9 years of having MGUS. His multiple myeloma was treated with Velcade, Revlimid, and dexamethasone.

After prostate radiation, his PSA started going up slowly. Since being on treatment for his multiple myeloma myeloma, his PSA is now jumping. It doubled in the last 6 months. I blame either the myeloma or the myeloma treatment. I hope it's the treatment, because he is now starting main­te­nance and I just hope his PSA will start to go down.

[coachhoke]

Re: Multiple myeloma & recurring prostate cancer

by coachhoke on Fri Aug 04, 2017 9:32 am

I'm in the middle of radiation treatment for prostate cancer (Gleason 7 (4+3) PSA 7) discovered on my PET/CT scan. My oncologist seems to think it's my age, more than myeloma or the treatment. Nobody really knows. I'm 76 years old and am beginning to feel my age.