[nymom]

Solitary plasmacytoma - when is treatment result known?

by nymom on Thu Mar 05, 2015 10:49 pm

Hi. I am 4 treatments away from finishing up radiation for a solitary bone plasmacytoma in my left iliac. Just wondering how long is necessary to wait before a scan can show how effective treatments have been.

First, radiation doc said I may have to wait 3 months, but then another time said maybe I can get scan about 6 weeks post radiation.

Thanks, Denise

[NStewart]

Re: Solitary plasmacytoma - when is treatment result known?

by NStewart on Fri Mar 06, 2015 6:34 pm

I don't know with plasmacytomas how long the wait is. But, with other cancers, a scan is usually done 3 months post completion of radiation.

Nancy in Phila

[nymom]

Re: Solitary plasmacytoma - when is treatment result known?

by nymom on Sat Mar 07, 2015 9:02 am

Thank you for the reply Nancy.

Even though I am anxious to get the results, I don't want to have the scan too soon where they wouldn't be accurate. A plasmacytoma is the same plasma cell tumor that patients with multiple myeloma have, so I figured there would be many people on the forum that have experience with the time length of waiting to have scans after radiation.

Thanks again.

[Dr. Edward Libby]

Re: Solitary plasmacytoma - when is treatment result known?

by Dr. Edward Libby on Mon Mar 09, 2015 12:52 pm

Hello Denise,

A followup CT scan 2-3 months after radiation is appropriate. Generally, radiation is VERY effective at treating solitary bone plasmacytoma (SBP) and, in roughly 90% of patients, the plasmacytoma does not recur in that location.

However ... I would like to take this opportunity to point out some important secondary issues relating to the evaluation and treatment of solitary plasmacytomas.

1. Even in patients in whom the radiation is a success, there is a significant chance that the patient will develop symptomatic multiple myeloma that requires treatment. The 5-year rate of progression to multiple myeloma in patients with SBP is roughly 50%, and the 10-year risk is at least 75%.
    
2. Therefore, it is CRITICAL that your doctor and hematologist / oncologist evaluate your risk for developing multiple myeloma in the future and follow your labs regularly over the next few years to monitor for the development of myeloma.
    
3. MANDATORY baseline testing in patients with SBP include: bone marrow biopsy; state-of-the-art imaging (either MRI of the spine and pelvis, or whole body MRI, or PET-CT) to search for other unsuspected or "silent" plasmacytomas; serum protein electrophoresis; and serum free light chain testing
    
4. If you have had a solitary bone plasmacytoma and this testing has not been done, or is not planned, talk to your doctor about the testing I mentioned. Because SBP is a rare disease, some physicians are not aware of the testing and followup recommendations.

Thank you for sharing your questions with the Beacon!

[nymom]

Re: Solitary plasmacytoma - when is treatment result known?

by nymom on Tue Mar 10, 2015 10:14 pm

Thank you for the reply Dr. Libby,

I believe I have had all the testing you recommend. I will see my medical oncologist in a few weeks to get all the exact numbers and details of those biopsy results. I do know there were no additional tumors found based on the PET scan prior to treatment. Prior to treatment, my blood was normal and my bone marrow were normal. There was protein in my urine and I was told something vague about light chains.

What information should I keep track of and ask for at this next visit?

We have been getting copies of all the lab results, but sometimes they are difficult for us to under­stand. Like the urine results that showed protein, we couldnt see that for ourselves.

Thank you for the guidance,
Denise

[nymom]

Re: Solitary plasmacytoma - when is treatment result known?

by nymom on Tue Mar 10, 2015 10:19 pm

And I just wanted to add that I have experience already with a doctor who diagnosed me with multiple myeloma because the bone marrow biopsy he performed was done at the site of my tumor in the left illiac. I am trying to stay as well informed as possible to make sure I am getting the appropriate care and follow up.

Thanks again.