Hello,
Well appointment with Hem-Onc doc went great! Lots of good discussion, i.e. risk assessment, future monitoring, treatment options, etc. Ordering MRI of spine, but only radiation therapy for now. First treatment went great today - the 'bunker' is on the first floor of the cancer centre with hardwood and tiled floors/ceilings, including recessed lighting and a skylight roof where glowing sunshine beams down on bountiful indoor plants. The treatment table faces this beautiful scene. Helps!
Forums
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georgia - Name: georgia
- Who do you know with myeloma?: My dad :(
- When were you/they diagnosed?: 2002-MGUS-64yrs; 2013-Plasmacytoma-75yrs
- Age at diagnosis: 64
Re: Solitary Plasmacytoma with MGUS or Multiple Myeloma
MRI Results..
The MRI of my dad's spine showed only degeneration in T2 - good news! He finishes his 20th radiation treatment tomorrow (left scapula). Wondering how they will tell if treatment worked - see if M peak is smaller or repeat CT of shoulder - would improvement be evident on scan? Still hoping it is just a Solitary Plasmacytoma!
georgia
The MRI of my dad's spine showed only degeneration in T2 - good news! He finishes his 20th radiation treatment tomorrow (left scapula). Wondering how they will tell if treatment worked - see if M peak is smaller or repeat CT of shoulder - would improvement be evident on scan? Still hoping it is just a Solitary Plasmacytoma!
georgia
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georgia - Name: georgia
- Who do you know with myeloma?: My dad :(
- When were you/they diagnosed?: 2002-MGUS-64yrs; 2013-Plasmacytoma-75yrs
- Age at diagnosis: 64
Re: Solitary Plasmacytoma with MGUS or Multiple Myeloma
Hello.
My dad had a follow-up appointment today. We got the results of his spinal MRI. It looks like he has a 9mm lesion in C4 of his cervical spine and degeneration in T2 of his thoracic spine (hadn't received ALL info about MRI in earlier post - same MRI). There was also mention of T7 - something about abnormal bone marrow finding (can't really remember but I think it was uptake overwhelmed).
Can anyone tell me what this means. I am assuming this will no longer be considered a Solitary Plasmacytoma, but rather Multiple Myeloma - Stage I? (See previous posts for recent previous findings). Question: Can C4 be radiated, like they did his shoulder? Also, will this mean chemotherapy also.
I also wanted to mention that the consult on his bone marrow exam remarked hat there was more like 5 to 10 % clonal plasma cells present rather than 5% as originally thought.
Please help - scared! Thanks, georgia
My dad had a follow-up appointment today. We got the results of his spinal MRI. It looks like he has a 9mm lesion in C4 of his cervical spine and degeneration in T2 of his thoracic spine (hadn't received ALL info about MRI in earlier post - same MRI). There was also mention of T7 - something about abnormal bone marrow finding (can't really remember but I think it was uptake overwhelmed).
Can anyone tell me what this means. I am assuming this will no longer be considered a Solitary Plasmacytoma, but rather Multiple Myeloma - Stage I? (See previous posts for recent previous findings). Question: Can C4 be radiated, like they did his shoulder? Also, will this mean chemotherapy also.I also wanted to mention that the consult on his bone marrow exam remarked hat there was more like 5 to 10 % clonal plasma cells present rather than 5% as originally thought.
Please help - scared! Thanks, georgia
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georgia - Name: georgia
- Who do you know with myeloma?: My dad :(
- When were you/they diagnosed?: 2002-MGUS-64yrs; 2013-Plasmacytoma-75yrs
- Age at diagnosis: 64
Re: Solitary Plasmacytoma with MGUS or Multiple Myeloma
Dear Georgia,
It sounds as though what initially began as MGUS in 2002 has slowly worked its way to an early case of multiple myeloma. The burden of disease seems quite low based on the bone marrow biopsy report and what you describe on the MRI. As such, even under the worst of circumstances, I think he will do great! Data from Arkansas would suggest that patients with myeloma evolving out of MGUS/solitary plasmacytoma of bone do quite well.
As a first step, I would verify with your father's doctor as to the nature of the C4, T2 and T7 abnormalities. While they could represent early myeloma bone lesions, there are other abnormalities that can be seen in the spine (e.g. hemangiomas) that are completely benign. A radiologist should be able to discern the difference. This is critical. If they are not myeloma lesions, close observation after radiation without chemotherapy would be highly appropriate. If these are myeloma lesions, chemotherapy and a bisphosphonate (e.g. zometa) would be warranted.
If the abnormalities are convincing for early myeloma changes, but there are no other high risk features related to the myeloma, a less intensive initial strategy would be appropriate, for example Revlimid and low-dose dexamethasone. Zometa would also be a good idea, once monthly.
I would not do radiation. If myeloma is starting to declare itself, one has to expect that additional lesions will pop up over time. Chemotherapy would hit everything that is there.
Let us know if you have any other questions. Hang in there!
Pete V.
It sounds as though what initially began as MGUS in 2002 has slowly worked its way to an early case of multiple myeloma. The burden of disease seems quite low based on the bone marrow biopsy report and what you describe on the MRI. As such, even under the worst of circumstances, I think he will do great! Data from Arkansas would suggest that patients with myeloma evolving out of MGUS/solitary plasmacytoma of bone do quite well.
As a first step, I would verify with your father's doctor as to the nature of the C4, T2 and T7 abnormalities. While they could represent early myeloma bone lesions, there are other abnormalities that can be seen in the spine (e.g. hemangiomas) that are completely benign. A radiologist should be able to discern the difference. This is critical. If they are not myeloma lesions, close observation after radiation without chemotherapy would be highly appropriate. If these are myeloma lesions, chemotherapy and a bisphosphonate (e.g. zometa) would be warranted.
If the abnormalities are convincing for early myeloma changes, but there are no other high risk features related to the myeloma, a less intensive initial strategy would be appropriate, for example Revlimid and low-dose dexamethasone. Zometa would also be a good idea, once monthly.
I would not do radiation. If myeloma is starting to declare itself, one has to expect that additional lesions will pop up over time. Chemotherapy would hit everything that is there.
Let us know if you have any other questions. Hang in there!
Pete V.
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Dr. Peter Voorhees - Name: Peter Voorhees, M.D.
Beacon Medical Advisor
Re: Solitary Plasmacytoma with MGUS or Multiple Myeloma
Thank you Dr. Voorhees!
You have lifted our spirits. My dad's physicians are currently doing more investigative studies for staging and treatment. I shared this thread and it was well received! Again, I can not thank you enough for your compassion in caring and taking the time to share your greatly respected expertise!
God bless you. Sincerely, georgia.
You have lifted our spirits. My dad's physicians are currently doing more investigative studies for staging and treatment. I shared this thread and it was well received! Again, I can not thank you enough for your compassion in caring and taking the time to share your greatly respected expertise!
God bless you. Sincerely, georgia.
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georgia - Name: georgia
- Who do you know with myeloma?: My dad :(
- When were you/they diagnosed?: 2002-MGUS-64yrs; 2013-Plasmacytoma-75yrs
- Age at diagnosis: 64
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