Hei hei,
Does anyone have experience with or knowledge about lytic lesions in the skull? In particular the interior skull bones? Can these heal following a auto stem cell transplant? Do bisphosphonates help the healing of these particular bones? Is one bisphosphonate better than others in treating this lytic lesion location?
Thanks! David
Forums
-
silverberg - Who do you know with myeloma?: Care provider to my wife
- When were you/they diagnosed?: October 2011
Re: Interior skull bone lytic lesions
Each case is different, I suppose, but here's my experience. I was diagnosed during what was to be a routine cosmetic procedure to drain and close a swelling on my skull. But when they opened it up, they found there was no skull below and about a baseball size hole. There were lesions across the top of my skull as well, but I don't know if anything was interior. For those, treatment was 13 days of radiation, but they held off on doing that until I had adjusted to chemotherapy.
I had a CR from the chemo and have held it after autologous stem cell transplantation (ASCT) in March 2011.
I had Zometa monthly for two years and now get it quarterly. A follow-up skeletal survey two years after the transplant showed nothing changed; the lesions on my arm and rib bones was no worse. I don't know if it can get better, but I don't think healing is an option,
Zometa has been shown to have anti-cancer properties, as well as those it is prescribed for. But it's more expensive and your doctor may have to get clearance from your insurance company.
I had a CR from the chemo and have held it after autologous stem cell transplantation (ASCT) in March 2011.
I had Zometa monthly for two years and now get it quarterly. A follow-up skeletal survey two years after the transplant showed nothing changed; the lesions on my arm and rib bones was no worse. I don't know if it can get better, but I don't think healing is an option,
Zometa has been shown to have anti-cancer properties, as well as those it is prescribed for. But it's more expensive and your doctor may have to get clearance from your insurance company.
-
Ron - Name: Ron
- When were you/they diagnosed?: Nov. 2010
- Age at diagnosis: 63
Re: Interior skull bone lytic lesions
David -
The skull is a common place for lytic bone lesions in myeloma. Plain xrays often don't show much improvement over time, but studies using more sensitive tests like MRI have shown that bone lesions can heal over time in patients who achieve excellent hematologic responses. This can take months to even years, and most often the bones never come completely back to normal, though they can improve.
Bisphosphonates can help all the bones and don't specifically help one area of the body more than others. One large study done in the UK has shown that Zometa was superior to clodronate (an oral bisphosphonate) for preventing skeletal-related events and improving survival in myeloma patients undergoing chemotherapy, and this is our first choice in most patients, as long as kidney function is okay.
Another intravenous bisphosphonate, pamidronate (Aredia) is also effective at reducing skeletal-related events (e.g fractures, need for surgery or radiation), and is a very reasonable option as well.
Best of luck!
The skull is a common place for lytic bone lesions in myeloma. Plain xrays often don't show much improvement over time, but studies using more sensitive tests like MRI have shown that bone lesions can heal over time in patients who achieve excellent hematologic responses. This can take months to even years, and most often the bones never come completely back to normal, though they can improve.
Bisphosphonates can help all the bones and don't specifically help one area of the body more than others. One large study done in the UK has shown that Zometa was superior to clodronate (an oral bisphosphonate) for preventing skeletal-related events and improving survival in myeloma patients undergoing chemotherapy, and this is our first choice in most patients, as long as kidney function is okay.
Another intravenous bisphosphonate, pamidronate (Aredia) is also effective at reducing skeletal-related events (e.g fractures, need for surgery or radiation), and is a very reasonable option as well.
Best of luck!
-
Dr. Adam Cohen - Name: Adam D. Cohen, M.D.
Beacon Medical Advisor
Re: Interior skull bone lytic lesions
I am currently having radiation to my right temporal cranium. I have developed floaters in my right eye. Should I be concerned? The tumour on my skull was the first indication that I had relapsed, from my stem cell transplant less than a year ago. I am also receiving radiation to my right femur.
I will be starting Revlimid on Monday and have already started dexamethasone. I am hopeful that I will be able to drive again, and that the floaters are a temporary side effect.
I will be starting Revlimid on Monday and have already started dexamethasone. I am hopeful that I will be able to drive again, and that the floaters are a temporary side effect.
-
Miggraham - Name: Marnie
- Who do you know with myeloma?: Self
- When were you/they diagnosed?: December20,2011
- Age at diagnosis: 54
Re: Interior skull bone lytic lesions
I have had multiple myeloma for 3 years and have had Zometa for the entire time. I have lesions everywhere, including the skull. Although nothing has shown to have gotten better, nothing has gotten worse either. I had a pathological fracture of the arm three days afer diagnosis, but nothing since. Zometa has to get some of the credit.
-
Chuck Lindgren
Re: Interior skull bone lytic lesions
If you have floaters in your eye(s), you should see an opthamologist. I developed them suddenly last year and was freaked out by them. When I saw the eye doctor, he said that it was leaking from blood vessels in my eyes. He said that this often happens in people as they age (he wasn't as kind as this and said that it's common in 'old' people). I was instructed to call emergently if I ever saw flashes of light in the periphery of my sight because this could mean the retina was detaching.
It's better to see an eye doctor to make sure that it isn't something more serious. They are now following my eyes every 3 months to be sure to catch anything that changes before there is too much damage. Most of the time I no longer have the floaters, but occasionally they appear again.
Nancy in Phila
multiple myeloma '08, ASCT 1/10
It's better to see an eye doctor to make sure that it isn't something more serious. They are now following my eyes every 3 months to be sure to catch anything that changes before there is too much damage. Most of the time I no longer have the floaters, but occasionally they appear again.
Nancy in Phila
multiple myeloma '08, ASCT 1/10
-
NStewart - Name: Nancy Stewart
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 3/08
- Age at diagnosis: 60
Re: Interior skull bone lytic lesions
I would definitely go see an eye doctor! A friend down the road (he does not have cancer) just started seeing floaters and the eye doctor said the retina is detaching from his eye. He has had one eye surgery already and has to have the other eye done soon also.
As far as the bone lesions not healing, I am confused. I thought when you took chemo / Zometa, it would make the bones lesions go away and your bones would heal? What is the point of treatment if it can't heal anything? Is it just to keep multiple myeloma from progressing and causing more bone lesions?
The doctors told me my hip fracture had healed after radiation and surgery. Although the surgeries and radiation involved really messed up my leg from my hip to my knee. I still have pain and can no longer bend my knee at all. Grrrr
Could be worse, and I am grateful, but cancer really sucks!
As far as the bone lesions not healing, I am confused. I thought when you took chemo / Zometa, it would make the bones lesions go away and your bones would heal? What is the point of treatment if it can't heal anything? Is it just to keep multiple myeloma from progressing and causing more bone lesions?
The doctors told me my hip fracture had healed after radiation and surgery. Although the surgeries and radiation involved really messed up my leg from my hip to my knee. I still have pain and can no longer bend my knee at all. Grrrr
Could be worse, and I am grateful, but cancer really sucks!
Re: Interior skull bone lytic lesions
Bone healing does occur. Plain x-rays are not good at showing this, but, as Dr. Cohen noted, MRI can show healing with successful treatment. The integrity of the affected bone may not revert to normal, but it can definitely improve.
I would definitely bring the floaters to the attention of the radiation doctor and get seen by an ophthalmologist, especially since the floaters are involving the eye on the same side as the temporal bone lesion being radiated.
Thanks!
Pete V.
I would definitely bring the floaters to the attention of the radiation doctor and get seen by an ophthalmologist, especially since the floaters are involving the eye on the same side as the temporal bone lesion being radiated.
Thanks!
Pete V.
-
Dr. Peter Voorhees - Name: Peter Voorhees, M.D.
Beacon Medical Advisor
Re: Interior skull bone lytic lesions
I just discovered a soft depression on my right temporal area of my skull. Upon diagnosis 5 years ago, I had many lesions throughout my body, some being in my skull, and numerous fractures. I have had a ASCT with an almost 5-year remission. I am currently back on chemo for the next 5 months
First time I have felt this teaspoon-size depression on my skull. What does it mean and will it require radiation, as my back recently did?
I am quite concerned. Does this mean the bony skull has dissolved over this depression?
Thanks,
Brenda
First time I have felt this teaspoon-size depression on my skull. What does it mean and will it require radiation, as my back recently did?
I am quite concerned. Does this mean the bony skull has dissolved over this depression?
Thanks,
Brenda
-
BMClhv1800
Re: Interior skull bone lytic lesions
This is a good question, but a bit tough to answer without knowing what the imaging looked like previously.
If you are back on treatment and the area over the skull is not enlarging or painful, I would not think radiation would be necessary. You can ask your doctor to review the images with you and see if this was an area previously affected or not. If the area does appear new, in addition to the new treatment, it may be worthwhile to go back on bone treatments like zoledronic acid (Zometa) or pamidronate (Aredia).
If you are back on treatment and the area over the skull is not enlarging or painful, I would not think radiation would be necessary. You can ask your doctor to review the images with you and see if this was an area previously affected or not. If the area does appear new, in addition to the new treatment, it may be worthwhile to go back on bone treatments like zoledronic acid (Zometa) or pamidronate (Aredia).
-
Dr. Jason Valent - Name: Jason Valent, M.D.
Beacon Medical Advisor
11 posts
• Page 1 of 2 • 1, 2