Doctor insights on:
Lesions Bone Myeloma
When a pet scan is done for multiple myeloma, is it to look at the solid lesions or a full body scan to look at bone marrow?
Both: A pet/ct scan looks at all parts of the body, from the skull top the feet, if appropriate. If there is abnormally increased (or decreased) glucose metabolism, it will be seen - in bone marrow or lymph nodes, lungs or solid organs. For multiple myeloma, since bone lesions are more likely, even more attention is paid to the bones and marrow. But, the rest of the body is also examined carefully. ...Read more
I had not heard of "kahler's disease" until seeing multiple questions on healthtap. It is multiple myeloma (mm). "multiple" is from the often seen "multiple" bone lesions (especially in advanced disease). Mm is a cancer of plasma cells [highly specialized b white blood cells (lymphocytes)] that produce antibodies. Sx are crab: hypercalcemia, renal insufficency, anemia, ...Read more
Do Standard99m Tc bone scans with tracer ever reveal lytic lesions of Myeloma, or only ever osteoblastic lesions, and fracture? Having workup for MM.
Bone scan, not helpf: Bone lesions of myeloma do not show up on a Bone scan. So it is not a useful test when looking for bone lesions which can be seen more easily with MRI scan. Alternatively a CT scan can help in a localised spot and PET scan can also be useful in certain select situations. ...Read more
Depends: The number of plasma cells is not the only determinant of prognosis. Are there bone lesions on x-ray? Is kidney function normal? Has there been a response to therapy? Many patients with 40% plasma cells at diagnosis can do well for years. ...Read more
5 yrs ago dr said from my bloodwork she suspected multiple myeloma, bone test is normal. She is still checking my blood. Can I stop? What should I do
Very: Multiple myeloma a plasma cell cancer could be very dangerous in some, in others (the lucky ones) the diseases can run for years. Have to speak to the treating oncologist good prognostic signs are higher albumin, lower beta 2 microglobulins, , plasma cell dna showing not having high risk chromosomal abnormalities. ...Read more
Resuming treatment for myeloma with rev and dex. Recent dexa scan says I have bones of young adult! Haem insists I have zometa infusions. Why?
More benefit: Zoomed makes the bone harder. Myeloma cells live in the bone marrow next to the bone and they bore into the bone. By replacing a mineral of the bone with Zometa the bone become less tasty to the digesting cells that then feed the myeloma. Dex also can soften bones. So these are good reasons to take Zometa but don't overdo it as too much can make the bone too hard. ...Read more
Can there be different opinion on beta 2 microglobulin and bone marrow biopsy regarding detection on multiple myeloma?
Beta 2 Microglobulin: Is a way of following myeloma response to therapy. The problem is that it can be elevated in other conditions- including benign ones. I've seen it very high in patients with kidney dysfunction. So the leel could be different than the bone marrow, which is the only real way to prove multiple myeloma. ...Read more
Would reviewing the bone marrow n aspiration slides by a better pathologist give a clearer picture how to fish tests help in myeloma?
2nd opinion can help: Never hurts to get your results verified by another doctor. ...Read more
I am wondering with normal SPEP, Bone marrow Biopsy, PET Scan All normal, high B2M is there chances for Myeloma or Waldenström's macroglobulinemia?
My father died about 5 years ago from multiple myeloma. I was the bone marrow donor for his transplant. I am an only child and am wondering about my risk factor for myeloma, especially since my marrow was considered a good match.
An nci study is looking at characterizing families that may be at higher risk to identify causes:
screening individuals and families at high risk for hematologic cancers
http://clinicaltrials. Gov/ct2/show/nct00052234? Term=nct00052234&rank=1. ...Read more
M57, which is the simple cheapest test for ruling out multiple myeloma first hand when person is in doubt like having pain mild pain in bones. Thanks?
Good but tough: Question. To rule in the diagnosis need a bone marrow aspiration and sophisticated protein testing of blood and urine. None of those are cheap. A more cost effective approach eliminating tests would only "partially" rule out the diagnosis of mm ie something could be missed. ...Read more
Can multiple myeloma be seen on a CT scan? The tumor/lesion part, and/or the bone marrow involvement, or both or neither? Injected 350 contrast.
Yes but not always: Xray, ct and MRI can be used to show bone destructions from multiple myeloma, but not always. Sometimes the disease is not severe enough & the bone destruction is not great enough to be perceptible. When enough disease is present, what can be seen is an area of loss of bone tissue, referred to as a lytic bone lesion. ...Read more
Kidney biopsy shows the reason for kidney failure is multiple myeloma. No bone damage, hemo. More than 12. Will kimo therapy help to recover fully?
Seek opinion from a: This is unusual way to make a diagnosis of multiple myeloma (mm). Typically we need to do a bone marrow biopsy and look for cancer cells in the marrow. These cells produce abnormal proteins (m protein) which will show up either in the blood (commonly) or in the urine. We use a test called protein electrophoresis. If these tests have not been done, seek a second opinion. Chemo will help to control mm. ...Read more
32 year old with lifelong HCV + a year of bone pain/discomfort (ribs, upper back, hips). Cbc normal, low ferritin/iron. Should I screen for myeloma?
Not yet: You're young for myeloma and even in the unlikely event that you have it, there's little benefit to early diagnosis. Look for the cause of your iron loss instead -- a total-body lack of iron may make you feel ill long before it makes you anemic. Today, bone pain from vitamin d deficiency and/or diet-related osteomalacia is extremely common. Might this be the explanation? Stay proactive. ...Read more
My friend HS phyllodes. Tumor ws removd. Tissue around negative. Sd breast b moved? She hd multiple myeloma & bone marow transplnt. In remission now. Tx
Depends: Phyllodes breast tumors are rare and most are benign. It depends on the final pathology findings. Benign tumors only need removal with clear margins. Cancerous phyllodes tumors may need mastectomy. See this site: http://m.Cancer.Org/healthy/findcancerearly/womenshealth/non-cancerousbreastconditions/non-cancerous-breast-conditions-phyllodes-tumors. ...Read more
Had a thoracic MRI for 9 mo history of rt upper abd pain, rt flank pain, said bone marrow intensity was normal. Does that totally rule out multiple myeloma?
I have inconsistent tests that lean toward multiple myeloma or MGUS. First xray lytic lesion; globulin series serum & urine monoclonal positive to gamma; 24 hr electopherurine neg; beginning anemia; BUN off; other small abnormals. Bone survey neg.
Need second opinion: The criteria for myeloma vs Mgus changed recently but both changes include exact percentages and size of lytic bone lesions. Your data as you summarized are not adequate and since mgus vs multiple myeloma are like dawn and day, you need to be seen and your precise numbers verified. That said, please see hemeonc in centers experienced in myeloma dx, management, and treatment. ...Read more
I have multiple bone lesions and also soft tissue mass near my spine and ilium what are the chances this is multiple myloma?
Varies: There are multiple potential causes. Certainly the concern for a neoplastic condition would be a consideration. A serum protein electrophoresis can usually give a good idea about whether it is multiple myeloma. A biopsy would certainly be the definitive test. Thank you for the question. ...Read more
It's not just the number, but how they crowd out normal cells, and how much other problems they cause (elevated calcium, sludging, infiltration of bone, etc.)
would probably need a special online consult to sort this out better.
Without an actual examination, I cannot give specific medical advice on your particular health, ...Read more
Multiple myloma specialist needed confusing reports no crab features low m spike below 1 but 14 percent plasma cells in bone marrow pls help me?
Http://www. Ncbi. Nlm. Nih. Gov/pubmedhealth/PMH0001609/
http://myeloma. Org/ArticlePage. Action? TabId=1&menuId=334&articleId=3462&aTab=-1
http://myeloma. Org/ArticlePage. Action? TabId=1&menuId=334&articleId=3467&aTab=-1
Sorry I am not an oncologist. I will try to find one for you. ...Read more
Multiple myloma specialist needed pls help me confusing reports low m spike below 1 no crab but 14 percent plasma cells in Bone marrow biopsy worried?
Might be myeloma: Your plasma cells >10% in the bone marrow biopsy mean either smoldering myeloma or active myeloma. If you have elevated calcium, anemia, renal insufficiency or lytic bone lesions, I'm sorry to say you have myeloma. If not, you have smoldering myeloma. Go to this link for more info: http://www. Nccn. Org/patients/guidelines/myeloma/index. Html ...Read more
Is it normal for your white blood cell count to fluxuate if you have multiple myloma (cancer of the bone marrow)?
Hi, White blood cell is low in Multiple Myeloma, now the count even in a normal person can vary from time to time but now the question is how wide of Fluctuation we are talking about and also are you on chemo medication?
If you are on chemotherapy then that could drops your white blood cell count significantly, you need to work with your Oncologist closely to monitor your count.
Good luck. ...Read more
F 43 back pain for many yrs recent CT scan shows serious bulging disc L4 L5.dad die from wt multi myloma. What are the chance having bone cancer?
Reassuring: Your MRI is an excellent test to reassure you that there is nothing seriously wrong, like cancer. Multiple Myeloma is a cancer that affects older adults and it is not known to run in families. Your bulging disc does not usually need surgery. You should do well with rehabilitation for your weakness and pain. An EMG test (see a Physiatrist for this) may guide your care and progress. ...Read more
Yes it does: Smoldering myeloma or mgus can produce high levels of m- protein but that does not require treatment. If there no bone lesions, you do not meet the criteria for myeloma yet, so active treatment for myeloma is not indicated unless you have bone lesions or other signs and symptoms of myeloma, (often called 'crab' criteria for instituting treatment.). ...Read more
Only if fracture +: Not everybody who has myeloma will have fracture when diagnosed. Yes, myeloma will involve the bone and there would be increased risk for fracture- however- just because one has myeloma-it does not mean that it is identical to pain unless you have fracture. And if you do-it depends on your tolerance to pain and how severe the fracture is. Pain is very subjective. Discuss with oncologist. ...Read more
Plasma cell & other: People who have diagnosis of plasma cell disorders- called mgus (monoclonal gammopathy of unknown significance) would be the one who is at risk for multiple myeloma. Other potential risk factors - include older age, male (hormone related?), black/african american, exposures to radiation, benzene, and other organic solvents, herbicides, and insecticides and other unknown risk factors. ...Read more
Bone is a living growing tissue made mostly of collagen (protein that provides soft framework) & the mineral calcium phosphate that adds strength & hardens the framework. Two types of bone are found in the body; cortical (dense compact outer layer) & trabecular (makes up inner layer, ...Read more