Question Brothers

[leo2634]

Good morning my Brothers, My question is I've been putting off Knee replacement for a long time ( Many years) and it is finally catching up to the point of no return. My question to this fantastic site and knowledgeable Brothers is as follows.

I have multiple mets and several in my legs top,middle, and bottom. I asked my Cancer doctor and he doesn't seem to think it would matter but when examined by Knee doctor he said there could be a chance surgery couldn't happen and more testingis needed. If any of you went through this predicament it would be awesome to here from you. My bone scans done recently showed no progression of Mets and all are stable. Leo

[tom67inMA]

I heard a story at work about a knee replacement. We make machine vision equipment, and a potential customer was investigating using machine vision to verify the correct size replacement knee was being used. As I understand it there's a portion of the replacement knee that slides partway into the cut bone (where the marrow normally is) and if the replacement isn't sized correctly (too large) there's a risk of breaking the bone open during installation. I'd imagine the concern is that cancer weakened bone may make such a break more likely.

On the other hand, my father-in-law had a knee replacement (no cancer) and it greatly improved his mobility.

Perhaps an MRI of the affected bone would give a better idea of how much cancer is in the important areas and help make the decision? I'm probably suggesting this because I'm getting an MRI today to try to find the source of a pain in my butt that's recently gotten severe. I think they'll be looking for a nerve "pinch point" that they can shoot cortizone into to make the pain go away. My pain is not consistent enough in location to accurately do an injection.

[leo2634 in reply to tom67inMA]

That's what the Doctor is going to do when the time comes. My bone mets are all over but stable with no increase in sizes. I also had a severe pain in the butt but as soon as I got my first Lupron shot 4 years ago it stopped. I still feel it sitting on a hard chair but nowhere near the pain before. It's a bone met in my lower pelvis buttocks area which happens to be the largest one. Leo

[Kaliber in reply to leo2634]

I’m no doctor but if you have been on Lupron for 4 years, you might want to ask your doctor hard questions relating to Lupron caused bone mineral density loss and suitability of the holding power ( screws ) of mineral deprived bone. With four years of Lupron there should be serious considerations given to potential bone quality. It’s something to consider. I take monthly Zometa infusions to try to compensate for Lupron bone loss but even Zometa is known to cause bone fractures and brittle bones while trying to bolster Lupron bone mineral loss.

Good luck with your knee replacement brother warrior.

Just say’in 💪💪💪❤️❤️❤️

[leo2634]

Thanks Nal your advice is appreciated. My Cancer Doctor will be at the helm of my decision to be sure. I have already spoken to several professionals in regards to my options just thought maybe someone on the site might have some first hand advice. Leo

[Quambygreg]

Hi Leo,

I had a full knee replacement 4 weeks, like you prior to the operation I had immense pain whilst walking and retained fluid in my leg which became unbearable of a night time, My GP prescribed Frusemide which helped greatly. I found the best surgeon I could and we decided that my stage 4 cancers wouldn't impact my recovery. 4 weeks on the wound has healed but the swelling has returned, doing physio which helps but I do feel I made the right decision as I couldn't tolerate the pain pre surgery. Happy to discuss if you need to.

Greg

[leo2634 in reply to Quambygreg]

Thanks Greg was any special testing done before surgery,scans, CT,etc. Also do you have bone mets in the area of the replacement? That's my problem I do.

[jfoesq]

I only had mets in my spine, hip, lymph node(s) and possibly 2 ribs, but not in my legs. I had my total knee replacement about 4 years ago and 5 years after being dx and starting Lupron/Pred. Neither my onc nor my knee surgeon saw any problems with me having the surgery and I have suffered no ill effects from having it. Good luck.

[Quambygreg]

Leo, I did MRI, X-ray and CT scan, I didn't do a PSMA scan as when I was first diagnosed it didn't show the 11 Mets in nodes even though they were 5mm in size so they thought there was no use repeating the test. My PSA is undetectable so I had comfort that even if I have Mets elsewhere they are not active. My deepest concern was is the surgery going to stir my cancer into action. In the end I decided I want to improve my QOL, ADT makes me tired, the hot flushes make life uncomfortable every day and I can't wait to come off it in 12 months and by then my knee should be completely normal, hopefully I will have my energy level back and be able to get back to the energetic level I was before my diagnosis.. I would be guided by your medical team and seek a second opinion if that gives you more comfort on the path that you choose.Greg

[leo2634 in reply to Quambygreg]

Thanks I'm also 0.1 PSA since first month of treatment four years ago. ADT certainly diminishes quality of life but the key word there is LIFE! I have complete confidence in my Doctor and Cancer team he promised to keep me alive to see my Grandkids grow up so far so good. He has cleared me for knee surgery but I'm going to try Sinvisk first to see if it can bye me until after the Christmas holidays. I have too many obligations between now and then. Thanks for taking the time to get back to me. Leo