Three primary cancers? Please help me understand these MRI results!

[Lynsi13]

It's been a while since I have been on this group. I hope everyone is doing well and having a good new year.

I am here for my dad. To recap, he was diagnosed in 2015 with stage 4 prostate cancer. He received hormone therapy and chemotherapy initially. When he failed that he began provenge and xtandi. After a few years he failed the second line hormotherapy and had radiation therapy. That seems to be holding his PSA in check presently.

Over the past 5 years he is also had a quadruple bypass which resulted in him suffering from afib. He is also had two heart attacks.

In the late fall of 2022 he was diagnosed with CNS lymphoma in his brain. He received five rounds of chemotherapy and immunotherapy and has been in remission since.

He also has a condition called myelydisplastic syndrome (MDS) which results in him needing injections and medicine to keep his platelets in a safe range.

This year he has been struggling with often on incidences of paralysis. They come on quickly and leave him unable to stand or walk for about 4 to 5 weeks. Then he slowly regains his strength before it strikes again. He has had it occur two times. We have been seeing a neurologist for it and over the course of the testing we had a MRI which has some concerning results.

The MRI results are suspicious for multiple myeloma. His oncologist is doing some tests for MM but I'm having trouble wrapping my mind around the fact that my dad could have three primary cancers! I asked Google how likely it was that someone would have three primary Cancers and it said the chances are less than 1%. I truly do not want my dad to be in that 1%. He has had so many struggles. I don't even want to have to tell him about this!

The MRI report mentions that it could be metastatic disease. Dad had only lymph node involvement, but I'm wondering if rather than it being MM, it could be metastatic prostate cancer?

I realized we won't know anything until the tests come back but I was wondering if anyone has any input or any words of wisdom for me?

I added an image of his MRI results.

I appreciate it!

[Shellhale]

I really think he needs a PSMA pet scan to see what is really going on. Does he take any diuretics? It says small bilateral plueral effusions, which can be related to the heart or kidneys. I would mention this to his cardiologist. I am sorry your dad is going through so much.

[Lynsi13 in reply to Shellhale]

I expect that is coming. His oncologist ordered a MM test among others and we're starting there.

He doesn't take any diuretics. I saw the mention of plueral effusions. 😩 He has had both heart and kidney issues, so I'm not sure which is responsible. I will be reaching out to his oncologist about it, however. Thanks for your reply; I'm so overwhelmed and broken for him right now!

[Shellhale in reply to Lynsi13]

He definitely has alot to deal with right now. I am glad he has you to help advocate for him. Your dad is lucky to have such a caring daughter. Take one day at a time, you will both get through this. God Bless.

[Lynsi13 in reply to Shellhale]

Thank you for your kind words. We will get through this, as we have everything else, together and with our faith!

[Shellhale in reply to Lynsi13]

Yes!! Mindset has powerful effects. Faith is essential for us all.💙

[Xavier10]

They can take some more detailed tests on the multiple myeloma. I was riding my scooter and somehow managed to crack my skull (I don't remember the accident itself) and the CT the admitting hospital did said I had some lesions that could possibly be multiple myeloma but after further tests by my PCa docs on that issue they said it was something benign. So things can be "maybe." They have blood tests they can run also that show the evidence of monoclonal gammopathies, which have something to do with MM. It's a complicated thing but an MRI saying "maybe" is not firm evidence.

[Lynsi13 in reply to Xavier10]

Thank you for sharing your experience. I am grateful that they can run simple labs to diagnose MM and that we don't have to rush to something invasive. His doctor has ordered these tests. It's good to hear that someone has had an MRI mislead in this regard. I'm just having a hard time rationalizing THREE primary cancers. Two was enough of a blow. Hopefully we can get some positive results like you did. Thanks again for sharing!

[SpencerBoy11 in reply to Lynsi13]

I have had 3 cancers at one time. Immediately you shrug your shoulders and ask, "Why me?". Had my bypass 1st when I was in better shape. Live the best for each day. Your Dad is lucky to have you in his corner, and you need to be his rock. Keep your head up and give the cancers the finger.

[Lynsi13 in reply to SpencerBoy11]

I'm so sorry. One cancer is enough, not to mention three! Many people wouldn't be able to handle that fight. You're incredibly strong! Yes, I'll always be in his corner. He's my best friend and I'll fight beside him until the end!

[j-o-h-n]

To Lynsi13, How old is your dear Dad and where is he located/treated? You're a great offspring and I do hope you have siblings and/or relatives that can help you deal with all of your Dad's issues. May 2025 be a good year for all of you. Give Dad our regards....(to you all also).

Good Luck, Good Health and Good Humor.

j-o-h-n

[Lynsi13 in reply to j-o-h-n]

Hi John, my dad (John also) is 83. We're in rural Ohio. He has a team at the Cleveland clinic and a team at the OSU James cancer center. The doctor that I have looking into this incidental finding is from the Cleveland clinic and has been with my dad from the start. He's a phenomenal doctor and friend.

[j-o-h-n in reply to Lynsi13]

Another John.......... well I'll be damned..... Cause that means he's a nice guy and he was born in 1941 (and I was born in 1936) and lives rural Ohio hmmm.... I know a little about Ohio especially south of Cleveland, near Canton/Akron, towns of Dover and New Philadelphia. Tell your Dad that my 1965 Corvette was stolen right out of the May Company Department store's (downtown Cleveland) circular parking lot in 1969.

A fist bump between the two oldies...🤜🤛

Good Luck, Good Health and Good Humor.

j-o-h-n

[Lynsi13 in reply to j-o-h-n]

Oh yes, two very good Corvette-loving Johns! My dad has always loved and had his Corvettes. He sold his Corvette a few years ago after the brain tumor caused him to give up driving due to vision issues. But, he still loves them! We're actually not too far from Akron/Canton. I went to college in Canton. We're about an hour south in Amish country. Unfortunately Akron/Canton haven't gotten much safer.. I sure wouldn't trust my Vette there! Thanks for the encouragement, John, and for always leaving me with a smile after reading your replies!

[j-o-h-n in reply to Lynsi13]

Sugarcreek Ohio.............. great Amish restaurant.........Belden Brick company. Walnut Creek and underground cheese cave (owner an antique car collector). etc. Anyway I know that area fairly well from years ago. Tell your Dad I paid $4,850.00 for a new fully loaded 1965 Vette and if he remembers "the hand wave" to other vettes on the road. Of course revving the engine at a stop light (showing off) was a must.

Enough is enough I'll give you all a little peace and quiet.

Regards again.

Good Luck, Good Health and Good Humor.

j-o-h-n

[Lynsi13 in reply to j-o-h-n]

Hi John! Yes, Sugarcreek is not far from us. We get lots of good Amish food here, that's for sure. It's lovely country full of lovely people. We're blessed.

I'll tell him! He's a Corvette man, through and through, so I'm sure he'll enjoy your stories!

Take care!

[swwags]

I'm sorry for you dad. Blood tests are the first route in diagnosing MM. They include M protein test known as SPEP. Then IgG, IgA, blood tests for a determination of the specific M protein. Red blood cell counts are important as well. If all of these point to MM, a biopsy of bone marrow is done for the final confirmation. All that info is then plugged into an algorithm to determine the stage of the disease and care. I have MM also. feel free to PM me if you have questions. My history is mostly up to date but I don't have my lab results posted. I'm not a doctor but can share my personal experience with you. Best of luck to him.

[Lynsi13 in reply to swwags]

Thanks for sharing! His oncologist is ordering a host of labs, so I'm assuming those are among them. I don't know whether to hope that his prostate cancer has spread or to hope that it's another cancer altogether? I can't believe I'm even debating these things, to be honest. Dad's 83 and tired. He has a lot of comorbibities.. I don't know how well he can even handle more medications at this point. 😩

[Cp014]

I was recently diagnosed w two cancers. First Thought to be prostrate cancer gleas9 that had spread to the lungs.

They did Pet first then pmsa scan. They could not tell conclusively from pmsa if the lung cancer was from the prostrate.

multiple scans and No cancer was found anywhere else other than prostrate and right lung.

They did a lung biopsy, stain test. The stains were not prostrate cancer and conclusively I’d as adenocarcinoma nsclc.

Based on my case, seems as though they need samples of the cancer in order to know for sure?

[Lynsi13 in reply to Cp014]

I'm so sorry to hear that. I remember when my dad was diagnosed with brain cancer, it seemed so implausible. It's almost as though the immune system is so weak that cancer cells just proliferate. From what I understand, with MM blood work can be enough to give you a proper diagnosis. I'm grateful it's something noninvasive. How are you doing with your treatments? Are you tolerating them well?

[Cp014 in reply to Lynsi13]

You can read my profile it is updated.

I just got my 2 Lupron injection monday12/30/24.

My psa was 6.25 when diagnosed. It is now <.05. So my pc is on hold while I treat the lung cancer.

In Hospitol now recovering from bilobectomy. 8 + hour surgery.

Dr says surgery went well.

Waiting on pathology to see if cancer was dead or not to determine next step, chemo. To get any micro met.

We see.

Glucose shot up from Keytruda? And now experiencing heat flashes frm the Lupron.

Other than that mild up and down stuff, tiredness, appetite.

Thank you for asking.

[Lynsi13 in reply to Cp014]

I'm glad you were able to get the prostate cancer in check at least. I'm sure it feels good to have that handled. My dad was able to get 5 years out of his initial hormone therapy before needing a second line one so hopefully you can have similar luck! Boy, an 8 hour surgery. That must have been hard! I wish you a speedy recovery and great results! Stay strong!

[Retireddoc]

Good morning. Just a few observations and comments after reading the thread:

Despite your Dad's health struggles he is a lucky man to have someone as caring as you as his daughter. I also have a daughter who loves me very much and it helps get through the journey.

Over my medical career I read many, many MRIs of the spine. It is difficult to give a definitive diagnosis with a diffuse abnormal signal within the vertebral bodies, especially in an elderly patient with a history of cancer with a propensity to metastasize to the bone (prostate). The interpreting Radiologist is giving an opinion that MM could give this appearance, but this is far from definitive. It could be related to his prostate cancer or even due to a variety of benign (non malignant) causes. When a Radiologist mentions a particular diagnosis (in this case MM) in the report, the oncologist is obligated to do additional tests to prove or exclude it. That doesn't mean the MO thinks your Dad has MM at this point.

I know the uncertainty is difficult, but if/until the tests are conclusive I would try to not perseverate on it. The explanation of the abnormality may well be something else.

The Cleveland Clinic is an excellent medical center and I'm sure your Dad is in great hands and they will do what is necessary.

Good luck to both of you.

[Lynsi13 in reply to Retireddoc]

Thank you so much for taking the time to reply to my post. I have read through your reply several times and it has brought me great comfort. More than anything, I have dreaded telling my dad. I've held off in hopes of a reply such as yours that will give me some words of comfort and hope to share with him. And you've given me that, and so I am incredibly grateful. I appreciate it more than I can communicate! Lynsi