lung, thoracic cancer, or myeloma - 1289005

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kathyripa1
lung, thoracic cancer, or myeloma - 1289005

I am a smoldering multiple myeloma patient of 5 yrs. I have not yet had any lesions on bones. I receive a bisphosphonate montly via IV and get a Pet/CT scan annually. My lungs "light up" every time, I have nodules, and I had a bronchoscopy 4yrs ago..dx with mycobacterium abscessus. I was on biaxin 500mg a day for about 2yrs. My last pet/ct was February 2016 and showed increased uptake right upper lobe, "probably from peripheral small airway inflammatory changes." A month ago started having severe right shoulder blade pain, neck pain, and chest pain. ER ruled out pulmonary embolism, ekg normal, chest x-ray showed no acute respiratory illness. Saw an ortho doc and he read all of my reports, did full spinal x-ray, physical exam and feels as though pain coming from lung. He ordered mri of right shoulder and thoracic spine to check for osteolytic lesions..I get results tonight. I have a pulmonary appointment scheduled in one week. Last night I noticed slight swelling in my right armpit. Multiple myeloma does not usually present first in the lungs and I am now scared that I have a pancoast tumor or another cancer in addition to the myeloma. The best case scenario if it is cancer would be an osteolytic lesion on the thoracic spine. Would lung or thoracic cancer show up on the thoracic mri or shoulder mri?

catdander
Hi Kathy,

Hi Kathy,

Welcome to Grace. I'm very sorry you're living with this diagnosis. One very common and important thing to know about all cancers is that it can and will do anything. So while it may be unusual for multiple myeloma to show first in the lungs it is very possible. With that said it's also possible to have 2 different cancers at one time. It's not known exactly why but stats show that people who have had cancer (or living with cancer) are more likely to have a 2nd cancer than someone to get a first cancer in the same time period.

MRIs are focused on a small area as compared to a CT so it's easier to miss if the MRI isn't directed at the right area. It's also possible for a tumor to hide behind bone in an MRI as opposed to CT which creates a 3D image of the area. It would be unusual to miss a tumor with an MRI pointed directly on it but it happens (it happened to my husband). With that said the shoulder area is a complex area and an MRI can give a detailed picture of what's happening in that area and probably a good first step in processing the issue. I imagine your oncologist would order a CT if the MRI doesn't pick up a problem.

I hope this helps.
Best of luck,
Janine