Metastatic Carcinoma of Lumbosocal Spine 
Author Message
 Metastatic Carcinoma of Lumbosocal Spine

My Case Study.

I have suffered from chronic back pain probably for the last 12 years or so.
Initially just in the lower back, but with aspirin and some stronger pain
killers, this usually just went away.
However about 1988 this pain was getting worse. Consequently stronger pain
killer were prescribed by the local GP. Another remedy was some ointment
like linement etc.
After some weeks of pain without pain, the local GP refered me to a
specialist.
This Doctor performed a mylogram, which indicated that I had some calcium
growth at about L4-L5 area.
Surgery was recommended, with him scraping this calcium in 1989. Ten weeks
after this operation, the pain was back again, and another mylogram
indicated that not enough was removed, so back in again for the second time.
This gave me a comfortable 4-5 years.
But again in early 1996, pain started to re-occur in the lower back, and
also irritation in the legs and feet. Areas of the foot would give needles
and pins. Right upper thigh would have a complete patch that would feel
'dead'. Certainly lots of pain in the area of bottom spine. Again the Pain
Killers and lotions and potions, and also a Thermal Belt, complete with IR
Heat lamp. Always the times without were short lived.
Local GP suggested after X-ray that Arthritis has set in. His comments,
Always working hard physically, and now that you have slowed down somewhat,
arthritis is in your spine.
Exercise, swimming, riding bicycle etc. Anti-inflammatory tablets were also
prescribed.
After a week or two, no signs of relief, so a referral back to the first
specialist whom recommended a mylogram. This was performed, and at the
appointment the following day, his recommendation was to go back to my GP,
as surgically there was nothing wrong with me, so it has to be Muscle,
nerves or tissues etc.
Back to the local GP, more exercises on bicycle, more lap swimming, more
anti inflammatory tablets etc. etc. etc.
After 3 weeks of sheer agony I suffered an almost breakdown as it was
getting on top of me.
Back to local GP, whom wrote out a letter of referral to the Royal Adelaide
Hospital. From his surgery straight down to the hospital arriving at 11 am
precisely on Friday 6-2-98. The casualty doctors performed their normal
tests etc., and after lying on a barouche for almost 8 hours, the send me
home a 6-50pm with a box of pain killers and told me to come back on Monday
next, and perhaps I could talk to a spinal doctor.
Arrived back in casualty on Monday afternoon February 9th at 2-00pm. I was
admitted at 6-30pm that night for observation.
I was placed in the orthopedics wing. The ward doctor suggested that we have
a CT Scan done on the lower back. This was done 3 days later on Thursday.
On the morning of the next day, Friday at ward round, the suggested that
something showed up on the CT Scan in the lower Spine region, which
indicated a lesion, infection or something like that.
Immediately he ordered a MRI Scan which was done that same afternoon.
On the following day, Saturday, the Ward Doctor in his casual clothes, (his
weekend off) sat on the bottom of my bed and said,:

" YOU HAVE CANCER IN THE SPINE! "

He ordered an immediate biopsy to be done. Three days later this was
performed, however Pathology could not determine were the Cancer originated.
The following tests were performed:

Thyroid Scan
Full body CT Scan
Full body Bone scan
{*filter*} tests for every known disease

It was therefore determined that I have a Metastatic Carcinoma of unknown
origin of lumbosocral spine.

The pains were getting increasingly stronger day by day, so the Spinal
Surgeon suggested they go in from the front and cut out as much of the tumor
as they could and strengthen the area with rods and packing or epoxy. This
operation was performed on Friday 8th march 1998.
Pathology were send large parts of the Tumor, yet still cannot determine the
Origin. It has to come from the lining of something, let it be stomach,
lung, kidney, the lining of something. Anyway the following Monday, (3 days
later) I had to try and stand up, but extremely painful, in fact far worse
than ever before.

The Head Surgeon  then suggested that they bring the second operation
forward, this operation is from the back, to strengthen and stabilize the
bottom spinal area.
 Wednesday 18th March this second operation was performed. I now have about
12 screws, 4 Rods and 4 strengthening bars holding the bottom spine in
place.
Stood on feet the following day but very painful. The Pain Unit people were
consulted, and a Pain relief system was put into place.
Tuesday 24th march 1998, I was transferred to Hampstead Rehabilitation
Centre to learn how to walk again, whilst monitoring the pain.
Received a wheelchair from the centre, and had a fitting for a new one to be
made. Did swimming, exercises etc in thew centre, and was discharged 9th
April 1998. This is now a full 2 months since I entered Hospital.
Started Radio Therapy on Thursday 23rd April 1998 initially for  treatment
over 5 weeks, however, I has 32 treatments over a 6 weeks period.
Still taking lots of morphine tablets and syrup to ease the pain.
Discomforts whilst being treated with RT were minimal. Very tired at all
times. Some vomiting, but both bowel and bladder still working normally in a
fashion, whilst taking six Coloxyl with senna tablets per day.
Friday 3rd July my first appointment with Chemo-Therapy clinic. I am not to
sure of the treatment at this point in time, but it has been indicated a
period of 3 weeks treatment.
 I will keep whomever is interested posted if you drop me a line. I will be
only too happy to compare, suggest or help anyone out there.
By the same token, has anyone out there had a similar experience, or know of
someone in a similar situation?

A Metastatic Carcinoma of lumbosocral spine of Unknown Origin

Look forward to receiving a reply from anyone.

Henri Speyer
Andrews Farm
South Australia



Tue, 05 Dec 2000 03:00:00 GMT
 Metastatic Carcinoma of Lumbosocal Spine

Quote:

> My Case Study.
> I have suffered from chronic back pain probably for the last 12 years or so.
> Initially just in the lower back, but with aspirin and some stronger pain
> killers, this usually just went away.
> However about 1988 this pain was getting worse. Consequently stronger pain
> killer were prescribed by the local GP. Another remedy was some ointment
> like linement etc.
> After some weeks of pain without pain, the local GP refered me to a
> specialist.

<snipped for brevity>

Quote:
> Arrived back in casualty on Monday afternoon February 9th at 2-00pm. I was
> admitted at 6-30pm that night for observation.
> I was placed in the orthopedics wing. The ward doctor suggested that we have
> a CT Scan done on the lower back. This was done 3 days later on Thursday.
> On the morning of the next day, Friday at ward round, the suggested that
> something showed up on the CT Scan in the lower Spine region, which
> indicated a lesion, infection or something like that.
> Immediately he ordered a MRI Scan which was done that same afternoon.
> On the following day, Saturday, the Ward Doctor in his casual clothes, (his
> weekend off) sat on the bottom of my bed and said,:
> " YOU HAVE CANCER IN THE SPINE! "

<snipped for brevity>

Reading this sad tale one realises that the Aussies have the same cost-saving
attitude to medicine as the Brits. But the first case if back pain in the 80's
probably was just degenerative changes.

Jon Naude MD (radiology & radiooncology)

--
The opinions expressed above are not necessarily shared by the U. of Vienna. To
email me, remove the zz from my address.



Wed, 06 Dec 2000 03:00:00 GMT
 Metastatic Carcinoma of Lumbosocal Spine

One wonders if (in the name of cost containment) the pathologist just
limited him/herself to traditional light microscopy or if immunostaining
was used. In most cases, good immunopathology can tell where a "cancer
of unknown origon" started -- either a specific organ or at least a
simlar family of organs (ie GI vs prostate, both of which can look
similar if poorly differentiated)

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Please note that all contents of this message, including any advice,
suggestions,  and/or recommendations has NOT been generated as part of
any professional
evaluation. No patient has been examined prior to making these comments;
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advised to
discuss these comments with his/her personal physicians and to only act
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Paul I. Roda, M.D., F.A.C.P.
http://www.DoctorsOffice.org/



Thu, 07 Dec 2000 03:00:00 GMT
 
 [ 3 post ] 

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