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PMR and Malignancy

Posted , 10 users are following.

barbara75814
barbara75814

I just came upon this: "The association of malignancy and PMR is well recognized.. . . ." and "Small-cell vasculitis in the elderly should always prompt a search for malignancy. . . ."

I didn't know this--at any rate, the site I read in this connection is a case study of a 73-year-old woman first diagnosed with PMR but who died some months later of B-cell lymphoma.

Here is site information if you care to read: 

http://www.nature.com/nrrheum/journal/v2/n12/full/ncprheum0352.html

Interesting that my primary physician, when I last saw home, said I needed to have an abdomen/pelvic CAT scan--obviously looking for cancer. I told him I couldn't put my arms over my head for the CAT, but that I was going to a rheumy who would probably put me on pred. The same doc also said I should have another heart test (name of which I have forgotten this second).

Now I am one week into Pred. 15 mg. and I have a rheumy to go see in three months, as taper continues and concludes. However, soon as I can I intend to go see primary doc again and begin the things he recommends.

Good grief but things get complicated. Any ideas, anyone??

Barbara

Emis Moderator comment: I have added the direct link. Let me know if it isn't the correct one.

2 likes, 20 replies

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  • elisa4
    elisa4 barbara75814

    Posted

    Barbara, I have had lately that many health problems that I did not get as far as.

    I studies Cancer and the cancer industry for over 10 years as I had breast cancer twice. I also study celiac desease and the causes of high blood pressure. At the moment I habe a severe digestive disorder, after the PMR seems to be in remission. I also try to find out how I can avoid a knee replacement and a catarax surgery. Medicine is such an enourmas spread out topic. I am always happy when others find new things I can follow up.

    My main goal is to find a correlation between all the different health problems I have to hopefully get to the root of the evil. Sadly our Doc's don't have the time to study individual cases in depth these days, as they have hardly the time to study a patients file before or during a patients visit as 6 min are just enough to write a script, measure blood pressure and ask some basic questions.

    Therefor we all have to help each other to fill the gap.

    best wishes El

    • Judygirl
      Judygirl elisa4

      Posted

      Well said!!!!!  For me cataract surgery went very well.  I corrected 

      heart burn through diet, your disorder may be more serious.  Three

      years ago, after a fall, it was suggested I had a knee replacement -

      decided to wait for stem cell research to take care of this!!!!!

  • kelmil
    kelmil barbara75814

    Posted

    My rheumatologist gave me similar advice...to go to my internal medicine doctor and request an MRI of my abdominal area.  He isn't able to write an order for an MRI since I'm not "yet" exhibiting any symptoms.  I have an atypical case of PMR in that I was diagnosed at a younger age than is considered the norm.  My rheumatologist decided to share with me that he has had a few atypical PMR patients who were eventually diagnosed with cancer.  This office visit was very recent, so I haven't yet followed up on his advice.  In the interim, I'm to pay close attention to my body for any unusual pains, etc.  Curious if anyone else has heard of any cases like this?
    • EileenH
      EileenH kelmil

      Posted

      The guidelines for diagnosis and treatment of PMR are very clear that PMR is a diagnosis of exclusion - at any age and not just for "atypical" younger patients. "Diagnosis of exclusion" means you rule out all the other possibilites that CAN be proven/disproven with available tests since PMR is a clinical diagnosis - made on clinical signs and suspicions. There is no blood test that "confirms" PMR at present - whatever a doctor might say. The raised ESR and CRP tests (found in 80% of patients) merely confirm there is general inflammation, they prove nothing, they go up with a chest infection. 

      This page on this site lists the most likely other options:

      https://patient.info/doctor/polymyalgia-rheumatica-pro

      In the case of lymphoma there would usually be other symptoms besides the fatigue, malaise and night sweats, an abdominal MRI might find an abdominal mass but not the CNS variety for example. Leukaemia is likely to be found in full blood count test, women don't get prostate cancer. 

      However, despite some doctor's dismissal of the use of a moderate dose of pred as a diagnostic tool, a patient who has an unequivocal response to 15mg pred is most likely to have the PMR we are talking about on this forum. It will have little or no effect in other options, including other arhtritides.

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