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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Do These Following Lab Reports Indicate?

It is a very big honor to me to dealing with your esteemed hospital, my doctor in Egypt told me about your hospital as I need to ask (the below mentioned question) as I had : On 6/1990 malignant fibrous histiocytoma in the distal third of my left femur & had radiation on the entire compartment including the thigh, muscle near the bone, the hip joint & femur condyles with total dose of 50 Gy On 26/8/2011, I had right breast infiltrative duct carcinoma 0.8x0.5 cm. Grade II, Surgical margins presented are free, Intraductal component 10% LNs 0/5 ER : Negative PR : Negative Her-2 : Positive 3 by sish technique. KI-67 : 5% Received adjuvant chemotherapy : Taxotere 75 mg /m² every 3 weeks for 4 cycles. Endoxan 600mg/ m² every 3 weeks for 4 cycles. 11/10/2011 01/11/2011 22/11/2011 27/12/2011 Herceptin 8 mg/kg for the first dose. then after 3 weeks 6 mg/kg every 3 weeks for a total of 17 cycles taken for 1 year starting on 11/10/2011 and ended on 3/10/2012 Radiotherapy for 30 sessions which was started on 23/01/2012 & ended on 15/3/2012 for a total dose of 60 Gy, Loco-regional radiation therapy for a total dose of 50 Gy/25 sessions then boost dose to the tumor bed. so it would be my pleasure & big honor to have your esteemed reply after reading all my emails with its content from x-rays & reports...etc. My question is the following : On 06/03/2012, I have taken Zometa 4 mg Only one time up till now & I had pain after it by one month & took only one injection (diprofos) as a pain killer. This pain stayed for a period of 4 months after taking the zometa at the following places : Left pelvis joint pain Back pain Left Thigh pain & was not able to come up from bed in the morning or any time from chair till I stand-up slowly. Now I walk with only one crutch (before zometa I was walking without crutches from 6/2010) The pain which is find up-till now is at the subtrochanteric region in left femur which is found when I walk without crutch or when I walk much with one crutch & very rarely Numbness in right femur only when tired I need to know is the suspicious area seen in the subtrochanteric region in the bone scan is from the zometa or not ?????? So as to know if I can take the prolia 60 mg injection (denosumab) or not as its date of receiving was supposed to be on 06/09/2012 & I didn t take it up-till now. Please take into your consideration that I have done in my left femur 6 operations up-till now In 1990 : Segment resection of the distal femur in the operation of 1990 the bone which had tumor was substituted by homologous spongiosa graft & the radiation was This is the question which I send for it all this history take prolia or you have an alternative to it or what to do? Because before treatment (26.08.2011) the bone scan was clear the new things are the chemotherapy, radiation on right breast, herceptin & zometa & radiation on left femur taken on 1990 I really need to know what is the reason… With my best Regards & all my Thanks in advance Miss / Doaa EL-Aassar 37 years old
Mon, 19 Dec 2022
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Anesthesiologist 's  Response
Hello,

Zometa is zoledronic acid and is used to reduce calcium levels in blood and also prevents the breakdown of bones due to cancer spreading to bone.
Some serious side effects include:
1) Increased or severe bone, joint or muscle pain
2) New or unusual hip, thigh, groin pain, jaw or ear pain
3) Eye or vision problems
4) Numbness or tingling, muscle spasms or irregular heartbeat

You need to report these serious adverse effects to your treating physician. Prolia is denosumab. Denosumab is used to treat bone loss (osteoporosis) in people who have a high risk of getting fractures. A few side effects of Prolia are symptoms of low calcium such as: muscle spasms or cramps, mental or mood changes (such as irritability or confusion), numbness or tingling (especially around lips or mouth or in fingers or toes), fast or irregular heartbeat, severe dizziness or fainting, seizures.

Denosumab can affect your immune system. You may be more likely to get a serious infection, such as a skin, ear, stomach/gut, or bladder infection. As your treating doctor believes the uses of Prolia is above the side effects it causes, you are prescribed that and you need to take it.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Pallavi M., Anesthesiologist
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What Do These Following Lab Reports Indicate?

Hello, Zometa is zoledronic acid and is used to reduce calcium levels in blood and also prevents the breakdown of bones due to cancer spreading to bone. Some serious side effects include: 1) Increased or severe bone, joint or muscle pain 2) New or unusual hip, thigh, groin pain, jaw or ear pain 3) Eye or vision problems 4) Numbness or tingling, muscle spasms or irregular heartbeat You need to report these serious adverse effects to your treating physician. Prolia is denosumab. Denosumab is used to treat bone loss (osteoporosis) in people who have a high risk of getting fractures. A few side effects of Prolia are symptoms of low calcium such as: muscle spasms or cramps, mental or mood changes (such as irritability or confusion), numbness or tingling (especially around lips or mouth or in fingers or toes), fast or irregular heartbeat, severe dizziness or fainting, seizures. Denosumab can affect your immune system. You may be more likely to get a serious infection, such as a skin, ear, stomach/gut, or bladder infection. As your treating doctor believes the uses of Prolia is above the side effects it causes, you are prescribed that and you need to take it. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Pallavi M., Anesthesiologist