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Is bone Cancer the same as having cancer in your bone marrow? Explain the difference.

By August 14, 2010 - 5:50am
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I had marginal zone lymphoma that was detected in my spleen. When the spleen was removed it was 8 lbs. They also removed some of the surronding lymph nodes and only 3 were found to have cancerous cells. It has been 2 years since my surgery and my blood work is very good the doctor tells me. How long before I will have signs that this disease is increasing and what are the signs.

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Thank you, Pat, for the wonderful care you bring to what you do to make things better for cancer fighters and survivors.

Wismare, the support group here at EmpowHER is very much worth joining. Much of what we experience on our cancer journeys is the same regardless of the type of cancer. Try checking in with lymphoma groups for cancer specific info and tips but with thoughtful, knowledgeable moderator/navigators like Pat, who draw on their own experience and wisdom, there isn't any place better to be than here!

August 16, 2010 - 7:29pm
Expert HERWriter Guide Blogger

wismare - Thank you for your question and welcome to EmpowHER! Please let us know if you have additional questions or if we can help you in any way. You may also be interested in joining our support group for cancer survivors which can be found at https://www.empowher.com/groups/cancer-survivors

As a fellow survivor I know that the end of the clinical treatment process isn't the end of learning how to live with a cancer diagnosis, and we all continue to need good information, support tools, emotional support and a network of other people who can help us go forward.

Liz and PAL - Thank you so much for your expert information, both in answering this question and in the work that you all do every day in helping patients better understand and deal with the world they're in.
You truly do help empower women - and men - with lymphoma and other cancers by providing cutting edge, expert information with good hearts behind everything you guys do.

Take good care wismare and Liz,
EmpowHER Cancer Guide

August 16, 2010 - 5:32pm

Hi Wisemar,

I am so sorry you are going through this worry.

First, let's clear up some very important differences between sold cancers (for example, bone marrow cancer) and blood cancers (lymphoma with bone marrow involvement). Marginal zone lymphoma (MZL) is a slow-growing blood cancer, specifically, as miscortes says, of one of your types of white blood cells, the B cells. B cells produce antibodies to fight germs. B Cells are borne and grow in the bone marrow. When they mature, they circulate in your blood stream and lymph system, which includes certain lymphatic organs such as the spleen.

Although lymphoma can advance to infiltrate the bone marrow, it is not at all the same as bone marrow cancer. MZL is a cancer of your B-cells. Bone marrow cancer is a cancer of bone cells and it's a solid cancer. Unlike some solid cancers (i.e., breast, lung, colon, bone and marrow, etc.), even advanced lymphomas can often be reversed. There is much reason to hope that you can live a long and good quality life with long periods (years and sometimes decades) of remission alternating with treatments. In an indolent (slow growing) lymphoma, treatment isn't generally needed unless a patient is symptomatic.

I am assuming remission is what you mean by "my blood work looks very good" and that you are currently in remission, or at least stable disease that is not progressing or increasing. Presumably, you also get periodically scanned (CT or PET) or to look for any possible recurrence or progression. If you are in remission, the disease isn't increasing. It's not detectable at all.

A solid cancer starts in one spot and may spread through the blood or lymph system to set up shop in another organ. That is called metastasis. In a sold cancer, the cancerous cells take over. They crowd out and starve healthy organ tissue and the organ eventually fails. If cells from a solid cancer are found in lymph nodes, that is usually not great news and we worry about it spreading to possibly destroy other organs. But in marginal zone lymphoma (mzl), the cancerous B cells are lymph cells. So, of course, lymphoma cells will be found in lymph nodes. That's how they roll. ;) Presence in lymph nodes per se is not bad news for a lymphatic cancer.

You don't say, but it sounds as if you have splenic marginal zone lymphoma, SMZL. In SMZL, finding lymphoma cells in bone marrow is not uncommon. But that was not the case for you apparently? (I can't actually tell from your question.) Did you have a bone marrow biopsy? That is how bone marrow involvement is detected and measured. If there was bone marrow involvement, the lymphoma can still be eradicated through chemotherapy and your bone marrow will regenerate and be normal again.

Splenectomy, such as you had, can result in remissions for SMZL. Other treatments (chemo, radiation, immunotherapies) are similar to other indolent lymphomas - not typically initiated until the patient is symptomatic.

In studies, rituximab (trade name, Rituxan), an immunotherapy, given with or without chemotherapy was found to have major activity in patients with SMZL. Rituximab is often the treatment of choice, especially in older patients with SMZL. It is not chemotherapy so usually has few side effects. For more on Rituximab/Rituxan: http://www.lymphomation.org/rituxan.htm

If you'd like to know more or have more questions, Patients Against Lymphoma's lymphomation is available on the web and on Facebook. We have a large group of survivors and supporters on FB and we invite you to join us to get knowledge and support from other patients and our patient navigators. We'd also suggest that you register for the webmagic discussion forum and NHL cyberfamily, these are two large lymphoma patient groups. There you will find other marginal zone survivors to share experiences with and be encouraged by.

PAL on facebook: http://www.facebook.com/lymphomation

NHL discussion forum: http://forums.lymphoma.com/

NHLcyberfamily: http://www.nhlcyberfamily.org/

More on Splenic Marginal Zone Lymphoma (SMZL): http://www.lymphomation.org/type-mz.htm#spleenic

big, healthy healing hugs,

Liz for Patients Against Lymphoma (PAL)

August 16, 2010 - 5:20pm
EmpowHER Guest
Anonymous (reply to Patients Against Lymphoma)

Thank you, this is more information than I received in the last 2 years. My doctor I think is afraid to tell me what I will encounter down the road. This has been very helpful. I will check out the support group. Thanks to all for your information.

August 16, 2010 - 6:47pm
EmpowHER Guest

Hi Wisemare,

Splenic marginal zone lymphoma is cancer of the B-cells that are located in the spleen. Since you had the spleen and the surrounding lymph nodes removed and your blood work is clear, this means it has not moved into the bone marrow. It is common however, that this sort of cancer will metastasize into the bone marrow and I am sure you are being tested for this possibility, as you explained that your blood work is fine. Removal of the spleen can also mean remission, so don't give up on that possibility.

The only thing you can do at this point is to follow your physicians instructions and regular follow ups with your physician for bone marrow testing. Here is a website that will provide you support and more information http://www.lymphomation.org/type-mz.htm#spleenic.

As for your question about symptoms of bone marrow cancer, here is some information form the Cancer Center of America specifically about bone marrow cancer.

Bone marrow cancer most commonly occurs in the shafts of long bones. Although the first signs of bone marrow cancer inevitably vary from patient to patient, symptoms may include fever, fatigue, poor appetite and weight loss. However, the early symptoms of bone marrow cancer may be so sporadic and subtle that the patient may not see a doctor until the bone marrow cancer has spread to other parts of the body.
Other possible symptoms of bone marrow cancer may include:
A hard lump on the bone
Swelling, stiffness, or tenderness in the bone (i.e., in or near a joint)
Restriction of movement
Unexplained fractures
Anemia (low red blood cells)
Weakness, shortness of breath, dizziness
Lowered resistance to infections
Note:  Symptoms may vary depending on the location and size of the cancer. Also, these symptoms do not necessarily indicate cancer. Only a doctor can determine whether or not a patient has bone marrow cancer.
Here is the website for more information http://www.cancercenter.com/bone-marrow-cancer.htm.

Does this information help you?

August 14, 2010 - 9:15am
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