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I have a few questions while we wait for our oncology

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Hello I have a few...
Hello I have a few questions while we wait for our oncology appointment in 2 weeks that I was hoping you could help with. I was wondering if brain mets from metastatised cancer wouks show on an open MRI of the brain WITHOUT contrast. Also the cancer has spread to the spine with severe back pain, what are the odds of blood clots or breakage of the spine from the metastasis.
Submitted: 1 year ago.Category: Oncology
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Answered in 12 minutes by:
4/1/2017
Oncologist: Dr.Saleem, Doctor replied 1 year ago
Dr.Saleem
Dr.Saleem, Doctor
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Hello and welcome to JA. Dr Saleem here. Will be answering you shortly

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Oncologist: Dr.Saleem, Doctor replied 1 year ago

Well where an MRI with contrast is the gold standard in detecting brain mets , an MRI without contrast can still pick up brain mets , but probability of missing is still there.

Mets in spine would cause more pain and neurological signs depending upon the part of spine involved. Fracture / collapse of vertebrae can occur in extensive involvement.

ANY malignancy increases a chance of blood clotting.

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Oncologist: Dr.Saleem, Doctor replied 1 year ago

Hope it was helpful.

Please click 5 stars to reward credit for the consult.

Feel free to ask any more queries.

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Customer reply replied 1 year ago
Hello. So the brain mets would have to be very small for the MRI without contrast to miss? Also would it pick up possible aneurysm without contrast? As far as the metastasis to the spine and the back pain maybe google isn't the best place to search but it says fracture of the spine is possible, so should we worry about my husband just collapsing or dropping dead if that's the case? Very frightening that it's in the spine. Thank you
Oncologist: Dr.Saleem, Doctor replied 1 year ago

Well you need to understand here that spinal cord runs within a bony framework made up of vertebrae. When we say fracture it means breaking or collapsing of vertebrae. If this causes compression in upper cervical / neck area close to brainstem it may cause respiratory arrest that can be fatal.

However sudden death by such fracture is rare as the mets tend to involve the lower spine more.

For mets to be missed they obviously need to be small.

Aneurysm would need contrast imaging as it helps in delineating the extent in much better way.

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Customer reply replied 1 year ago
Would the upper cervical/ neck area be shown on any part of just the brain MRI? To where they would have mentioned the mets in that location. I do not know the exact location of the mets in the spine just that they are there and we have an appointment in 2 weeks to discuss. Would the brain MRI in which I have the results show that upset cervical area at all
Customer reply replied 1 year ago
I will rate 5 stars
Oncologist: Dr.Saleem, Doctor replied 1 year ago

MRI Cervical spine will show that however as its evident usually from patient's symptoms so your doctor would have advised this if he had suspected upper spine involvement.

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Customer reply replied 1 year ago
Thank you
Oncologist: Dr.Saleem, Doctor replied 1 year ago

You are welcome.

Please remember to leave a positive 5 stars rating for my work.

Kind regards.

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Customer reply replied 1 year ago
One more question - How common is a fracture from metastasis? If he lets this go because he can't tolerate the treatment anymore does it raise the chances of a feature since it's already in the spine and he has severe pain or is it rare and the pain would be even more severe than he has before a fracture would happen.
Oncologist: Dr.Saleem, Doctor replied 1 year ago

I cant quite give you the numbers but with old age ,weaker bones and extensive metastatic involvement vertebrae are vulnerable to collapse.

Obviously any more nerve compression would definitely lead to greater pain. If he is receiving treatment ,he should continue to do so as it might decrease the chances of any further spread.

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Customer reply replied 1 year ago
Thank you again
Oncologist: Dr.Saleem, Doctor replied 1 year ago

You are welcome.

Please remember to leave a positive 5 stars rating for my work.

Kind regards.

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