I have relied on this board for so much info over the last 3 years, and would like to ask for it again. I have been in remission for the last 2 and 1/2 years. In January, I was hit by a semi while driving home from school. My hip was shattered and I developed a severe MRSA infection causing me to have 3 operations to get me up and moving. I have had arthritis for years in my knees but my right one is giving me miserable pain, so I went to a orthopedic surgeon who x-rayed both of my knees. He found bone changes in the right knee not associated with tramua or arthritis. He said chemo could have caused bone death but it could also be bone cancer. He scheduled an MRI there in his practice Thursday for me, but I wonder should I contact the cancer docs to do it. Does Brian or anyone know- is this a possiable mets from the oral cancer? I had stage IV with several sizeable lymph node tumors, and had radical neck disection on the left side, chemo and radiation. Any info would be welcomed...I am a little dismayed with this, but am trying to be optimistic. However, last time a doc looked at me like that...well,you guys know the score. Thanks, sue

I get a little of that attitude from my MO when I complain about things like no PET/CT scans for distant mets, etc. Common mets for SCC seem to either be in the respiratory system or in places where blood (and hence cancer cells) goes through some kind of a transition like the liver for example.

I was told that Cisplatin had minimal impact on bone marrow, whatever that means, but it is no secret that the treatment itself can have adverse effects ranging from minor to major. This is the first that I have heard of a possibility of bone cancer from the treatment. Maybe Brian has newer data.

I have never seen a remote bone met from oral cancer discussed at any of the symposia that I go to or heard of it in an oral cancer patient before. Osseous invasion of the disease in the immediate area of the primary of course happens all too often in advanced cases. Of course I'm no authority here. I just went through a search for Cisplatin and bone issues, and while there are a few scattered issues, bone necrosis isn't something that is coming up. Clearly treatments can cause cancers themselves, and osteosarcomas in about year ten, happen in mandibles of patients that have had 72+ cgy of radiation. That is in less than 3% of individuals that get that level of exposure, so don't everyone panic. (For me I would just like to hit that 10 year mark in the first place.) But that is radiation related and in the area treated, not remote from the site. I will ask some questions tomorrow from docs on our advisory board, and see what is said. This could be something completely unrelated to your oral cancer.....