Has anyone with CML had a partial or total knee replacement. I have to have total knee replacement and with the cml, I am concerned about complications or anything special the surgeon would have to do for me. Any input would be helpful. Thank you, sandi
CML and Total Knee Replacement
Posted 09 April 2011 - 08:27 PM
As long as your blood is clotting normally there should not be much to be concerned about. The doc may take a conservative approach and stop the Gleevec a few days before the surgery. There is some evidence that Gleevec inhibits metabolism of some minerals needed for tendon and ligament health. You may want to ask the doc about taking mineral supplements starting well before the surgery.
Posted 10 April 2011 - 07:47 AM
the other issue with Gleevec is how well can you take it on light foods? You will not be given the foods you are used to eating with the drug right after surgery and maybe even for the following day. That is the main reason I have heard for stopping Gleevec for a short period following the surgery.
Good luck with your surgery - it has made a world of difference for my husband!
"You can't change the direction of the wind but you can adjust your sails."
DX 12/08; Gleevec 400mg; liver toxicity; Sprycel 100mg.; CCyR 4/10; MMR 8/10; Pleural Effusion 2/12; Sprycel 50mg. Maintaining MMR; 2/15 PCRU; 8/16 drifting in and out of undetected like a wave meeting the shore. Retired 12/23/2016! 18 months of PCRU, most recent at Mayo on 7/25/17 was negative at their new sensitivity reporting of 0.003.<p>
Posted 10 April 2011 - 03:36 PM
I do not know anything about the Gleevec and Surgery. I am on Gleevec for 10 years. My husband did have to get total knee replacement a year ago this month, and he did very well with his surgery. He is like a new person, and pain free. I do know he was put on blood thinner Coumadin for 6 weeks after the surgery for his clotting factor. He was able to eat whatever he wanted except for anything with Vitamin K. That would be salads mostly. There is a whole list f what contains Vitamin K. I myself have a blood clot in my leg, and I am now on Coumadin with restrictions on certain types of food. I have not had to make any changes with my combination of Coumadin and Gleevec. Just thought I would share that information with you.
Let your Oncologist and Surgeon consult with each other on how to proceed with your medications etc. I wish you well. I am sure you will feel a lot better after you get your surgery.
Posted 10 April 2011 - 07:56 PM
I had my second total knee replacement 3 yrs into CML. The first one was 6 mo after lumpectomy and radiation for breast cancer. I was on Sprycel for the second one and went to a rehab after surgery. I had to supply my own Sprycel, (because of expense) which was no problem. I had no special treatment or problems recovering due to TKI or CML, second one was a little harder to recover from and seemed more painful but I was 5 yrs older (68) and a lot of life had taken its tole, so it may have just been from that. I can tell you this, my experience has been it is well worth the pain but you have to be willing to do the rehab exercises and go thro the pain or moving when you don't want to and walking, walking ,walking. The knee pain you have been used to will be gone, if all goes well, but the expected discomfort of this kind of surgery takes some effort to get thro. It's one of those, the more you put into it the more you will get out of it. Be patient, be persistent and give it a good 6 months. If you need or want support while going thro this, feel free to e-mail me.
Posted 10 April 2011 - 10:07 PM
That was good information regarding the rehab part of knee surgery. I forgot to mention that. My husband did three times a week outpatient rehab for 16 weeks, and it definitely had a impact on how he healed. It definitely takes a lot of effort on the part of the patient like you said.
Glad your doing well after having 2 of them along with everything else you went through.
Posted 14 April 2011 - 12:00 AM
Could you tell me a little more about the minerals needed for tendon health.
I was only recently dx and started Glivec 600mg 2 months ago tmr. Before CML I was running 100+ km per week and competing at a good level, but leading into the diagnosis and subsequently I've had way more than my share of tendon problems. I was diagnosed with a WBC of 12.8 (x10-9/L Australian units) by a very on the ball sports doc. Even with the so very close to normal WBC count I knew something was wrong by how I felt when running (higher than normal heart rates / effort) and it seems that my tendons knew something was up too. The docs say now they don't know if the tendon trouble is related to CML and all I can do is the normal rehab things. I sort of hoped that once the meds kill all the bad guys in my blood the tendons might cheer up a bit. Of course I now have other issues with exercise but strong intentions to keep doing as much as I can.
Dx Dec 2010 @37
2x IVF egg collection
Glivec 600 & 800mg
PCRU March 2012
Unsuccessful pregnancy attempt - relapsed, 3 months interferon (intron A), bad side effects from interferon
Nilotinib 600mg Oct 2012
PCRU April 2013, 2 years MR4.5 mostly PCRU with a few blips
April 2015 stopped again for pregnancy attempt (donor egg), pregnant first transfer, 0.110 at 10wks, 2.1 at 14wks, 4.2 at 16wks, started interferon, slow dose increase to 25MIU per wk, at full dose PCR< 1 for remainder of pregnancy
Healthy baby girl Jan 2016, breastfed one month
Nilotinib 600mg Feb 2016
MMR May 2016
PCRU Feb 2017
Posted 14 April 2011 - 08:13 AM
I also noticed increased tendon and/or ligament issues, especially at first. I believe it was more related to the Gleevec than CML. Here is some info about this issue:
Here is some info about supplements for tendons & ligaments:
Posted 17 April 2011 - 10:17 AM
Depending how old you are, I would not advise anyone, who already has CML or any type of blood disorder, to get any kind of implanted medical device and here is why:
- Everything that is made will age, degrade and decay. The process is called entropy and it's outlined in the hard to understand second law of thermodynamic but it's a law of nature, we all have observed. An example is iron turning into rust, through corrosion from exposure to oxygen and water. When metals, found in implanted orthopedic medical devices, are put into the wet and oxygen rich environment of the body, over time, the process of entropy and corrosion, will happen.
- The medical industry has defined wear debris, from both metal and plastics medical devices, which have been liberated from aging and failed medical devices - as a serious systemic problem,It which has created a new illness they call "Particle Disease".
- Metal rubbing on metal, from orthopedic medical devices, also creates nanoscale wear debris. The particles are small enough for some of the metals to end up as ions. Metals ions have the potential to cause diseases such as cancer, including blood cancers. Even FDA is worried about the heath risk of liberated metal ions from orthopedic medical devices.
- While there are environmental, industrial and workplace limits and standards for exposure to toxic metals, such as cobalt and chromium, there are not any exposure standards or limits, to the same metals, if they are released inside the body from aging and degrading medical devices.
- There is an acknowledgment in the medical community that wear debris from implanted medical devices is creating major problems, as it is the prime reason for revision surgery due to implant loosening. (particle-induced osteolysis)
- Anyone considering a medical device should be told that they have the potential in developing cancer and another systemic, chronic, non-treatable illness that are created by their medical devices.
- Currently, manufacturers are disclosing the problem of wear debris to patients but they leave it as an abstract concept. Manufacturers are not fully explaining the long-term dangers of wear debris or how it will impact an individual's health in 25 to 30 years
Before making a decision on knee replacement surgery look at the recalls on medical devices, they are numerous.
Medtronic, one of the nation's largest medical device manufacturers, said yesterday that it had agreed to pay the federal government $40 million to settle accusations that its spinal-implant division had paid kickbacks to doctors as a way of inducing them to use its products.
Journal articles - read Lancet
Posted 19 April 2011 - 11:20 AM
Eur J Cancer. 2011 May;47(7):1061-71. Epub 2011 Jan 10.
Increased cancer risks among arthroplasty patients: 30year follow-up of the Swedish Knee Arthroplasty Register.
Institute of Clinical Sciences Lund, Department of Orthopedics, Lund University Hospital, Lund University, Sweden.
BACKGROUND: An increasing number of young patients are undergoing knee arthroplasties. Thus, the long-term risks of having a knee prosthesis must be evaluated. This study focuses on the potential carcinogenic effects of the prosthesis; it is a long-term follow-up of all patients in Sweden between 1975 and 2006.
METHODS: The incidence of cancer in a total population of operated individuals was compared to the overall national cancer incidence in Sweden by means of standardised incidence ratios. Analysis of cancer latency period was performed to identify potential aetiological factors.
RESULTS: For male and female patients with rheumatoid arthritis (RA) or osteoarthritis (OA), the overall cancer risks were elevated, ranging from 1.10 (95% confidence interval (CI): 1.03-1.18) for men with OA to 1.26 (1.23-1.29) for men with RA. The greatest increases in risk were observed for the leukaemia subtypes, myelodysplastic syndromes (MDS) and essential thrombocytosis (ET), ranging from 3.31 (1.24-8.83) for ET in men with OA to 7.38 (1.85-29.51) for ET in women with RA. Increases in risk were also observed for breast cancer, prostate cancer and melanoma. The latency analysis revealed elevated risks late in the study period for both solid and haematopoietic cancers. However, only increases in MDS and possibly prostate cancer and melanoma rates appeared to be connected to the operation.
CONCLUSION: This study showed that OA and RA arthroplasty patients have a significantly higher risk of cancer than the general population. Elevated risks of MDS and possibly prostate cancer and melanoma indicated a potential connection to exposure to metals in the implant. The observed excessive incidence of ET was likely associated with the inflammatory disease.Copyright © 2010 Elsevier Ltd.
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