Seeking Advice on Back Pain and Lesions After Melanoma History
Hello everyone, I would greatly appreciate any insights you might have. My father has been experiencing significant lower back pain since April 2025, which started after he engaged in some physically demanding work. The pain was so intense that it became difficult for him even to rise from the couch, prompting a visit to the emergency department. They performed spinal x-rays that revealed degenerative disc disease (DDD). Following that, he was scheduled for an MRI in August and was prescribed pain medication. While the intensity of the pain has decreased since then, it remains a constant issue. A few weeks ago, he underwent a non-contrast MRI, and the findings indicated two lesions situated in the posterior thecal sac. Both lesions were described as hypointense on T2 imaging. One measures 3mm x 4mm located at the L3/4 level, whereas the other is smaller, at 1mm, around L5/S1. The recommendation is to perform an MRI with contrast, but unfortunately, he faces a 1.5-month wait for that appointment. Given his history of melanoma excised eight years prior, I'm increasingly concerned about the possibility of leptomeningeal disease considering the current details. Aside from the mild discomfort, he shows no other symptoms, but the prolonged wait for clarity is driving me to anxiety, especially if metastases are likely. Any advice would be invaluable.
Answers (1)
8/22/2025, 9:23:31 PM
OpenHealth AI
I understand your concerns about your father's back pain and the recent MRI findings, especially given his history of melanoma. It’s completely natural to feel anxious while waiting for further evaluation. Let’s break down your situation and explore some steps you can take while awaiting the MRI with contrast.
Main Points:
- Back Pain and MRI Findings: Your father has degenerative disc disease and two lesions in the spinal area that require further evaluation.
- Melanoma History: Given his prior melanoma, monitoring for potential metastases is important.
- Immediate Actions: Focus on managing his current symptoms and making the wait more bearable.
Explanation:
The degenerative disc disease your father has may explain some of his back discomfort. The lesions found on the MRI are concerning due to his history of melanoma, as they could represent various conditions, including possibilities of metastases. However, it’s essential to keep in mind that not all lesions are cancerous. The need for a follow-up MRI with contrast suggests that his healthcare team wants to gather more detailed information to make an informed decision.
Next Steps:
-
Pain Management:
- Encourage your father to continue taking the prescribed pain medication as directed.
- Consider discussing over-the-counter pain relief options with a pharmacist, such as NSAIDs (like ibuprofen), if suitable for him.
- Gentle physical activity and stretching can also help alleviate discomfort—aim for light exercises that do not exacerbate his pain.
-
Monitoring Symptoms:
- Keep a detailed record of any changes in symptoms, such as new pain locations, numbness, or weakness in the legs. This log can be very useful during his next doctor visits.
-
Stay Informed:
- While waiting for the MRI, don’t hesitate to reach out to his healthcare providers for any immediate concerns. They may provide insights or even faster options for imaging if symptoms worsen.
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Support and Reassurance:
- Engage him in conversations about his feelings regarding the wait and provide emotional support. Sometimes sharing the burden of worry can help alleviate anxiety.
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Prepare for the MRI with Contrast:
- When he does have the appointment, it might be helpful to talk to the provider about the findings and the possibility of a quick follow-up on the results.
While it's understandable to feel worried about what the lesions might mean, try to focus on managing the current situation. His healthcare team will be able to provide clearer insights once they have the necessary imaging. If new or worsening symptoms arise before the MRI, it’s important to reach out for medical advice sooner. You’re doing the right thing by gathering information and advocating for your father's health.
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