(More) Metastatic cancer or just a coincidence?

Question

My mom has been fighting cancer for quite a long time now, originally diagnosed with breast cancer in 2000.Since then,it spread to her lungs in 2005 and her hip bone just this past winter.She did intense radiation in March and was put on stronger chemo drugs to fight it.(Has been on chemo,period, every week for 2 years straight now.)About a month ago,her right leg started hurting pretty badly.Her doctor said it was her sciatic nerve and was given everything from narcotic skin patches to muscle relaxers to help with the pain,along with physical therapy. It's been a month and the pain is worse than ever,limiting her to all but complete bedrest.She insists it is arthritus or a disc in her back giving her trouble,but my sister and I are afraid the cancer has spread to her spine.She cannot stand or sit in a chair for more than 2 minutes at a time, and has to lay flat on her back in order for the pain to be bareable.The pain in her hip was never this severe,so I am not sure what is wrong...

Would bone cancer be causing this much pain? And can it spread so quickly they cannot catch it?She's been on chemotherapy since 2005 and the cancer spread from her lungs to her hip while on treatment, so it wouldn't be suprising if it spread again.I am afraid I know the answers to all these questions,but am looking for other's opinions or experiences.Thank you so much in advance.

I made a typo. The pain is bareable laying flat on her stomach, not her back. (Not sure if that changes anything.)

My mom is only 53 years old and NOT ready to give up. She has been working full time for years now and doesn't want to let this stop her. She worked 40 hours a week through her first chemo and radiation in 2000, and as much as she could after having her lymphnodes removed. She is off work until the pain is gone-period. Right from her cancer doctor's mouth. She won't just give up and wait to die, and that's what's really hard for her.

Answer 1

Cancer pain can be immense. I have an aunt who is on a tremendous amount of narcotic pain medicine for her metastatic cancer. It started in her breasts and was treated, then she found another doctor who discovered that her cancer was not isolated in her breasts... So, now she has ? long to live and she is being treated for cancer pain with heavy medications.

My mom told me about the pain medication regime one of her patients had. The cost of morphine was becoming an issue for the hospice. Morphine is pretty cheap, as medication goes. That person was taking bottles of it a day and still in pain. The solution was a special pain control system that was like an epidural (in the spine) with a medicine pump attached to it. In the end, it worked pretty well and that person was not in pain for a month or two before dying.

Don't be surprised if she ends up on an enormous amount of narcotics and is still in pain. The important thing to remember is that people don't get high off drugs if the pain matches the medication. In addition, if someone has cancer, the nicest thing your doctor can do is put them on strong medication without being concerned about possible addiction. To be blunt, if you're going to die, you may as well be comfortable.

People with excellent experience dealing with cancer pain are hospice. If you haven't already, see if they can do something for your mother. My mom used to joke that all she did was give morphine. She was in the business of pain control, so that's what she did. They know their stuff and will likely be able to make life bearable for your mom.

Answer 2

First things first. You need to take your mother back to her doctor so that he can reaccess the pain issue. She needs a definitive pain diagnosis, so it might help for her to have a bone biopsy or at least a full body PET scan. If the cancer has spread to the CNS, than your Mom needs to know that. And, than there are guidelines for cancer pain that could be followed. Your mother may need to go into the hospital until they can regain control of her pain. Please read through the guidelines.

NCCN: Patients guide to cancer pain
http://www.nccn.org/patients/patient_gls/_english/_pain/1_introduction.asp

NCCN: Adult Cancer Pain Professional guidelines
http://www.nccn.org/professionals/physician_gls/PDF/pain.pdf

Next, if your mother wants to continue fighting her disease and she has not yet done so . . than she should located a comprehensive cancer center where you will find all the newest and latest treatments available for her disease. If she is still relatively healthy you might consider a Clinical Trial that may offer a new approach to her disease.

NCI: Comprehensive Cancer Centers List
http://cancercenters.cancer.gov/cancer_centers/cancer-centers-list.html

And, if you are searching for online support or more information in regards to what is going on with your mother, try the ACOR email list. Often people with the same types of cancer and lend an ear or point you in the right direction since they are going through similar issues.

ACOR: Breast Cancer Electronic Support Group
http://listserv.acor.org/archives/brca.html

Best to you and your Mom. Hope she feels better soon.

Answer 3

I would suspect that she has a metastasis to her spine which is impinging upon her spinal cord or a nerve causing pain.

I would try a trial of dexamethasone (an oral steroid) first, which should give quick relief. Her doctor should be willing to try that tomorrow (8/17/2007). There is very little in the way of serious side effects and this might help a lot. I would also ask the physician administering chemotherapy what they think the problem is. It is quite likely that they already know what the problem is - but if they have not done any sort of xrays or CT scans or MRI scans then they ought to do it, because writing progressive pain off to "sciatica" in a cancer patient with known metasteses is NOT appropriate without ruling out other things first.

Focused radiation therapy can "burn away" small areas of cancer causing severe pain. It cannot be used to cure cancer (the amount of radiation would be too much and would cause problems in and of itself) but if you had a mass pressing on the spinal cord then that could be taken care of with high-intensity radiation therapy.

The fact that the pain is increasing is indicative of a severe problem. It sounds like it is limiting her quality of life quite significantly. I would be very aggressive in pursuing the cause and possible treatment of this pain. Quite honestly your mother has a limited amount of time left and should not be left to live her life in such agony. While aggressive treatment in terms of a cure is unrealistic it is very appropriate to be aggressive in terms of taking care of pain. If her doctor is unwilling to pursue it then I would remind him or her that it is their duty to keep their patients from suffering and that you would like something done. If you meet resistance (I really doubt you will, but if you do) then seek a second opinion at another physician's office. At the same time, google your state medical board and report the physician

I hope that helps - call her doctor tomorrow - don't let her suffer through the weekend. Remember that politeness and firmness go a long way ("I'm sorry, but she is in a lot of pain, and the pain medications are not helping, what can we do?"). Insist on speaking to the physician or obtaining an appointment tomorrow. Emphasize that your mother is in pain and the medication is not helping.

Let us know how it goes!

Answer 4

When a person has a history of cancer and suddenly has severe back and leg pain, the first thing to rule out is metastisis. Cancer pain is typically unrelenting and unbearable without any position of relief or rest...and is typically worse at night.

The fact that your mom does feel better lying on her stomach might be indicative of a disc related problem, however, in her case, she needs to rule out the worst before she assumes anything else. If she walked into my clinic for physical therapy, I would immediately send her to her oncologist first.

Answer 5

When my mother's breast cancer metastacised, the resultant tumour was pressing on a nerve, causing constant, intence pain.

A friend who had renal cancer which metastacised to the bone, found the pain of bone cancer unbearable.

I hope your Mother finds relief but I would be following up with her Dr and getting a second opinion if she is not getting the pain relief she needs.

Answer 6

i am so sorry.i had aN experience like it.my girlfriend diagnosed cancer in her leg when she was 17 and ler leg had been cut part by part.then cancer spread to her lung.she got surgery to take them out but now cancer is in left lung.she had chemos didnt work at all.now she is 19.i have no idea what to do if she goes.METASTATIC.i search many alternative traetments are still in study..and try herbal treatment too.tell your mom read ALLAHs book once.love.

Answer 7

I would recommend a consultation with a Pain Management doctor if she's not done that already. They have a lot of things they can do to help ease the pain.

Answer 8

I apologize, but I know nothing about cancer except that my grandfather died from it in 1989. I'd contact the American Cancer Society, and try to get some information from them, you may also try to talk to an oncology professor ( if he will see you) to ask him for information. I apologize again for my lack of knowledge, but I hope you get the information you seek. God bless your mother and your family, I hope that they can treat what ever she has.

Answer 9

she needs a bone scan.............bone cancer is very....painful... ..i can't believe these doctors....they brush me off too......a person knows when the pain is too bad to be just arthritis or sciatic ..........