Chronic pain pre brachytherapy

Hi everyone!

It’s Kayla here. I apologise for asking a lot of questions here but I just feel like this forum is a safe haven for me and my mum who is currently undergoing cervical cancer treatment.

My mum was diagnosed with Cervical Cancer Stage 3C due to lymph nodes involvement (external iliac and internal iliac) in August 2021. After 5 chemo of carboplatin and taxol in late December, MRI showed that the tumor is significantly shrinking, a great and superb news for us all. She then proceeded with 25 sessions of radiotherapy until 10 of February. I live in a developing state in Southeast Asia where we ought to wait a month for her brachytherapy (3 weekly sessions), which supposed to begin last Monday, 7 March.

Unfortunately, we caught covid just the day before and thus the brachytherapy shall be postponed until we’re negative (thankfully we got tested today and negative so fingers crossed brachytherapy may commence on Monday next week). However, this week my mum is complaining about chronic pain that she is experiencing on her pelvic and legs (sciatica) and honestly, it’s really taking a toll on her body. She told me that it’s really painful to lay down and thus, it’s hard for her to sleep. I told the radiologist about this but he doesn’t seem too concerned, he suggested my mum to take ibuprofen but it’s not really working. I mean, the pain subsides but it’s still there.

I tried to research about it and I saw many of the ladies here experiencing pain (back pain/pelvic pain/leg pain/sciatica) after radiotherapy but I wonder if the pain is chronic like this that even makes you unable to sleep? I truly don’t know if it’s side effect of radiotherapy or is it because of the tumor? From what I know, it is normal for the tumor to still present prior to brachytherapy. Her tumor was initially 2.8 cm so it was quite small to begin with (and it was shrinking after carbo taxol). She is currently unable to sleep so I decided to post this to seek possible answer/reassurance from all of you here…

Thank you everyone for your kindness and courage. Let’s strive together to fight this. Sending you all lots of love, positivity, and strength x

Kayla,

Sorry no-one has replied in 4 days - I hope your mum is okay and feeling a little better. It sounds to me more like a trapped or inflamed nerve in her back than anything else. Most pelvic post-radiation pains take time to emerge - often they are ‘late effects’ which could happen years after treatment, sadly - and occur after treatment involving brachytherapy which is highly targeted in the pelvic area. It’s HIGHLY unlikely to be due to the tumour, as this will be decreasing and not expanding. It could be a back issue from the radiotherapy ‘bed/slab’ itself - it’s not easy to be comfortable, and I often tweaked myself getting up from the treatment slab. I think it’s important that someone addresses the chronic back pain - even if it means referring her to an osteopath. It sounds like the method of brachytherapy your mum’s hospital is using is not one I’m familiar with (I was an inpatient for 3 days). There will be a lot of lying down very still involved, and it’s important that the right support is given for her back. Lying in bed, if you’ve got a bad back, is often uncomfortable as well and some sort of cushioning support will be necessary. We can’t tell you what actual position will be best, but do ask for some help to work this out. I hope things start to improve for her soon. Incidentally I got backache with COVID… along with a return of the upset stomach and fatigue of the radiotherapy treatment…

All the best to you and your mum. I would be in the ‘mum’ position too, as I’m an older patient, and it’s lovely mum has a daughter like you to look after her and fight her corner! X

Hi Kayla, I agree with everything Jacks has said but it sounds like your mum will be having the same brachytherapy that I had. I had three weekly sessions and it does involve lying flat for 2 or three hours. However, she may well be numb from the waist down and will not have any feeling in her legs for again, 2 or 3 hours so this may help her to be comfortable. I wish you both all the best and hope that you can now finish the treatment xxx

Hi Kayla31

I had significant lower back pain very soon after my radiotherapy in 2017 - it was difficult to turn over in bed and I generally had to move very carefully to prevent jolting my back. It’s hard to know if the pain stopped me sleeping because at the time I also had a nightmare bladder that kept me awake a lot

I often felt unwell and tired during the radiotherapy and didn’t get a lot of exercise and my GP concluded that the pain was mostly due to musculoskeletal weakness but referred me for an X-ray to rule out other possibilities (not sure what). My X-ray came back as normal and I was referred to a physiotherapist for strengthening and stretching back exercises which helped. It took about 4 months until the pain had largely resolved and it the meantime I just got along the best I could working in my physio exrcises as and when.

With hindsight I think another possible reason for my back back pain may have been compression fractures in my lumbar vertebrae which were only discovered during a CT scan in 2020. Radiotherapy can weaken the bones in the area of treatment and I think it’s possible I sustained the compression fractures during or soon after my radiotherapy. Luckily I have been left with no more than a bit of a stiff back which is helped by keeping up with the physio exercises. After the CT-scan I had a DEXA scan to assess my bone density and I was diagnosed with osteoporosis for which I was prescribed alendronic acid plus Calcium/vitamin D supplements.

I’m in mid 60s and like Jacks would be in the ‘mum’ position. It’s great that you are looking out for your mum - no apologies needed for asking questions - keep asking.

x

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