Coping with Post-Mastectomy Pain Syndrome

It is certainly well within the level of expectation to have some pain and/or discomfort after a mastectomy or lumpectomy. But when pain continues for more than a few months post surgery and begins to impact quality of life, this is very likely Post-Mastectomy Pain Syndrome (PMPS).

Studies have shown that between 20 and 30 percent of women who have breast surgery develop PMPS.

What is Post-Mastectomy Pain Syndrome?

Post-mastectomy pain syndrome (PMPS) is chronic nerve (neuropathic) pain after lumpectomy or mastectomy…The classic signs of PMPS are chest wall pain and tingling down the arm. Pain can also be felt in the shoulder, scar, arm, or armpit. Other common complaints include numbness, shooting or pricking pain, or unbearable itching

The exact cause of PMPS is unknown.  A strong theory however is that during surgery damage is caused to the intercostobrachial nerve.  This nerve extends from the outer edge of the breast and runs along the underside of the arm.

Treatments for Post-Mastectomy Pain Syndrome

There are treatments to help relieve PMPS.  This often starts with the use of ibupofen and/or other nonsteroidal anti-inflammatory drugs.

The application of topical anesthetics can be effective for treatment in many cases.

Steroid injections or local anesthetic can be helpful for those who suffer from pain around the scar area.

As well as medical interventions, Integrative therapies can also be of help for those suffering with PMPS.  These include massage therapy, reflexology and acupuncture.

Why Seek Help?

In light of the toll that cancer therapies can have on the body, it may seem somewhat trivial to question your doctor about aches and pains. But it is not.

Pain not only has a physical impact, it can also have a mental one.

Research has demonstrated that the pain women experience suffering from PMPS has been linked to fear of recurrence.  This can be a paralyzing feeling.

Depression, as well, is strongly associated with pain.

Conclusion

Post-Mastectomy Pain Syndrome is real.

Do not dismiss symptoms or concerns that you are experiencing.  Consult your doctor and get relief.

We must be advocates of our own health.


References

https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/pain/post-mastectomy-pain-syndrome.html

https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/pain/post-mastectomy-pain-syndrome.html

https://well.blogs.nytimes.com/2015/06/08/pain-after-breast-cancer-surgery-pmps/

https://www.painresource.com/cancer/post-mastectomy-pain-syndrome-pmps/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031190/

 

 

 

 

 

Oncologists Endorse Integrative Therapies for Breast Cancer Patients

Perhaps the best way to start here is to give you an understanding of what Integrative Oncology is.

Integrative oncology is a patient-centered, evidence-informed field of cancer care that utilizes mind and body practices, natural products, and/or lifestyle modifications from different traditions alongside conventional cancer treatments. Integrative oncology aims to optimize health, quality of life, and clinical outcomes across the cancer care continuum and to empower people to prevent cancer and become active participants before, during, and beyond cancer treatment.¹

So let’s break this down. In its purest form Integrative oncology uses evidence-based complementary therapies with conventional cancer care. It is meant to work with standard of care allopathic cancer treatments i.e. surgery, chemotherapy and radiation not in place of them. Integrative oncology considers the whole person, mind, body and spirit providing a health protocol to work alongside the medical one.

It is estimated that between 60 to 80 percent of cancer patients use at least one form of integrative medicine following a cancer diagnosis². Frequently met with resistance from oncologists, cancer patients are often faced with a decision of hiding therapies from their doctors or eliminating them while in active treatment.

But, at least for breast cancer patients, the tide is changing. An expert panel from American Society of Clinical Oncology, ASCO, recently endorsed clinical practice guidelines for integrative therapies presented by the Society for Integrative Oncology, SIO.

“If patients are using these therapies in addition to effective scientifically proven cancer therapies and their doctors are aware of it, we’re comfortable with it,” said ASCO senior statesman Dr. Gary Lyman of Fred Hutchinson Cancer Research Center…The only time it becomes an issue is when these are not disclosed or are used instead of conventional effective therapies.”³

Not all therapies were endorsed but the following have been:

  • Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction.
  • Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders.
  • Meditation and yoga are recommended to improve quality of life.
  • Acupressure and acupuncture in addition to anti-nausea medications are recommended for reducing chemotherapy-induced nausea and vomiting.

It is noted that breast cancer was selected by SIO because it has the largest patient population and the largest amount of scientific data.

ASCO’s endorsement for these therapies is not only a positive step for breast cancer patients but for the area of Integrative Oncology as a whole.


References

¹http://www.ascopost.com/issues/february-10-2018/the-state-of-integrative-oncology-a-new-era/

²https://medicalxpress.com/news/2018-06-asco-endorses-oncology-guidelines-breast.html

³https://www.fredhutch.org/en/news/center-news/2018/06/asco-endorses-integrative-oncology-guidelines-for-breast-cancer-patients.html

http://www.ascopost.com/News/55552

https://www.sciencedaily.com/releases/2018/06/180612092128.htm

 

 

 

 

 

 

 

“Cancer Hates Kisses” with Jessica Reid Sliwerski…This Week on TheHealthHub

This Week on TheHealthHub

Jessica Reid Sliwerski

Jessica Reid Sliwerski is a literacy specialist, reading enthusiast, and former elementary school teacher. Her picture book, Cancer Hates Kisses, was inspired by her own breast cancer treatment and recovery. She lives in Oakland with her husband and daughter.

 

Talking Points:

  • How writing her book became part of Jessica’s healing
  • How Jessica, a mom of a new baby, dealt with her breast cancer diagnosis
  • Why Jessica feels it is important to help parents with cancer talk to their kids in an empowering way.

 

 Listen live or catch the podcast on iTunes!

 


Every Tuesday from 11am -12pm I host The Health Hub, an interactive, forward thinking talk show on Radio Maria Canada.   Call, tweet or email your questions as together we explore health issues that are relevant to you from new and innovative points of view.

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Lesson Learned

I just posted an article to my Facebook and Twitter called When Pain Persists After Breast Cancer Surgery written by Leslie Garisto Pfaff. I literally read the article and thought ‘By God I am not losing it!’

Without going in to detail the article is about persistent pain following breast cancer surgery. A strong causal theory is damage to the intercostobrachial nerve. The subject matter is extremely interesting and I encourage you to read it but it’s not what provoked me to post this.

After reading this article I felt rather stupid. Although I don’t suffer with pain since my surgery, I always have a tenderness running down my side. But in light of the bigger picture I felt this was a somewhat trivial thing and didn’t bring it up to any of my doctors. But here is the question: WHY NOT?! Getting that explanation 4 years ago would have greatly set my mind at ease and gone a long way to explaining other minor things that I have experienced.

Being hit between the eyes with this just brought home to me something I so easily ascribe to others. Personal advocacy is key to healing. Our health is our own responsibility.  Yes we have a team to guide us along the way but we drive the ship.

So sadly I learned today that I am victim of the old adage ‘Do as I say and not as I do’. But I am coming clean with the hope that a short article has led me to a greater lesson.