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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Stage IV Breast Cancer,spread To Bones, Pain Management?

My mother was diagnosed at Stage IV with Breast Cancer . She has tumors on her neck and it has spread to the bones. She is in severe pain and no amount of drugs they have prescribed have been able to alleviate it. Any suggestions on pain management?
Mon, 7 May 2012
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Oncologist, Surgical 's  Response
Very sorry to hear about your mother. Pain management is a very specialized branch and there are may interventions which can be tried but you need to consult a pain management expert for that.
There is a pain ladder which is to be followed and considering the pain you are describing your mother would require round the clock analgesics under supervision.
If she has bony pain, then radiotherapy and steroids can also be helpful. Steroids are also helpful in cases of cerebral metastasis.
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Oncologist, Surgical Dr. Mohammed Ibrahim M's  Response
Hi

I am very sorry that your mom has a stage 4 breast cancer which has spread to bones also to neck nodes. A group of drug called bisphosphonates can be used to reduce the bone pain. If it has been already used and still in pain then opioid analgesics like morphine can be tried. But these drugs are not available in pharmacy but only in cancer hospitals and institutes.

Dr. Mohammed Ibrahim
Surgical Oncologist

mdibrahimdr@yahoo.co.in
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General & Family Physician Dr. Madhu's  Response
Im sorry to hear about your mother. I think the treating doctors are prescribing the best possible pain relieving drug(generally Morphine).
However if you are from India its a different story. Morphine which is the best drug for palliative treatment of cancer is rarely prescribed because of the very complex procedure involved in procuring it. Its one of the worst aspect of cancer treatment in our country. So please discuss the use of morphine for pain relief if its not already being used.
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Stage IV Breast Cancer,spread To Bones, Pain Management?

Very sorry to hear about your mother. Pain management is a very specialized branch and there are may interventions which can be tried but you need to consult a pain management expert for that. There is a pain ladder which is to be followed and considering the pain you are describing your mother would require round the clock analgesics under supervision. If she has bony pain, then radiotherapy and steroids can also be helpful. Steroids are also helpful in cases of cerebral metastasis.