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cancer and pain, Do mets hurt?

foxhd's picture
Posts: 3183
Joined: Oct 2011

Who? me ramble? Here is my latest. I wish that I had brought this up for input from Ron. Try to follow and add or subtract your 2 cents.

Here goes. If you cut your finger, it hurts. Pain receptors get stimulated from the damage. Messages are sent to the brain and we interpret them as us having hurt ourselves.  The same thing goes for things like getting burned, spraining an ankle, or breaking a bone. All these tissues have free nerve endings. (pain receptors). Damage a finger, it releases chemicals and signals are sent. Our finger hurts.

OK, so now we have cancer. Some cell somewhere developed with damaged genetic material. It grew and soon some cells went on an adventure. Loose from the mother ship, they float around looking for a new place to set up shop. Certain cancers have preferred locations but lungs, bone, and brain are favorite hotspots.

So now we have that secondary tumor. It taps into our blood flow for nutrition.  But, a big but, is that this tumor has no innervation itself. So the tumor sends no pain impulse for us to feel.  We can't complain about it. However, the tumor is a thief. It steals space and nutrition. This causes some impact to surrounding tissue which has free nerve endings. The damage to healthy tissue receptors sends the messages.

 Our neuroanatomy has established nerve pathways. Some transmit information from the brain to our body. Some transmit from our body to our brain. Some pathways are used alot.  Just look at the motor skills that develope in a muscian or athlete or dancer. Practice, practice, practice. We are looking for precise repeatibility. Or, how about those old injuries that can come back to haunt us. That tennis elbow that acts up every so often. Or that questionable rotator cuff pain. When the nervous system gets stimulated in those areas the impulse travels along familiar pathways. We can identify the old injury we feel. "Doc, I've got some tendonitis again."

As a runner for 30 years, I've had my share of hip bursitis and tendonitis. 2 years ago it got really bad. It was a very familiar pain. I had felt that before. The pathway being used had been established. I had a frame of reference for what I felt. Tests revealed it to be a pelvic met...WHAT?..The met STOLE a pathway. It mislead me. DAMN You! With no  neuropathways established from the met, it used the next best thing. A pathway in the area, that has been used in the past.  Mets hurt by utilizing available pathways which lead to believing that what you really feel is something else. Others here have complained of hip and shoulder pain,  then found out they have mets. No wonder every ache and pain scares us.

  What was familiar is no longer reliable.  It gives us false information. Misdirection is another of cancers tricks up it's sleeve. What you think you feel may not be accurate. That muscle strain you have been babying may just be a bone met.

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rae_rae's picture
Posts: 300
Joined: Oct 2010

Good explanation, Fox! I used to worry about every ache and pain. I admit, it still crosses my mind. I figure if it's mets, it won't get better, it will progress to a point that I know I need to get checked out by a doc. 

Jojo61's picture
Posts: 1310
Joined: Oct 2013

And that is how cancer can grow within us, Foxy....it finds good hiding spots until it gets big and strong and then finally, it can't hide anymore - our body tries to tell us. But yes, every ache and pain is on our mind. Once we have been hit with it once, we won't be as naive the next time around. In fact we become more paranoid. Cancer is not just a thief of space, nutrition, and parts of our bodies....it is also a thief of our peace of mind, and sometimes of our hopes and dreams.

But having cancer has also shown us how to savor life's precious moments, to love deeper, to appreciate what we have. It has shown us that we can be strong, can trod through this difficult journey with grace and with our head held high. We unite here, and among family and friends and we gain strength from each other, we educate and support each other...our way of giving cancer some bad attitude - of saying "in your face, cancer!!".


APny's picture
Posts: 1998
Joined: Mar 2014

"We unite here, and among family and friends and we gain strength from each other, we educate and support each other...our way of giving cancer some bad attitude - of saying "in your face, cancer!!"."


Absolutely. Except you're a lot more lady-like than I am in what you say to cancer Wink

Jojo61's picture
Posts: 1310
Joined: Oct 2013

Hahahaha! Yes, I thought of writing those words. We all can read between the lines though!!



Jan4you's picture
Posts: 1327
Joined: Oct 2013

Well said, Fox! I could easily follow what you said and concur that now we are more vigilant. As for many of us Renal cancer came with no warning, often found accidently.

I have spasticity from MS, a separate, rare Kideny disorder, along with LumbarSpinal stenosis and now RCC. It really gets confusing as to specialist do I call. I don't say that for sympathy, hardly, as I am more lucky than not.

So I do my little self evaluation: do I need more stretching, exercise and better nutrition? I live a life of hope! Yet I am ready for anything which can "surprise" me any time.

I now choose to live in the moment, savor it and count my many blessings that I am stable..well at least physically LOL

Hugs and hope to all!

foxhd's picture
Posts: 3183
Joined: Oct 2011

thinking of you when I wrote that. By the way, I have always hated MS. It's just not fair... Knowing who to call is tough. I can argue the case to see 3-4 different specialists for what I have going on now. I'm trying to use drugs and time. At least awhile longer.

dhs1963's picture
Posts: 513
Joined: May 2012

Probability of Detection (Pd) vs. False alarm rate (FAR).

An ache may have a good Pd for a bone met, but it will have a very high False alarm rate:  how many aches do you have compared to how many bone mets?  For me, I have not had any bone mets, but many aches.  On its own, it is not a good detector:  too high of a FAR.  Now, combining with other info, such as ache that does not move, and is persistant, that will decrease the FAR while maintaining the Pd.

In RCC, there are very few detectors that we can observe without scans:  pee blood:  moderate Pd, low FAR, but also a high false negative (you do not have to pee blood to have RCC).  For me, there was mild non discript pain in my back.  But, if I took 100 people, probably 50% at 50 will have similar pain, and no cancer, so high FAR, probably low PD -- bad detector.  

For me, there was also unexpected weight loss.  That is a good cancer detector.


But, the scans:  CT with contract for kidney cancer:  nearly 100% Pd, less than 10% FAR for tumors over 3 cm -- that is a really good detector.


Sorry.  Geeked out on this post.

foxhd's picture
Posts: 3183
Joined: Oct 2011

I like the way you said that.

BDS's picture
Posts: 172
Joined: Aug 2012


Nice informative post Fox.  But once diagnosed with RCC and scanned on a regular basis, one just has to hope that any new pain we feel is just that - old injuries coming back haunt us; whether it be tennis elbow, rotator cuff pain or tendonitis. Lately, I have been suffering from all three and have been paranoid with fear with the possibility of bone mets. But, Life is Good; luckily the latest scans show no new mets. So with the extreme urging of my wife I have been backing off on the duration and intensity of my work outs.  Hopefully, things will sort themselves out- BDS   


foxhd's picture
Posts: 3183
Joined: Oct 2011

I count on the same thing. 3 years of scans that have been really good encourage me to believe they will stay that way.

foroughsh's picture
Posts: 779
Joined: Oct 2014

Hi foxhd, a very good informative post. Thanks for posting. I didn't know it earlier

vccortes713's picture
Posts: 51
Joined: Oct 2014

i've been having constant pain on my toe and ankle...the toe for a gout and the ankle for previous sprain....until now they both still hurts for around a month now.....but x ray shoes no mets....thank God....

Billy's Wife's picture
Billy's Wife
Posts: 52
Joined: Jan 2014

Fox--It is amazing to me how you put into words that which other may grapple with but be at a loss to express.  My husband's first met went to his illiac crest.  As I look back now over our earlier notes (I kept four books of notes on this journey)  I have read over and over how there had been a cloudiness around that area when his right kidney was removed three years prior to that illic crest met being found.  That area was his achilles heel so to speak, a weak area of some on again off again pain.  His mother had both of her hips replaced so he just thought that would be his fate someday.  The tests were done to check to be sure.  He had multiple x rays, MRI's and his repeated scans over those three years and nothing was found until IT. a four centimeter tumor in the left illiac crest  was discovered on a routine CT, moving it up to stage four from an encapsulated, 'we got it all ' stage 1, in one felled swoop. Was that earlier cloudiness significant?  I think it probably was, but no one could find anything to treat so it was left alone until it was able to be seen.

Then a year and a half later he noticed something felt funny in his head.  Jokingly he told us that he could hear himself combing his hair--we laughed but followed up with a visit to the GP then and ENT trying to believe that it was just an ear infection or something unrelated to RCC, relieved when they couldn't find anything.  Finally a CT scan of the head discovered a bone met in the skull.  He HEARD it at least three months before the tests found it.  Then a cold was really mets to the lungs causing a plural effusion, and cloudy thinking was mets to the brain resulting in a seizure.  The final kick in the teeth. literally,  was when the oncologist barely looked in his mouth and prescribed thrush medication, then one week later,  thinking he had a tooth issue the oral surgeon diagnosed an RCC tumor in his mouth

I can't emphasize enough to shop around for your doctor.  Find an oncologist that you can talk to and that really listens.  Looking back I wish I could have convinced him to do that.  We did have someone who was considered an expert in the field of RCC but the communication and empathy wasn't part of their relationshp and I come away from the experience scarred and with regrets I can't resolve.  Cancer had stolen his father when his Dad was only 41 and he himself was only 13 so the fears and angst ran very deep. 

Care givers are in the battle too. We love the patient.  RCC took my peace of mind along with his.  It took my partner and my future.  HUG your caregivers, partners, wives, husbands, children...they are part of the RCC fall out and it hurts us beyond measure during the battle and sometimes long after as we struggle with our own form of PTSD.  We can't always express how much it hurts because we know we are not the patient and that it is not about us, but second chair is no fun either. 

Posts: 482
Joined: Dec 2013

to the last paragraph, i say AMEN!

you put into words how it feels



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