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Pain question

AndyE
Posts: 51
Joined: Nov 2014

hi everyone,

It had now been a little over two months since I had my partial nephrectomy. The good news is that the pathology report was about as good as I could have hoped  for...stage 1b, grade 3, no microscopic invasion of lymph system or blood vessels, and cleab edges were confirmed.  I was thrilled with that result.  My question is regarding some pain I am feeling now.  I have noticed some very tender areas oaround my rib cage.  Pressing on them feels almost like a bruise, but there isn't discoloration.  It is hard to tell if the pain is coming from the ribs or from the skin, as you really only have to lightly touch the skin to get s skin pain reaction.  There is no rash.  Some of these sites are on the same side as my abdominal incision, but there are one or two on the opposite side as well.  The more painful ones are located on the incision side ar the bottom rib and slightly below that rib.  The other is on my back toward the bottom of my shoulder blade.  I can almost feel that pain radiating from my spine which feels out of place right now...maybe a pinched nerve or something.    Is this a common thing?  I worry about bone mets, but my doctor really didn't think that the Cancer had spread given the pathology report, success of the surgery, and location of the tumor.  He said there was maybe. 2% chance it had spread and it would most likely show up in lungs before bone If it did.  I am calling my PCP for an appointment this week, but wanted to get some thoughts first.

thanks,

Andy

icemantoo's picture
icemantoo
Posts: 3216
Joined: Jan 2010

Andy,

 

Small tumors do not metastisize to the bones right out of the gate. You just had major abdominal surgery. You are going to feel sore and weak in certain places for months to come. That being said, I am an  attorney, not a doctor  so see what the PCP thinks.

 

Icemantoo

 

todd121's picture
todd121
Posts: 1425
Joined: Dec 2012

You mentioned all the important stuff from your pathology except the size of the tumor. How large was it? It's good news that you're Stage 1, of course. Grade 3 isn't good and neither is a large tumor. It's not very likely it's spread to bones. Not sure about the 2% number they threw out. It's certainly less than 10% chance, but larger tumors and higher grades are not good.

Further staging with regards to bone mets, would be a nuclear bone scan. It's they way they rule out bone mets. However, often/usually something shows up on CT scans too. If they didn't see anything on your CT, it's really very unlikely you have bone mets in multiple places.

Your so soon out of your surgery. Insides take a lot longer to heal than outsides. You're probably still healing even at 2 months. On the other hand, the pain you describe is odd and can't be accounted for with respect to what you've had so far.

Bone mets take awhile to get to the point to cause pain. That you'd have several causing pain with a CT scan that showed nothing, not at all likely this soon after having had your scans. Assuming you had a CT with contrast recently of your chest?

Follow ups are important. I attended a presentation yesterday on active surveillance. The facts presented showed that the NCCN guidelines miss something like 30% of recurrences for kidney cancer, and the number for Stage 1 is even higher. So get your scans and if you can find a doctor that will follow you longer than 3 years, go for it. Chest/abdomen and pelvic CTs are the best for catching stuff early. I'd get scanned minimally every 6 months for 5 years if it were me, and then annually after that. If you can do every 4 months for the first 2 years, that's even better. 1.9 years is the mean time to first recurrence for those of us unlucky enough to have one.

Sorry I don't know what's causing your pain.

Best wishes,

Todd

AndyE
Posts: 51
Joined: Nov 2014

Thanks for the feedback everyone. The size of the tumor was 3.5 X 4.5 X 5 cm if that helps.  

Positive_Mental_Attitude's picture
Positive_Mental...
Posts: 454
Joined: Jul 2014

I had pain in that same location.  My surgery was in July.  Late in July or early August, I had a sneezing fit, and it felt like I pulled a muscle in that area.  It remained tender for a while. It eventually went away.  The surgery involved cutting through many layers of tissue and muscle, and it will take months to fully heal.  Stop poking at it! Laughing

jason.2835
Posts: 337
Joined: Nov 2014

Andy,

i had a robotic radical neph back in October and I still have tenderness when I press on my pelvic bone, right below where the surgery happened. It's not pain all the time, only when you home in on it. I would think that having tenderness in that area for some time is totally normal. Now, it's funny that you mention the back because I've had pain in almost the exact same spot for a while now. It's not overwhelming, just a nuisance at times. I just think it's our bodies reaction to changing musculature, healing incisions, etc. 

That being said, I had the same fears about metastasis but those fears are slowly subsiding. The largest my tumor was was 2.8 cm, so I think I'd be a right jacka$$ to think it metastasised. 

Bottom line, healing this much takes time. but, if it is a concern, find a way to allay your fears and don't let anyone talk you out of it. 

 

Footstomper's picture
Footstomper
Posts: 1238
Joined: Dec 2014

I had my kidney out in May 2013. I was stunned at how long it took me to recover, if indeed I ever have entirely. You have the right to ask your doctor about any concerns and I'm sure they would welcome your questions. But youve had a ruddy great hole cut in you and thats going to leave you with aches and pains for a while.

Jojo61's picture
Jojo61
Posts: 1310
Joined: Oct 2013

It does take a long time for your insides to heal...please give yourself time. However, if you are concerned, see your doctor. Hopefully we are right and it is just your "healing feelings" that you  are experiencing. But hearing those words from your doctor can give you a lot of peace of mind - which is invaluable!

Hugs

Jojo

AndyE
Posts: 51
Joined: Nov 2014

I finally went to my PCP because of these painful spots, and he ordered rib and chest X rays.  All X rays came back clear.  He suggested that I have bone scan in June if the pain has not subsided by then, but he thinks a lot of these bruise-like spots (without the bruise) may be skeletal/muscular in nature.  I feel like I have something horribly out of place in my back between my shoulderblades, and there is a burning sensation in a few locations around my shoulder blade.  This is driving me nuts!  I wish I could convince myself that nothing serioius was wrong.  It has now been three months since my surgery....when will this stop.....

Footstomper's picture
Footstomper
Posts: 1238
Joined: Dec 2014

At how many things hurt after surgery> Things that seemingly had nothing to do with the operation. The thing is, surgery of that amplitude has an effect on the whole body. So its probably just that. But, hell, youve got cancer. If your worried get it checked out! No one will blame you. Peace of mind is worth all the money in the world.

jason.2835
Posts: 337
Joined: Nov 2014

Andy,

if you look above, you will see that I reported very similar back pain to yours... However now that I am on my a$$ again recovering from surgery yet again the back pain has subsided completely.  I really think that it's just the abdominal muscles pulling on the other muscles and causing an overall sore feeling.  The back pain was bad enough to be a very big nuisance for me as well so you are not alone... But I really think it's just continued recovery pains, my friend.  Now that I know that rest cures the pain, I'm nearly sure of it.  Now I have a whole new set of recovery pains to look forward to :-/

- Jay

Positive_Mental_Attitude's picture
Positive_Mental...
Posts: 454
Joined: Jul 2014

Andy, my pain near my rib cage went away.  My surgery was in July 2014--open partial nephrectomy on my right kidney to remove a very small 2.9 cm grade 2 tumor.  At the beginning of this year I had severe back pain.  I went to a chiropractor, and the major pain went away.  I have been working out to get myself back in shape and to lose weight.  I'm working out at home to some bodyweight excercise videos (Rushfit, You Are Your Own Gym and EFX).  Nothing really crazy or too intense, but many Yoga type moves--planking, pushups, etc.  I have had a dull pain in my lower left back and hip that will not go away.  It is worst in the morning, and subsides during the day.   I can work through it, but it is annoying.  I have an appointment with my PCP in about a month, and I will ask about it, but I doubt it has anything to do with my surgery.

AndyE
Posts: 51
Joined: Nov 2014

So glad to hear that your pain has improved!  Excercise is key from what I understand, and I also need to get back into the gym very soon.  I have some similar back pains as were described in some of these comments; however, I also have these bruise-like pains that concern me.  I was terrified that they were bone mets, but x-rays showed nothing out of the ordinary.  I would think that any bone met small enough to not show up on a close up x ray would also not cause such pain, but I could be completely wrong about that. My tumor was also on the smaller side (5cm at its largest), and pathology reported clean edges with no lymph node or blood vessel involvement.  I would assume that a tumor like this would not have spread to the bone, but again, I suppose that cancer will go where it can.   The worse pain is between my right shoulder blade and my spine.  I may ask the doc to have an MRI of that area to see if someting is torn or injured. Trying to stay positive and not let this bother me, but at the same time, if I leared anything through this experience it is to listen to my body and don't ignore warnings. 

 

AndyE
Posts: 51
Joined: Nov 2014

My doctor ordered a bone scan, chest MRI, and bloodwork to try and determine where this scapula, back, and rib pain is coming from.  I had the tests yesterday, and I am happy to say that the bone scan and MRI were both normal and indicated "nothing with which you should be concerned."  I have not yet received the blood work tests back.  While this is great news, it unfortunately does not help me identify the cause of this pain.  A nurse friend of mine mentioned that it might be scar tissue pain, and scar tissue apparently begins to form roughly 3 months after surgery apparently.  Has anyone else experienced scar tissue pain?  If so, what did it feel like?  I wonder if scar tissue might form around a nerve and cause radiating pain?  Just thinking out loud.

APny's picture
APny
Posts: 1945
Joined: Mar 2014

I can't answer the pain question but I'm so happy to hear your MRI and bone scan came back normal. Hope the pain issue is resolved soon!

aamdsi
Posts: 284
Joined: Apr 2014

about 5 months after surgery - not having had it before it scared me.  I was working out at the gym one morning and just happened to ask a PT that worked there. 

She said that the surgery weakened the muscles alog my back and flank making them work all the harder, but not better.  And even with my resuming my running and swimming, I wasn't doing enough for those muscles. She then gave me a series of very simple stretches and stregthening things I could do - even at my desk - and within a week I noticed a vast improvement. I have since contiunued to do the things everyday and have not had any pain since. 

Now - that aside, it's been a year since my open partial and the scar has days that it is all pins and needles.  Or it feels like it's "ripping" for short periods of time. Dr. said normal.

Check with your Doc. then see if you can find a PT that can help you.  Exersize really really helps.

Laurie

foxhd's picture
foxhd
Posts: 3183
Joined: Oct 2011

Short story. My pain into my right shoulder and arm started in march of last year. Weakness started in may. I identified neck and brachial plexus issues. Nothing could be found through ct scans, mri, nerve conduction studies and emgs. Look at me now. If you are unfamiliar with my story, read back a little bit. My advice is to stay on top of this. Do not trust that therapist. But then again, I've only been a PT for near 40 years.

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