Muscle pain after radiation

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dawnj
dawnj Member Posts: 4

I finished 30 radiation treatments for ovarian cancer in December. A few weeks later, I developed pain deep in my buttocks. Recently learned it is probably piriformis muscle. Have had PT for past two weeks and pain persists - can't walk w/out it. Noticed on another forum that this could be a side effect of pelvic radiation. Anyone else?

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  • LorettaMarshall
    LorettaMarshall Member Posts: 662 Member
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    Dawn~Pelvic radiation can cause bone damage~see references B Low

     Hello Dawn

     Relative to your radiation treatments, I looked up possible side effects.  Perhaps the references below will be helpful.  Anytime we’ve had “30” of anything we can expect some unexplained side effects.  In briefly reading about latent side effects of radiation to the pelvic area, I find it  interesting to see that more than one link says that radiation can cause damage to the bones. I firmly believe it.  As for me, I have residual neuropathy from my very first series of chemo treatments. I now have new ones in my fingers and also have experienced my tongue tingling, that was not evident the first go round.  So I say to myself, “Well Loretta what do you expect when you’ve been receiving “poison” into your system for this long now?”  

     I’ve had radiation to the Caudate Lobe of my Liver, but not in the pelvic area YET!  However, I noticed that even today when going to the oncology clinic that on two occasions, my left ankle wanted to “momentarily” give way.  Sometimes it is in my left knee.  I always use a cane when I go out in public, because I feel more secure just in case something like that should happen.  Also, I’ve been having some intense pain at the base of my spine when I sat down for the past couple of days.  I only say this, not that our pains are similar, but only to say, “I’m never really surprised at the strange and sudden feelings I have.  After all, I’ve been at this for now 4 years, but I can’t complain because I’m still alive.  But by the same token, I’m praying that God will give me sense enough to know when the treatments are doing me more harm than good. 

     So after reading your letter, I asked “Dr. Google” about side effects from radiation therapy to the pelvic area which seemingly include pains which you describe.  Now I’m not “prescribing” any remedies because that’s above my pay grade, but these references might well explain why you are experiencing pain in your buttocks. 

      One of the articles below suggests that there might be tiny cracks in the bone and that a DEXA scan can be done.  Now I’m not a doctor, but knowing how much damage we can have as a result of trying to make things better, I don’t doubt that this can’t be possible. 

     And since we both have Ovarian Cancer, and I am experiencing pain, sometimes momentarily excruciating, might it be some natural effect of this cancer as well?  I always make a note on the calendar and tell my oncologist about it.  Not that I expect him to be able to “fix everything that breaks”, but there just might be something that can be done about it.  Even “no fix” exists, I always want to know “what’s happening” if I can.  So sorry I can’t be of more help, and I hope that it is something that you can tolerate, because we simply must take the good with the bad when we sign up for these treatments.  We always hope they will do more good than harm. 

     Love Loretta

     Peritoneal Carcinomatosis/Ovarian Cancer, Stage IV

     _________________________________________________________________



     ______________________________________________

    2.  http://www.macmillan.org.uk/information-and-support/coping/side-effects-and-symptoms/late-effects-pelvic-radiotherapy/other-late-effects.html

    “Other Late Effects - Pelvic radiotherapy can cause some other, less common types of changes in your body.

     Pelvic lymph nodes can be damaged by radiotherapy. This can cause fluid to build up and legs can become swollen. Protecting your skin, legs and feet, simple massage and compression garments can prevent and reduce swelling.

     Pelvic bones can be damaged by radiotherapy; this can cause fine cracks in the bones. Your doctor may prescribe painkillers to control any pain, bone strengthening drugs and vitamin supplements. You may be referred to a specialist bone doctor for advice.

     Pelvic radiotherapy can also cause changes in women. Early menopause causes symptoms such as hot flushes, mood swings and low sex drive. Your doctor may be able to prescribe hormone replacement therapy to help but it’s not suitable for everyone.

     Changes to vagina include narrowing, dryness and bleeding. These can usually be managed or treated successfully.

     Having pelvic radiotherapy slightly increases your risk of a second cancer but this is outweighed by the benefits of pelvic radiotherapy as initial treatment. Your doctor or nurse will discuss this with you.”

     ____________________________________________

     3.  http://www.cancerresearchuk.org/about-cancer/cancers-in-general/treatment/radiotherapy/side-effects/abdominal/stomach-or-pelvic-radiotherapy-side-effects-pain

     “Abdominal or pelvic radiotherapy side effects: pain

     …Pelvic bone changes

     Unfortunately radiotherapy treatment for cancer in the pelvic area can sometimes lead to hip and pelvic bone problems later in life. Radiotherapy can damage our bones in different ways. Problems after pelvic radiotherapy may include weaker bones and tiny cracks in the bones.

                                                                Weaker pelvic bones

     Radiotherapy can damage the bone cells themselves, and also the supply of blood to the bones. The blood supply delivers nutrients (food) to the bones. Without these nutrients the bones become weaker. 

     When bones are damaged because of a loss of blood supply, this is called avascular necrosis. Damage to the bones can cause pain and sometimes makes it hard to walk or climb stairs.

     Your doctor might monitor you carefully after pelvic radiotherapy, including checking your bone strength with a DEXA scan. They may suggest treatment with painkillers and walking aids to help you get around, such as a stick. You might also take drugs to strengthen the bones called bisphosphonates. These drugs can help to control pain and reduce the risk of fractures.

                                                           Tiny cracks in the bones

     Sometimes, tiny cracks can appear in the pelvic bones some years after radiotherapy. They are called pelvic insufficiency fractures. This is more likely to happen in people who have general weakening of their bones as they get older (osteoporosis). It is also more likely in people who are taking hormone therapies or steroids. 

     The pain in this case can be quite bad. It usually gets worse if you move around or do exercise and gets better when you sit still or rest. This type of pain normally goes away overnight. It doesn't stop you from sleeping well. Your doctor might ask you to have X-rays, a CT scan or an MRI scan (or a combination of these) to see if there are any fractures in the pelvic bones.

     If there is a high risk of fracture your doctor might recommend a hip replacement or surgery to strengthen the bone. They will ask you to see an orthopaedic surgeon (a specialist in bone disease and repair). Surgery for a hip replacement means a stay of about a week in hospital, as well as several weeks recovery time afterwards…”

    _____________________________________________________________

     4.  http://www.nhs.uk/Conditions/DEXA-scan/Pages/Introduction.aspx

     "A DEXA scan is a special type of X-ray that measures bone mineral density (BMD).

     DEXA stands for "dual energy X-ray absorptiometry". This type of scan may also be called:

    •  a DXA scan
    • a bone density scan
    • a bone densitometry scan

     DEXA scans are often used to diagnose or assess someone's risk of osteoporosis, a condition that weakens bones and makes them more likely to break.

     As well as being quick and painless, a DEXA scan is more effective than normal X-rays in identifying low bone mineral density..."

    ___________________________________________________

    5.  http://www.nhs.uk/Conditions/DEXA-scan/Pages/How-is-it-performed.aspx

     

  • dawnj
    dawnj Member Posts: 4
    Options

    Dawn~Pelvic radiation can cause bone damage~see references B Low

     Hello Dawn

     Relative to your radiation treatments, I looked up possible side effects.  Perhaps the references below will be helpful.  Anytime we’ve had “30” of anything we can expect some unexplained side effects.  In briefly reading about latent side effects of radiation to the pelvic area, I find it  interesting to see that more than one link says that radiation can cause damage to the bones. I firmly believe it.  As for me, I have residual neuropathy from my very first series of chemo treatments. I now have new ones in my fingers and also have experienced my tongue tingling, that was not evident the first go round.  So I say to myself, “Well Loretta what do you expect when you’ve been receiving “poison” into your system for this long now?”  

     I’ve had radiation to the Caudate Lobe of my Liver, but not in the pelvic area YET!  However, I noticed that even today when going to the oncology clinic that on two occasions, my left ankle wanted to “momentarily” give way.  Sometimes it is in my left knee.  I always use a cane when I go out in public, because I feel more secure just in case something like that should happen.  Also, I’ve been having some intense pain at the base of my spine when I sat down for the past couple of days.  I only say this, not that our pains are similar, but only to say, “I’m never really surprised at the strange and sudden feelings I have.  After all, I’ve been at this for now 4 years, but I can’t complain because I’m still alive.  But by the same token, I’m praying that God will give me sense enough to know when the treatments are doing me more harm than good. 

     So after reading your letter, I asked “Dr. Google” about side effects from radiation therapy to the pelvic area which seemingly include pains which you describe.  Now I’m not “prescribing” any remedies because that’s above my pay grade, but these references might well explain why you are experiencing pain in your buttocks. 

      One of the articles below suggests that there might be tiny cracks in the bone and that a DEXA scan can be done.  Now I’m not a doctor, but knowing how much damage we can have as a result of trying to make things better, I don’t doubt that this can’t be possible. 

     And since we both have Ovarian Cancer, and I am experiencing pain, sometimes momentarily excruciating, might it be some natural effect of this cancer as well?  I always make a note on the calendar and tell my oncologist about it.  Not that I expect him to be able to “fix everything that breaks”, but there just might be something that can be done about it.  Even “no fix” exists, I always want to know “what’s happening” if I can.  So sorry I can’t be of more help, and I hope that it is something that you can tolerate, because we simply must take the good with the bad when we sign up for these treatments.  We always hope they will do more good than harm. 

     Love Loretta

     Peritoneal Carcinomatosis/Ovarian Cancer, Stage IV

     _________________________________________________________________



     ______________________________________________

    2.  http://www.macmillan.org.uk/information-and-support/coping/side-effects-and-symptoms/late-effects-pelvic-radiotherapy/other-late-effects.html

    “Other Late Effects - Pelvic radiotherapy can cause some other, less common types of changes in your body.

     Pelvic lymph nodes can be damaged by radiotherapy. This can cause fluid to build up and legs can become swollen. Protecting your skin, legs and feet, simple massage and compression garments can prevent and reduce swelling.

     Pelvic bones can be damaged by radiotherapy; this can cause fine cracks in the bones. Your doctor may prescribe painkillers to control any pain, bone strengthening drugs and vitamin supplements. You may be referred to a specialist bone doctor for advice.

     Pelvic radiotherapy can also cause changes in women. Early menopause causes symptoms such as hot flushes, mood swings and low sex drive. Your doctor may be able to prescribe hormone replacement therapy to help but it’s not suitable for everyone.

     Changes to vagina include narrowing, dryness and bleeding. These can usually be managed or treated successfully.

     Having pelvic radiotherapy slightly increases your risk of a second cancer but this is outweighed by the benefits of pelvic radiotherapy as initial treatment. Your doctor or nurse will discuss this with you.”

     ____________________________________________

     3.  http://www.cancerresearchuk.org/about-cancer/cancers-in-general/treatment/radiotherapy/side-effects/abdominal/stomach-or-pelvic-radiotherapy-side-effects-pain

     “Abdominal or pelvic radiotherapy side effects: pain

     …Pelvic bone changes

     Unfortunately radiotherapy treatment for cancer in the pelvic area can sometimes lead to hip and pelvic bone problems later in life. Radiotherapy can damage our bones in different ways. Problems after pelvic radiotherapy may include weaker bones and tiny cracks in the bones.

                                                                Weaker pelvic bones

     Radiotherapy can damage the bone cells themselves, and also the supply of blood to the bones. The blood supply delivers nutrients (food) to the bones. Without these nutrients the bones become weaker. 

     When bones are damaged because of a loss of blood supply, this is called avascular necrosis. Damage to the bones can cause pain and sometimes makes it hard to walk or climb stairs.

     Your doctor might monitor you carefully after pelvic radiotherapy, including checking your bone strength with a DEXA scan. They may suggest treatment with painkillers and walking aids to help you get around, such as a stick. You might also take drugs to strengthen the bones called bisphosphonates. These drugs can help to control pain and reduce the risk of fractures.

                                                           Tiny cracks in the bones

     Sometimes, tiny cracks can appear in the pelvic bones some years after radiotherapy. They are called pelvic insufficiency fractures. This is more likely to happen in people who have general weakening of their bones as they get older (osteoporosis). It is also more likely in people who are taking hormone therapies or steroids. 

     The pain in this case can be quite bad. It usually gets worse if you move around or do exercise and gets better when you sit still or rest. This type of pain normally goes away overnight. It doesn't stop you from sleeping well. Your doctor might ask you to have X-rays, a CT scan or an MRI scan (or a combination of these) to see if there are any fractures in the pelvic bones.

     If there is a high risk of fracture your doctor might recommend a hip replacement or surgery to strengthen the bone. They will ask you to see an orthopaedic surgeon (a specialist in bone disease and repair). Surgery for a hip replacement means a stay of about a week in hospital, as well as several weeks recovery time afterwards…”

    _____________________________________________________________

     4.  http://www.nhs.uk/Conditions/DEXA-scan/Pages/Introduction.aspx

     "A DEXA scan is a special type of X-ray that measures bone mineral density (BMD).

     DEXA stands for "dual energy X-ray absorptiometry". This type of scan may also be called:

    •  a DXA scan
    • a bone density scan
    • a bone densitometry scan

     DEXA scans are often used to diagnose or assess someone's risk of osteoporosis, a condition that weakens bones and makes them more likely to break.

     As well as being quick and painless, a DEXA scan is more effective than normal X-rays in identifying low bone mineral density..."

    ___________________________________________________

    5.  http://www.nhs.uk/Conditions/DEXA-scan/Pages/How-is-it-performed.aspx

     

    Thanks for the info. I did

    Thanks for the info. I did see a lot of that in my research, but it is good to get feedback from real people who have experienced these effects.

    I thank you for the encouragement and wish you the best.