Bone Pain and MBC
In metastatic
breast cancer, bone pain can be a side effect of your treatment or a sign that the cancer has spread to the bones. The thinning bones themselves can lead to bone breaks, or fractures, which can be very painful.
Certain chemotherapy medicines can cause aches and pains in joints and bones. So can hormonal therapies, including tamoxifen and aromatase inhibitors. You might also feel aches and pains from medicines you take to treat side effects of cancer treatments, such as bisphosphonates to manage bone thinning. It’s common to feel joint pain from growth factors given for neutropenia such as filgrastim (Neupogen) and pegfilgrastim (Neulasta).
If breast cancer metastasizes, it often spreads to the bone. The spine, pelvis, ribs and long bones in the arms and legs are common places for metastases. When breast cancer spreads into bone, it interferes with the bone’s normal growth, causing pain and a higher risk of fractures.
Bone pain can range from slightly uncomfortable—a dull ache in your shoulder or other joints—to severe, ongoing pain that needs to be treated with medicine.
Your providers can help if you report your symptoms promptly. Write down which symptoms you have and how long you’ve had them. Rate your discomfort on a scale of 1 (not at all uncomfortable) to 10 (the most uncomfortable you have ever been). Note whether the bone pain comes or goes or is persistent. Be as specific as possible, and let your team know how much bone pain impacts your life.
What You Can Do About Bone Pain
One solution may be to switch your treatment. You and your doctor must always weigh the pros and cons of a given treatment, whether it is being given to treat the cancer or to prevent a side effect. Remember, your needs are an important part of your treatment plan. Open communication with your providers is very important. You and your providers will decide together whether continuing with a certain treatment is right for you.
You may be able to take medicine to pain associated with your bone metastasis. These medicines include:
- denosumab (Xgeva), a targeted therapy called a RANK ligand inhibitor
- clodronate (Bonefos), pamidronate (Aredia) and zoledronic acid (Zometa), bisphosphonates
If you continue to feel pain while you’re taking bisphosphonates, talk with your healthcare team. They can help you with solutions.
Sometimes radiation therapy or surgery is used to relieve pain and to shrink metastases that are causing bone pain. Your cancer team will help you find the cause of your joint discomfort or bone pain. They may refer you to a pain specialist. You should never have to cope with untreated pain.
There are also some self-care techniques that can help with joint and bone pain. Try:
- Placing a hot or cold pack on the affected areas. Ask your provider which to try.
- Exercising. Movement can relieve pain.
- Maintaining a healthy weight. Too many extra pounds can put stress on your joints and bones.
- Acupuncture. Studies show this ancient complementary therapy to be effective at managing bone pain from aromatase inhibitors. You could also explore other complementary therapies, such as meditation.