Hip pain

[reconjj]

Hello All , Ive had this left side hip pain for about 6 months . Not to bad during the day . Night time hard to sleep . Dr. gave me 400mg Ibuprofen for night time , helps a little . I had a MRI at U of Chicago and CT-scan at V.A. , nothin g conclusive . Ive had initial SBRT 6 yrs ago , then 3 fractions of SBRT to pelvic lymph node then 25 fractions to pelvic field in march 21. Could this pain be caused from radiation . Should I ask for a different Scan ? a Bone Scan ? Im doing good with labs . PSA <01 , T <7. All liver ast,alt, normal , been on Eligard , Zytiga , prednisone 10 months . Can mets cause pain ? Thanks Brothers

[EdBacon]

Yes mets can cause pain, I was in the similar situation recently. On Abi and Enza for years, my PSA had been rising and I did have mets show up on a PSMA PET scan. That's a very sensitive scan and you might see if you can get one.

When was your last PSA? If it was more than a month ago, I'd consider having it rechecked.

My hip pain started when my PSA was still fairly low, but continued to get worse. My PSA was in the teens when my second PSMA PET was showing active mets. I'm currrently on Cabazitaxel chemo. That eliminated my hip pain within days of starting it.

[reconjj in reply to EdBacon]

I had the psma-pylarify in Dec21 PSA was at 4 . Thats when they found 1 lymph node .My primary GP at V.A. thinks its a nerve . I hope she understands the Stage 4 I am . You think it could be radiation damage from the 25 fractions ? V.A. doc gave me 5% lanocaine patches . Very little relief .

[EdBacon in reply to reconjj]

If your most recent PSMA PET was in December, I'd get another if you have significant pain. I would also be talking with a Medical Oncologist, not a GP about this. I don't think it's from radiation, but I'm not a doctor. Best to let imaging make that determination. My doctor said that the amount of pain isn't necessarily a function of how many and how big the mets are. I had a lot of pain for a small increase in my mets. He said sometimes there can be very small micro fractures that can be very painful.

When was your last PSA test?

[reconjj in reply to EdBacon]

last labs were Aug-16. I have 2 MOs , 1 at Uof Chicago and at 1 V.A.,I was given an MRI at U of C and a scan CT from V.A. Nothing found . That tell me those scans dont see it . I probably will suggest Pylarify again .

[spw1 in reply to reconjj]

We recently met with Prof De Bono at Royal Marsden and he said that MRI is good for identifying active mets but it does have to be interpreted by very skilled persons and the Marsden team routinely use it prior to biopsy.

[docbulldog in reply to EdBacon]

My PSA has continued to claim following 10 infusions of docetaxel and three infusions of Cabecataxel(sp) and is now at 300. I have had no real noticeable pain except a little bit in what I call my groin area, but I know it’s not a grain muscle pull.

I had a PSMA scan and have started the LU 177 treatment. Following treatment I did have some pain in my hip area.. My understanding is that pain is coming from the treatment.

I’m looking forward to my second round of this new treatment.

Best of luck to you on finding the culprit.

[EdBacon]

Has your Alkaline Phosphatase been rising and/or out of normal range?

[reconjj in reply to EdBacon]

All labs are normal , Alt, Ast liverall good , Thanks

[spw1 in reply to reconjj]

Did you check LDH? My husband's ALP does not correlate to his PSA or mets rising but LDH appears to do so.

[Tall_Allen]

It's not from radiation or metastases- it's part of getting older. See an orthopedist.

[OldGuysRule in reply to Tall_Allen]

TA, are you saying that there can be no pain from cancer on bone from mets?

[Tall_Allen in reply to OldGuysRule]

No, not saying that at all. I'm saying that it is not the cause of reconjj's hip pain.

[ADTMan in reply to Tall_Allen]

This may be incorrect: casereports.bmj.com/content... There is also a YouTube video from the Mayo clinic showing a surgery on a prostate cancer patient's sciatic nerve to remove a metastasis. A year before I was diagnosed I had the worst pain in my hip which went unexplained. Coincidence?

[Tall_Allen in reply to ADTMan]

I replied to reconjj, not you. Your situations are different.

[London441]

Have you had simple x rays to rule out osteoarthritis?

[reconjj in reply to London441]

no xrays . Something to do probably . Thanks

[London441 in reply to reconjj]

Good. Best to do it before anything else, because if it is osteoarthritis it will be the easiest source to see and diagnose.

[Grandpa4 in reply to London441]

ct and MRI if hip included both are good at looking for arthritis. I am liking bursitis as it is very common. Is there tenderness over the hip (trochanter) bone. Do you have pain if you lie in that side. I would see ortho.

[BobbyMac07]

Could be sciatica

[larry_dammit]

I have the same issue but right side, side sleeper in the past but the Mets in my hip makes me sleep on my back now, no matter how much pain med I take. Just saying

[pilot52]

Hi, we always tend to go to the "C" when we have pain and some of it may be a result of previous radiation and a cheaper bone where we have tendon attachments. For instance I have had SBRT to my scapula. When I do a heavy lift I ( usually back, but bench press can sometimes bring it on I feel it at night.) However, I never had had hip issues with cancer . I have had multiple bone mets. I do ride a peloton a minimum if 75 mins. a week and sometimes double that. We race every two weeks. I have had right hip pain , and sometimes bilateral hip pain long before any cancer diagnosis. This can be caused by ITB tightness. Do some reading , stretching , maybe a pillow between your knees. I am just throwing this out as a side bar. Blue Skies , Sky King and Penny (woof)

[docbulldog in reply to pilot52]

some very good points there, I found when walking my hips would start bothering me and so I would turn sideways and do the grapevine as I callef it. It’s a little drill we did in track and football practice to help limber up the hips. Sometimes called karaoke, not the singing type. Cross over cross under three or four steps and then switch and go the opposite direction, that seem to really loosen up my hips.

[DSJo]

I have had recurrences with hip, knee, and ankle pain. Usually from too much walking or cycling. Also being stuck in long traffic jams - gas-brake-gas-brake....It is usually worse at night too. I blame the Eligard (Leuprolide) and old age. Eligard/Lupron are notorious for causing joint pain. Rest, ice, and NSAIDs usually work.

[OldGuysRule]

I just received my very first injection of Lupron just 5 days ago. I have had severe pain in t2 vertebrae area for quite some time before treatment began. The t2 showed Mets in my latest scan. The pain is in my back, not in my head!

[groundhogy]

Look up sciatica. It may be lower back deterioration.

My lower back decided to start to crumble right when i got PCa, sending all kinds of false pain signals all over.

Makes it more exciting....

[OldGuysRule in reply to groundhogy]

Dang!

[Atlpapa]

Others have said it but do get a simple xray. I've had hip pain for the last 6 months and had an xray and it showed significant loss of joint space, sclerosis and osteophyte formation. Basically advanced osteoarthritis, due to aging and maybe accelerated progression due to adt+ for two and a half years.

[Hidden]

I've had hip pain that only bothers me at night while lying in bed. I've been told that it is trochanteric (hip) bursitis.

my.clevelandclinic.org/heal...

You might try using a foam roller on the side of your leg for the IT band and also on the glute on that side. That's what I do for it.

[groundhogy]

with sciatica if you concentrate on the pain, you will notice it will travel the nerve pathways, which mainly go kinda horizontally out the buttocks toward the hip, and down the back of the legs even through the calf back and sometimes to the heel of foot.

But... there are many offshoots, some traveling the inside thighs to inside knees etc.

Fun times

[cfsteak]

You might try some Physical Therapy , there are a couple of therapist on YouTube, Bob and Brad, in the last year or so they helped me with neck, shoulder and foot pain, They are kind of goofy but they have sure helped me out doing their stretches. The time I had persistent Hip pain my recliner broke down and all the sudden my pain went away.

Good Luck

[john4803]

Have you had a Dexa Scan? Forgive me if you already said this or I missed it? I Stretch my hips before walking/running by sitting on a chair & crossing my leg over my knee & holding it for 60 seconds. If I don't do this, they pain me when I walk.

[reconjj in reply to john4803]

yes , I had a Dexa a few month ago , all good , Thanks

[GumpaD28]

i noticed the talk about sciatica sometimes when mine hits I'll have pain in my right gonad..also when i initially found out i had it i was getting bad pain in the right hip and that is where the biopsy was plus my PSA was at 254...there were mets in my hip causing the pain..did 10 rad treatments on it still get pain occasionally..also doing Lupron shot every 3mnths Zytiga and prednisone been 8mths PSA at .03 ...Best of Luck ✌

[London441]

Seven years ago I went through 2 years of trying to source the cause of my hip pain without getting a X-ray of it. YouTube videos, massage, yoga, chiropractors, PT, my PCP and more. Incredibly, no one said a word about arthritis.

In the end it was very obviously osteoarthritis, visible on a simple X-ray. Solved 100% with a total hip replacement.

This is why I recommend a hip X-ray first before going down the series of rabbit holes kindly suggested.

[jfoesq]

I have had hip pain in my right hip, where there are NO mets, for many years that began sometime after my DX and treatment. My hip only bothers me when I sleep. I have no problems when walking or playing tennis and/or golf. I believe a side-effect of Lupron and/or Zytiga can be joint pain, so I chalk it up to that. I started taking an Aleve before bed, which seems to provide some help.