Pain Management

[Juju0713]

My dad continues to have severe pain in his lower spine due to mets. This has been going on now for about 2 months and he received his first pluvicto infusion on 2/25 but his pain level remains about the same. He is now on a fentanyl patch with morphine for breakthrough pain which provides some relief but he still is not very comfortable most of the time. He also received an IV dose of solu-medrol this week and has been taking ibuprofen as well for potential inflammation from pluvicto. Just curious about any other input for what others have done for management of pain in spine mets? Thanks.

[Kaliber]

my friend Mark dealt with spinal pain numerous times in his aPCa experience. If it gets bad enough then radiation or surgery may be avenues of relief , …but fentanyl and morphine are very effective tools to manage spinal / bone pain. Mark eventually had a morphine pump implanted for his spine. Working very closely with your palliative care specialist / team will be key to resolve this pain to a suitable level.

I’m intimately familiar with bone and spinal pain myself, not to the level of your father or Mark, but I can deeply empathize with your father . I hope he gets that under control quickly.

Your father is very lucky to have you on here advocating for him.

❤️❤️❤️

[spencoid2]

my symptom management doctor thinks that methadone might be better at alleviating bone pain.i am also on fentenyl patch oxycodone and occasional morphine so it is difficult to know what is really helping.

i have also gotten wack a mole radiation treatments for the worst areas of bone pain. again not sure how much this helps with all else going on. Pluvicto did little for me even though i did show uptake in the various mets. targeted radiation at lease is known to hit the target. i got it to C1 and L4. Warning!!!! If they zap cerebral vertebra they will lock your head down with a mask. If you have any confinement claustrophobia this can be horrible. I had radiation to my skull and to C1 so I went through this twice. The second time the mask was less awful. There was a single clamp that I knew i could release if i was freaking out and just knowing that I could together with atavan helped me get through it.

[janebob99]

Sorry to hear about your Father's back pain. I used to take 90 mg of morphine a day to handle my back pain. After a successful 5-level fusion surgery, I've been able to reduce it to 20 mg/day, but I still have some breakthrough pain.

Surprisingly, the best thing for breakthrough pain is cold gel packs. I use the kind that wrap around the entire low back with a Velcro closure around the front. It works in about 5 minutes and lasts for 1/2 hours. $20 from Amazon.

Just a thought...

[SteveTheJ in reply to janebob99]

FWIW, the brand I like is Rester's Choice. There are two sizes, one for the back and one for the neck.

Back: amazon.com/dp/B07VDMZP65?re...

Neck: amazon.com/dp/B07WTQP7R1?re...

Note: My back pain is unrelated to prostate cancer; it's a degenerative spine condition and not nearly as severe but every little bit helps. Hopefully you'll find some more relief.

[Professorgary]

stay away from Ibuprofen. Ask your doctor for a prescription for celebrex. Ibuprofen blocks Cox 1 enzyme as well as Cox 2 enzyme. Celebrex only blocks Cox 2 which causes inflammation. The Cox 1 enzyme is a protective enzyme for the gastric tract. You will also want to take some supplements for inflammation. I take curcumin and berberin for inflammation and bp and glucose regulation. Magnesium is also good for heart. As always, discuss with doctor first. These work very well for my back but unfortunately they are not pain killers, they relieve pain by reducing inflammation which takes 4 to 8 weeks to realize full potential.