question about Mets

[Jenniferp2122]

hi everyone- I wrote in here a few days ago regarding my father with his Er+ PR+ MBC that he was diagnosed with in June of this year. He has been on letrozole lupron Ibrance and xjeva since June. His first PET scan 9/14 showed no evidence of active disease.

my father is very active living in Florida. He plays 2-3 sports per day- pickle ball, tennis, and golf (which all involve shoulder muscles). He has been recently complaining of shoulder soreness and tightness WHILE serving the ball and while actively using his shoulders during sports and hasn’t had much time to rest both of his shoulders. His right hurts more than the left because he serves righty.

Can someone calm me down- I am really really praying this isn’t more bone metastases. His tumor markers have been stable at 23. I really just need any reassurance right now in any way you can provide. Thanks.

[Jenniferp2122]

I also want to add the pain is located on top of the shoulders not on the shoulder blade area.

[Claireperth]

Can you accompany your father on his next oncology visit? Is it possible to contact his oncologist by phone after hours with him sitting next to you? 🌷

[Jenniferp2122 in reply to Claireperth]

for the purpose of easing my own anxiety do you mean?

[Claireperth in reply to Jenniferp2122]

yes, until my father died in July I always accompanied my father (over 8 years) to his appointments etc and was able to text his oncologist if I was worried. I never abused this direct contact and was able to reduce my anxiety about my father’s situation.

[bikebabe]

I posted something similar about shoulder pain and a few people mentioned they thought letrazole might be aggravating it. I do t know but would be worth speaking to onco about options.

[Kerryd22]

Letrazole does cause joint pain so it could be that. I was on Letrazole for a short time but I can’t recall what I experienced with it. I do know that bone scans showed arthritic changes in my hands in particular. I find that the pain reduces once I’ve started moving. It’s a good idea to raise the issue with the oncologist because it could be a symptom or it could be a side effect or it could be unrelated to the cancer. Letrazole isn’t the only AI so the oncologist could make a change to one of the other options.

All the best

Kerry

[LDR1]

Hi Jennifer, from your description of the pain being on the top of his shoulders and related to exertion, it sounds like it could be more muscle- or joint-related. As some of the other commenters suggested, this could be due to medication side effects. Since your Dad is so active (which is fantastic!) it’s also possible that it’s muscle or joint issues from athletic activity. Or it could be a combination - your Dad’s recent treatment and medications (plus ongoing ageing) may have changed how his body responds to that kind of exertion. If that’s the case some PT might help, to address the pain and advise him how he could reduce it while still enjoying the activities he loves.

At the same time, you’re wise to be vigilant about any new symptoms - so consulting his oncologist to see if a scan is warranted might be a next step there. Try to stay calm in the meantime - when I have a concerning new symptom I try to make an agreement with myself not to freak out until we have all the data / test results in hand. You are probably going to be on this journey with your Dad for a long time, and different things will come up along the way. With your love and devotion to him you will help him navigate whatever the challenges may be 🙏🏼💕

[13plus]

Hi Jennifer,

I am a personal trainer. Letrozole can cause joint issues/stiffness but if your father has already taken it for 6 months without issues and this is new symptoms, I tend to think this is not the issue.

How long has been playing all 3 sports? Has he recently Upped the amount of hours Playing them? Does he do any stretching? I would find a good sports doctor and get an assessment. It could very well be overuse. As people get older they’re more prone to an injury where the bursa sac in the shoulder gets pinched as you raise your arm above the head. He may just be overdoing the same Type Of sports without complimentary movements and strengthening of other muscles to keep things balanced. The shoulder is a complex joint. Visits asap sonit doesn’t get worse. Take the report of his latest scan with you. Hope this helps .

[Jenniferp2122 in reply to 13plus]

thanks so much. He definitely recently upped his sports games. He used to play 1 sport per day and now he easily plays 2-3 sports per day. He says when he serves he is able to loosen it up a bit. Does this sound like arthritis and stiffness with joints? Also, maybe the longer you’re on letrozole the more of a cumulative effect it has contributing to the stiffness. I’m just praying it’s not more bone Mets when his last scan was literally NED on 9/14. It’s also in both shoulders on the top of both shoulders so I find it to be interesting that it’s symmetrical. Any peace of mind here is helpful

[13plus]

I can’t diagnose but have given you some information that helps explain other causes. He still should get it assessed as the physio can give him specific exercises to help, if it is either injured or arthritis vs Mets. The symmetry might be from an incorrect movement technique (or needs improvement), which a physio could also help improve . Please stop worrying, it doesn’t help anything at all and he will feel your anxious energy - not good for either of you. Send him off to get it assessed and also take steps/ get help for yourself as caregiver. You need support too in your role, it’s a lot! There are many resources out there if you Google and also I’m sure at his hospital of you enquire at the oncology department . Be well