Post-Mastectomy Pain: More Common Than We thought

When friends ask me about my current breast cancer condition, the only real news I have to share is that it seems stable and dormant for the time being.

And that is certainly good news. The only real complaint I’ve had over these last four years is the degree to which my mastectomy scar has caused me some discomfort, often subtle but sometimes significant.

There is a good portion of my breast missing of course, along with some important nerves and a lymph node or two — small potatoes compared to the many women with ample breast tissue and more advanced cancers. Of course there are also guys with significantly more breast tissue than I have, weighing in at just 145 pounds.

But despite the fact that I had less breast and fewer lymph nodes removed, the residual discomfort is still with me sometimes and I wish it would be gone.

In a recent study published in The Breast Journal: “The Post‐mastectomy Pain Syndrome—A Systematic Review of the Treatment Modalities” by Inga Agdalena Larsson M.D., Jens Ahm Sørensen M.D.,Ph.D. and Camilla Bille M.D., Ph.D., they reported that a number of patients are given antidepressants and anti-epileptics to alleviate pain, and according to the observed results, they are effective for some people, but they often present serious side effects.

In another study, a topical treatment with Capsaicin cream (a derivative of hot chili peppers) was also examined. When you put capsaicin on your skin, you help block pain messages to your nerves. Studies show capsaicin creams and patches can help relieve pain that's due to joint conditions like rheumatoid arthritis and osteoarthritis, fibromyalgia and surgery. And to some degree, it also seems to reduce mastectomy pain in some patients.

Fat grafting is a relatively new approach being studied for breast pain. The premise is that these injections may result in a softening of scar tissue and a reduction in inflammation.

It’s important to note that almost without exception, these medical studies regarding breast cancer rarely include men.

In another attempt to deal with this issue, Emory University Winship Cancer Institute in Atlanta, Georgia, is now undertaking a 22-patient pilot study to examine the effectiveness of cryoablation on post-mastectomy chronic pain syndrome. Cryoablation uses extreme cold to destroy or damage tissue — in this case, the intercostobrachial nerve—a possible cause of residual breast pain.

"Some patients may have experienced trauma to the intercostobrachial nerve during surgery, formed scar tissue or neuroma causing them persistent pain," said Janice Newsome, M.D., an Emory radiologist, in a statement. "Then, we freeze the nerve for over five minutes, unthaw, and freeze again." A CT scan is used to guide the needle containing the freezing element to the correct position.

I recently had both of my knees replaced, and the surgery was preceded by an ultrasound-guided long needle that delivered a pain-killing drug directly the primary nerve in my leg. My recovery was not without pain, but as a result of this innovative procedure, I had very little discomfort for the first day or two after the surgery, the time when most surgical pain is present.

So, while not uncommon, there seems to be no easy solution for the many who suffer from post-mastectomy pain. Hopefully these new studies will uncover multiple options for the women and men who are searching for relief. It seems to be one of those nuisances that many of us put up with, but wherever there is pain there is reason to study, understand and find help.

www.MaleBreastCancerSurvivor.com