Muscular skeletal side effects from radiation

Posted by cedar75 @cedar75, Jul 7, 2021

I had lumpectomy surgery. Did great with that no residual pain or change in range of motion of my right dominant arm. Three weeeks after radiation I developed severe pain, decreased tang of motion of my arm, my rib cage, and shoulder pain. I had nerve pain that went from my chest to arm pit to just above my elbow. I saw physical medication and rehabilitation doctor and have begun program of physical therapy. I developed cording. I am curious if other patients have developed these symptoms and did they go away with time. How long did they last? I feel that the only symptoms radiation oncology addressed was skin and fatigue. I have read that 7/8 women have muscular skeletal issues after radiation. One of my other questions is why all women who undergo surgery and radiation are not referred to physical therapy prior to intervention for PT program and education of what to watch for. Also measurements can be takes at baseline for possibility of lymph edema and baseline range of motion measurements. I still cannot lay on my right side. Any one else with similar issues?

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Oh my word, you certainly have had a time with it. I did have a little muscle and joint issues but nothing severe. However I could not sleep on that side for a long time. I know there are more people on connect who have had similar issues. I am not as savvy on here as some of the mentors, about tagging people. But I am going to try and figure that out. How far into PT are you now, is it getting any better?

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I was looking back on some threads about radiation, and I want to tag our moderator who has been around a while and is really good at finding people to help, I am also going to tag a newcomer who asked about radiation and pain in her knee replacement. I am hoping we can support each other in his. @colleenyoung @creeder. I am looking forward to hearing from you again.

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@auntieoakley

Oh my word, you certainly have had a time with it. I did have a little muscle and joint issues but nothing severe. However I could not sleep on that side for a long time. I know there are more people on connect who have had similar issues. I am not as savvy on here as some of the mentors, about tagging people. But I am going to try and figure that out. How far into PT are you now, is it getting any better?

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I have been in PT for two months and pain is a lot better. I would wake with throbbing pain at night. I feel like I have less lateral rib pain. But when you look at me you can see my right shoulder is now anterior to my left. Range of motion has improved but is not back to full. My PT provider and PMR doc are terrific. Radiation as my therapist said fried the “ “ of my pectoralis muscle!! Thanks for your rapid reply!!

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I just started volunteering on here and I am not too good yet but I have breast cancer experience, and I care. I know that some fried muscles is not that uncommon with radiation. I am glad you reached out, and was scheduled into PT quickly. It sounds like you are a pretty active person. What kind of radiation, how many treatments did you have? Did you have any other side effects?

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Oh boy you hit the mark! I had double mastectomy. And while I believe I had the best of care & doctors, somehow this was left out. Excruciating pain when trying to lift my arm. Couldn’t open my arm straight. I was still seeing my dr every week so I told her. She immediately had me signed up for therapy. I had 3 nodes removed, so I learned it was expected from a protocol, just got overlooked. I reread all my notebook I was given and nothing! I am still feeling some pain but the cording popping was a lifesaver. Knowing to wear compression sleeve and glove when traveling is comfort too. My pain did go down my chest and ribs. And still does when I really stretch. It’s still there, but I am aware what the pain is and try to stretch it out 2 years later.
I wrote to the head of the department to let him know that although they helped me, I would have appreciated knowing beforehand.
One aspect I’m sure of; they tried very hard not to overwhelm cancer treatment patients. I wanted to know everything. They instead took me a step at a time. I knew radiation was coming, but they kept me in the present. It was a good thing, bc my symptoms overwhelmed me many times. For example, my tongue kept swelling up. I even made a microfiber little tongue ‘pillowcase’ to keep it away from my teeth. I can laugh about it now. I thought I had a great new invention. That’s how wrapped up we become. But it still would have been better to know what was happening w my arm before it happened. Best I can offer is to write and let them know to include it in their ‘what you should know’ notebook.

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@auntieoakley

I just started volunteering on here and I am not too good yet but I have breast cancer experience, and I care. I know that some fried muscles is not that uncommon with radiation. I am glad you reached out, and was scheduled into PT quickly. It sounds like you are a pretty active person. What kind of radiation, how many treatments did you have? Did you have any other side effects?

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For me it was due to the lymph nodes being removed. They started drying up in my arm. Like a blood vessel or ligament. I’m not sure radiation was addtl cause. I will look that up. It was pain I hope never to have again!

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@cedar75 @happy2bhear @auntieoakley, you may also be interested in this discussion that @roch started a while back.
Cording / Axillary Web Syndrome (AWS) https://connect.mayoclinic.org/discussion/cording-axillary-web-syndrome-aws/

@sparklegram @trixie1313 @dmpill offer tips on stretching and exercises.

What stretching exercises have helped you?

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@auntieoakley

I just started volunteering on here and I am not too good yet but I have breast cancer experience, and I care. I know that some fried muscles is not that uncommon with radiation. I am glad you reached out, and was scheduled into PT quickly. It sounds like you are a pretty active person. What kind of radiation, how many treatments did you have? Did you have any other side effects?

Jump to this post

I had whole breast with bursts over the tumor area. Probably did not help that my tumor was very close to my pectoralis muscle. My skin issues were
minimal. I have some areas of skin with loss of sensation. I did have nausea that started on last two days or radiation and lasted for 3 weeks. I also developed acid reflux. The latter has now waned but nausea continues which now maybe more related to chemo.

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@happy2bhear

Oh boy you hit the mark! I had double mastectomy. And while I believe I had the best of care & doctors, somehow this was left out. Excruciating pain when trying to lift my arm. Couldn’t open my arm straight. I was still seeing my dr every week so I told her. She immediately had me signed up for therapy. I had 3 nodes removed, so I learned it was expected from a protocol, just got overlooked. I reread all my notebook I was given and nothing! I am still feeling some pain but the cording popping was a lifesaver. Knowing to wear compression sleeve and glove when traveling is comfort too. My pain did go down my chest and ribs. And still does when I really stretch. It’s still there, but I am aware what the pain is and try to stretch it out 2 years later.
I wrote to the head of the department to let him know that although they helped me, I would have appreciated knowing beforehand.
One aspect I’m sure of; they tried very hard not to overwhelm cancer treatment patients. I wanted to know everything. They instead took me a step at a time. I knew radiation was coming, but they kept me in the present. It was a good thing, bc my symptoms overwhelmed me many times. For example, my tongue kept swelling up. I even made a microfiber little tongue ‘pillowcase’ to keep it away from my teeth. I can laugh about it now. I thought I had a great new invention. That’s how wrapped up we become. But it still would have been better to know what was happening w my arm before it happened. Best I can offer is to write and let them know to include it in their ‘what you should know’ notebook.

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I have reached out to providers. I find it ironic that some of my friends not Mayo patients who have breast cancer were automatically referred to PT/PMR before surgery and after radiation. It did not matter what type of surgery or radiation. It was just standard practice. The PMR folks will reel you they would like to see you before interventions so they can get baseline measurements and provide education and pre and post therapy suggestions.

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This all is an eye opener. I'm scheduled for a lumpectomy next week and have asked doctors what to expect without much information. I live alone and have a big dog to care for, so it's important for me to know what to expect. Tell me what cord popping is?

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@cedar75

I had whole breast with bursts over the tumor area. Probably did not help that my tumor was very close to my pectoralis muscle. My skin issues were
minimal. I have some areas of skin with loss of sensation. I did have nausea that started on last two days or radiation and lasted for 3 weeks. I also developed acid reflux. The latter has now waned but nausea continues which now maybe more related to chemo.

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I will make a quick joke: ur probably nauseous bc you now have time to reflect on what you just went through. Seriously, I lost feeling under my arm, armpit and down a bit. It is still like that, maybe slightly better. Acid reflux, quick diarrhea, everything at once. But I will say I was and am more optimistic than unhappy. I’m alive, relatively healthy, hair has come back. So doctors being off a bit is a very small complaint.

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@kjn

This all is an eye opener. I'm scheduled for a lumpectomy next week and have asked doctors what to expect without much information. I live alone and have a big dog to care for, so it's important for me to know what to expect. Tell me what cord popping is?

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Fun fun! When lymph nodes dry out they shrink. That’s what causes pain. Therapists will take your arm and slowly massage and stretch your skin. You may or may not hear a little pop. It’s breaking those shrunken vein like structures between the lymph node in your underarm going down to your hand. It is a bit of a workout but feels so much better. They won’t do all at one time. And tell you to raise arm and lean into it like on a door. You press w your palm high above your head. But if your nodes are affected, you won’t be able to do it all. A little each day.

First though is your surgery. Then a good month or so not lifting even 5 lbs. maybe less for you. So even if they take a node, you won’t do anything for a couple months. If there’s no cancer, they won’t touch them.

But you’re right, it’s good to know. I believe one reason I wasn’t told is they thought my limp was smaller. When the surgeon got in she found it was bigger, and sent a biopsy of a node right then. It came back positive, so she had to take 3. I went from simple maybe no chemo to double, nipple, node radiation. But again I went with it. Nothing fazed me. Just went through the motions and got through.
I will say, I am hearing impaired. I had a beagle who came with me and slept on my chair/bed. She made it to my last radiation day and was time to head to rainbow bridge w kidney cancer. She was a great help to me.

I don’t think doctors keep info from us on purpose. They just do their best for you and are human too.

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