Frequently I am asked how I feel, my usual response is good, and for the most part I do feel good living my new normal. The pain is constant, and despite being for the most part greater than ten on a scale of one to ten I often work through it or just carry on with it. It’s a persistent pain that never goes away; at times worse than others; jaw cringing, sharp and bone pain. One can imagine how frustrating it really can be. It is after all my new normal, and I have always been determined not to let MBC keep me from doing anything, instead I keep going. I joke I should own stock in Aleve, I take it enough but it never really works, a little relief I guess but pain is never a zero. I would love it to be but that’s not reality. I read an article recently regarding bone pain related to mets, “No matter how pain behaves, it is the most common complaint of people with bone metastasis, says Julie Fasano, MD, medical oncologist with Memorial Sloan-Kettering Cancer Center’s Commack Facility in Long Island, N.Y. In fact, 70% of people with bone metastases, or “mets,” have bone pain.” So it is my normal and I just have learned to live with it. I am not naive to think I will have zero pain, but an acceptable and manageable level is my goal. Something that I have always found most helpful in managing anxiety and stress is a good workout, so I still push through pain to maintain that part of my life. Pain is a reminder I am living with breast cancer, and new pain or worsening pain is scary. Any new pain triggers anxiety, and worry that my cancer has spread, it’s hard not to think like that. There are times when I wonder if I am losing my mind, am I over thinking the pain. I figure if maybe I ignore the pain then it will go away, but that unfortunately isn’t the case. I try many things to relieve pain, from heating pad to acupuncture, and yes hard to believe but I do rest when I feel like I need too. My husband Matt frequently reminds me as does my friend Laura that I need to rest; that for me is hard in my mind I know I need it but I have never been one to take it easy. It is a battle and I often find myself fighting not to let MBC slow me down but the reality is I need to take care of me, and everything I can control to continue to fight.
So how do you know if it’s cancer pain? One difference is that cancer pain persists while other types of pain are more likely to come and go. Despite my scans every three months, it is important to get any new or changing pain checked out, honestly to put my mind at ease I would get scans every week but that’s not realistic nor is it recommended, and my oncologist would never agree to it, trust me I try to bargain with her. The anxiety of not knowing what the pain is can be very stressful. In the past I had ongoing hip pain; I still do but did complete some radiation therapy to that area that has given me some relief. There are plenty of options to manage pain; simple pain medications to orthopedic procedures to radiation therapy, a wide range of options can help control pain. My fear is that the pain is a sign of worsening disease, and that at some point stronger more aggressive chemotherapy will be the best option to reel in the cancer and regain control. I’m on an oral chemo medication pill now and have been for months. It allows me to fight cancer but still live my life. The more aggressive intravenous chemo is hard to continue to live normally while being treated. I listened to Dr. Julie Gralow speak at a convention I went to in Philadelphia, “it is always important to get the disease under control with whole-body therapies. “This might include chemotherapy, hormone therapy, or other cancer treatments.” I do know at some point additional more aggressive chemo will be part of my fight, I just hope that some pain relief from other options will be effective; I worry and fear new pain means the cancer has spread, it is an daily battle to not think worst case scenario and think positively. No matter what I will not give up.