How can we keep Mom comfortable and relieve bone pain?

A fellow caregiver asked...

How can we help mom relieve her bone pain from cancer? My mother is in stage 4 breast cancer and it has now spread to her bones and liver. She is in a lot of pain and taking pain medication. What else can she do to help the bone pain she feels? Also, how long with the spread of the cancer to her liver can one expect? She is still doing bone pain treatments, has a healthy diet, but has decided against chemo and I respect her decision. What can I recommend to her for diet? She does seem not to eat as much as she did before. Last, she is having trouble have a bowel movement. Can she take anything for that or is it the liver?

Expert Answer

Bonnie Bajorek Daneker is author and creator of the The Compassionate Caregiver's Series, which includes "The Compassionate Caregiver's Guide to Caring for Someone with Cancer," "The Journey of Grief," "Handbook on Hospice and Palliative Care," and other titles on cancer diagnosis and end of life. She speaks regularly at cancer research and support functions, including PANCAN and Cancer Survivor's Network. She is a former member of the Executive Committee of the CSN at St. Joseph's Hospital of Atlanta and the Georgia Chapter of the Lymphoma Research Foundation.

You ask a lot of good questions. Let's take them one at a time.

We use our bones with nearly every movement (including breathing and eating). With osteosarcoma, pain can be highly magnified and, unfortunately, usually increases with time as the cancer advances. Because this pain usually comes from inside the bone, there is little besides pain medicines that are given to help it subside. However, depending on her age and agility, you may want to encourage her to exercise slowly and gently (as with yoga or walking) and to soak in a warm bath afterwards. Some patients also find relief with meditation or hynotherapy.

But back to pain medicine -- One of the downsides of pain medicine is the cause of constipation, or inability to have a bowel movement. Be sure to keep her hydrated with plenty of liquids, such as water, broth, sports drinks and juice. My father's oncologist recommended prune juice as a natural way to work the waste through the system.

In terms of survival, the median rate with Stage IV is 20% at 5 years from diagnosis, but you need to directly ask her oncologist for the prognosis, especially without chemotherapy.

In terms of a diet, understand that she will probably want less and less food as time goes on, and she will likely lose weight. One of the terrible characteristics of cancer is that it robs the rest of the body of nutrients to help the tumor grow. You'll want to encourage her to eat small meals when she can. Try nutritional supplements or drinks (like Ensure and fruit smoothies), and flavorful, light meals without a lot of red meat or dairy, and if she's still having trouble with constipation,  go light on the fiber.

Good luck.