Should we have been aware of long term radiation damage after mom's surgery?

1 answer | Last updated: Sep 19, 2016
Lollyrs asked...

My mum had breast cancer in 1978. She was given radiation treatment after the operation which left purple burn marks on a wide area on her chest and back and arm 8 years ago she had further surgery for carpel tunnel as she was experiencing pain and pins and needles in her left hand. (Her breast removal was the left hand side and the lymph nodes were also removed ) The carpel tunnel wasnt successful and she has had a great deterioation over the last 3 years with the loss of use of the arm and still having to deal with pins and needles and swelling and itchyness of the lower left arm. Recnetly she had tests for a possible nerve block operation but the surgeon who did the mri scan and a nerve test said that the damage to the nerves in her arm were likely to be from the radiation in the 70's. Mum now has very limited use of her arm and physio wont help because of the nerve damage, Is this something we shoul dhave been aware of, and is there nothing that can be done to reduce the swelling in the arm ?

Many thanks for any help you can give even if its only an outline and a point in the right direction for where to go next

Lorraine


Expert Answers

Andrew Putnam, M.D. is a Palliative Care physician at Smilow Cancer Center at Yale New Haven Hospital and Yale University.

I am so sorry that your mum is having such a hard time with the side effects of the various treatments for her breast cancer. While some of this may be nerve damage due to radiation, it also sounds like some of this is likely lymphedema due to the surgery that removed the breast and the lymph nodes on the left. The lymph nodes and the rest of the lymphatic system help the veins remove fluid from the body and bring it back toward the heart. When the system is disturbed, fluid will often build up in the affected arm (in this case) and lead to pain and itchiness and is very hard to treat. It sounds much worse with the nerve damage.

There are two avenues that might help. Some physical therapy groups have lymphedema specialists who might be able to help with the swelling in the arm. There is no magic bullet and it involves wrapping and trying to keep the arm smaller by tight wrapping. The other possible avenue would be medicines to help with the pain from the nerve damage. These would include gabapentin (Neurontin) or pregabbalin (Lyrica). They often help with this pain more than opioids like morphine do. My hope would be that the lymphedema specialist would be able to reduce the swelling that would also reduce the pain.