Pain Experienced and Resolved, but Quadramet Was Not Needed

RB's experience follows.

I have what I would call a cautionary experience with Quadramet (Sm-153).

In the spring of 2000, I started experiencing severe pain in my right leg, with the apparent locus in the calf, although the pain radiated from my thigh down to the calf. Interestingly, I could massage the pain loci vigorously with absolutely no increased pain--it didn't hurt to touch the sore spots! The pain became progressively more severe, until, in June, I was walking on crutches.

My radiologist daughter-in-law got after me, saying we need to find out what is happening and fix it.

By that time I was miserable with pain, maybe level 6-8.

I went into the hospital to attack the pain and get some scans to identify the problem. My ASSUMPTION at that moment was that I was experiencing pain as DIRECT side effect of the cancer. I BELIEVED that, somehow, the bone metastases were hurting. This ASSUMPTION was slightly off, resulting in the WRONG treatment.

Step one was the administration of some of the lesser opiates, which had no significant effect. By that time I was flat on my back with no thoughts other than the pain. Next came the shot of Quadramet to suppress bone pain; it had no significant effect. Next came the morphine, which seemed to have only minimal effect. We ramped up the morphine to the point at which it was driving me out of my mind, but it eventually did suppress the pain. The psychological effects of the morphine, however, were--to my thinking--even worse than the pain. So we left the hospital after about 5 days, went home, and discontinued the morphine cold turkey.

The pain had been palliated, but not eliminated.

By that time we also had the scans back, and the source of the pain was clear. Metastases had extended into my lumbar vertebrae and caused stenosis(blockage) of the foramen (channel) conducting the offshoot from the spinal column down my right leg. The metastasis was compressing the nerve in my spine causing pain in my leg!

The pain stayed. I decided to go for surgery to clean out the stenosis. I went in to the hospital on crutches and, 5 days later, walked out normally. Cleaning out the stenosis was the answer. The painkillers and the Quadramet had been the wrong (?) tx's.