Pump for pain? MRI vs. C.T. Scan?

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kpjpmom
Posts: 197
Joined: Sat Nov 26, 2011 10:27 pm

Pump for pain? MRI vs. C.T. Scan?

Postby kpjpmom » Tue Feb 23, 2016 7:55 pm

Hi everyone,
I am exploring the option for a pump to be placed in my abdomen with catheters that would carry the med's to an area in my spine. I have cc in my bone that is in the sacrum. My pain Doctor believes this will help my pain which has ramped up in the last two weeks. I had a C.T. Done that came back negative for growth. I am holding steady. My CEA was really high, was 839 three weeks ago and now1207 :evil:
. Has anyone had one of these devices implanted and how did it work for pain management? Also, a question about MRI vs. C.T. Which is better for following mets?
Once the pump is placed, I will not be able to get MRI.
Thanks for your help!
Kpjpmom
DX March 2011 stg 3 cc
Kidney cancer May 2011
Folfox 6months (12 rnds)
It's Back! October 2012 colon resection, kidney removed.FOLFIRI/Erbitux starts Jan.2013
Completed FOLFIRI June 2013, Erbitux continues
March 2015 Met to spine. Radiation 15 treatments
Folfri, 5fu dropped after 3x, Erbitux and Iri continued CEA rising. Moved to
Folfox, Xeloda,Avastin until Feb. 2016 oxilap. Neuropathy returns.
Xeloda,Avastin continues.

midlifemom
Posts: 1358
Joined: Wed Jan 15, 2014 10:58 am
Location: NJ

Re: Pump for pain? MRI vs. C.T. Scan?

Postby midlifemom » Wed Feb 24, 2016 7:53 pm

Bump
Stage 3 cc - dx Jan '14 age 53, cea 2.9
t2n2m0, KRAS mutant, MSS
Folfox Feb - Aug '14
Nov '14 cea 27.7 -2 liver masses
Dec '14 left lobectomy and HAI
Jan '15 FUDR and FOLFIRI
Aug '15 fudr done, liver clear, add avastin for lungs. Cea 4.3
Feb '16 CEA rising
May '16 2 wk break then drop Iri for 6 weeks.
Jul '16 cancer grew, constricted main bile duct. Stent inserted. On break till jaundice clears. CEA climbing. Doing reduced Folfox. Allergic to Oxali.
Sep'16 chemo failed. Trial or hospice?

Nik Colon

Re: Pump for pain? MRI vs. C.T. Scan?

Postby Nik Colon » Wed Feb 24, 2016 11:10 pm

I would ask your doctor about your concerns. The only time I had my 2 MRIs done were to get a better look at my liver.

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dianetavegia
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Joined: Sat May 16, 2009 8:47 pm
Facebook Username: Diane Weldy Tavegia
Location: Villa Rica, Georgia

Re: Pump for pain? MRI vs. C.T. Scan?

Postby dianetavegia » Fri Feb 26, 2016 12:38 pm

I don't remember John's username. He and his partner both posted and it's been a number of years since his passing, but John had a pain pump put in when the pain in his sacral / pelvic area became unbearable. It gave them many more months to enjoy friends, cook outs, etc.

MRI's are good for watching for mets in the liver/ abdominal area and CT is good for watching for lung mets. You cannot have metal implants and have an MRI.

CEA readings are more indicative of liver than lung concerns. I honestly don't know about the bone mets and CEA.
Stage III cc surgery 1/7/09. 12 tx FOLFOX
Stage IV PET = 1.5cm liver met. HR 4/11/12

11 years since dx and 7 3/4 years post liver resection.
Pronounced CURED and discharged by onc

“O Lord my God, I cried out to You, And You healed me.” Psalms 30:2

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CRguy
Posts: 10285
Joined: Sun Feb 10, 2008 6:00 pm

Re: Pump for pain? MRI vs. C.T. Scan?

Postby CRguy » Fri Feb 26, 2016 1:46 pm

Diane a couple of your comments are a bit misleading / incomplete :

MRI : you cannot have FERROMAGNETIC metals in your body ( iron containing, steel etc. ) which can be magnetized by the fields and get ripped ouuta' you !
You CAN have NON-ferromagnetic metals like surgical titanium, which I have in my resection staples and had in the frame/hub of my power port when I had 2 MRIs without any issues. The MRI techs should ask you and your Docs should know what IS and what is not allowed so patients need to be proactive and check things out for themselves with their own doctors.

Which is better MRI or CT ? depends upon who is looking for what, where. There is no one best imaging modality but most Onc and Rads like CTs with IV contrast for general followups of CAP, and then go to other things as needed
( PET, MRI, U/Sounds, X-rays etc. )
I have had all of these depending upon what we were looking for and where.

CEA : always an enigma !
CEA needs to be a marker for you so if it is not it won't matter where a problem is … it won't be indicative.
CEA is generally MORE responsive to any inflammation in the body and is especially so in the lungs !!!! which is why folks with a chest cold or smokers will have HIGHER CEAs than normal and it may not mean anything in terms of CRC follow up.
Alkaline phosphatase would likely be monitored with concerns of bone mets.

kpjpmom
I have only had experience with external automatic and PCA pain pumps which work kind of the same as internal. Depending upon which meds are used, they should in fact get you to a better level of comfort for sure. I know opiates, neuromodulators and local anesthetics can be used alone and in combination for great effect. Think of it as a continuous IV of pain meds delivered to a specific site in higher levels locally than you would get from general IV or oral medication. The option here is to act at the level of where the pain is generated and on the nerves which transmit the pain impulses, so you can also still add systemic medication if that is needed to control pain at the level of the brain receptors. It is called multimodal analgesia and attacks the problem form a number of areas.

Sending you MEGA POSI ++++++ Vibes you get more comfortable ASAP.

Cheers and Harmony
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
14 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

midlifemom
Posts: 1358
Joined: Wed Jan 15, 2014 10:58 am
Location: NJ

Re: Pump for pain? MRI vs. C.T. Scan?

Postby midlifemom » Fri Feb 26, 2016 1:56 pm

CRguy wrote:Alkaline phosphatase would likely be monitored with concerns of bone mets

CRguy


CRguy,
Can you explain, what is relationship between alkaline phosphatase and bone mets?
Stage 3 cc - dx Jan '14 age 53, cea 2.9
t2n2m0, KRAS mutant, MSS
Folfox Feb - Aug '14
Nov '14 cea 27.7 -2 liver masses
Dec '14 left lobectomy and HAI
Jan '15 FUDR and FOLFIRI
Aug '15 fudr done, liver clear, add avastin for lungs. Cea 4.3
Feb '16 CEA rising
May '16 2 wk break then drop Iri for 6 weeks.
Jul '16 cancer grew, constricted main bile duct. Stent inserted. On break till jaundice clears. CEA climbing. Doing reduced Folfox. Allergic to Oxali.
Sep'16 chemo failed. Trial or hospice?

User avatar
CRguy
Posts: 10285
Joined: Sun Feb 10, 2008 6:00 pm

Re: Pump for pain? MRI vs. C.T. Scan?

Postby CRguy » Fri Feb 26, 2016 2:15 pm

Alk Phos has a couple of isozymes ( versions of the molecule) which are produced in different areas. Liver and bone are 2 major areas they are used for. When bone is actively being destroyed and / produced by normal or abnormal means, the enzyme levels go up accordingly. The docs need to figure out with other evidence if they are dealing with bone mets and then use the AlkP as one tool.

Normal lab values will indicate average adult "resting" metabolism of bone and liver. If either / both areas are affected the AlkP may be up so they'll check isozyme, if it is bone they'll do different scans which we have not talked about here but any of CT, MRI, bone scan, PET could be used.

growing children/teens, post surgery bone fracture patients, post liver resection patients etc. may also have elevated AlkP as that enzyme will be active during repair and maintanence of the healing state as well as during ongoing "damage" from any of a number of causes

( seems to me I recall the placenta also produces higher levels of one AlkP isozyme … sorry just going from memory here :shock: )

HTH
Cheers
CR
Caregiver x 4
Stage IV A rectal cancer/lung met
14 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

midlifemom
Posts: 1358
Joined: Wed Jan 15, 2014 10:58 am
Location: NJ

Re: Pump for pain? MRI vs. C.T. Scan?

Postby midlifemom » Fri Feb 26, 2016 2:52 pm

Thanks CRguy, very helpful.
Stage 3 cc - dx Jan '14 age 53, cea 2.9
t2n2m0, KRAS mutant, MSS
Folfox Feb - Aug '14
Nov '14 cea 27.7 -2 liver masses
Dec '14 left lobectomy and HAI
Jan '15 FUDR and FOLFIRI
Aug '15 fudr done, liver clear, add avastin for lungs. Cea 4.3
Feb '16 CEA rising
May '16 2 wk break then drop Iri for 6 weeks.
Jul '16 cancer grew, constricted main bile duct. Stent inserted. On break till jaundice clears. CEA climbing. Doing reduced Folfox. Allergic to Oxali.
Sep'16 chemo failed. Trial or hospice?

kpjpmom
Posts: 197
Joined: Sat Nov 26, 2011 10:27 pm

Re: Pump for pain? MRI vs. C.T. Scan?

Postby kpjpmom » Fri Feb 26, 2016 5:27 pm

Thank you for your responses and help. I have decided that I will get the pump. I cannot have the surgery until the Avastin has cleared my body. I am in so much pain. I hope the medication/pump works.

Kpjpmom
DX March 2011 stg 3 cc
Kidney cancer May 2011
Folfox 6months (12 rnds)
It's Back! October 2012 colon resection, kidney removed.FOLFIRI/Erbitux starts Jan.2013
Completed FOLFIRI June 2013, Erbitux continues
March 2015 Met to spine. Radiation 15 treatments
Folfri, 5fu dropped after 3x, Erbitux and Iri continued CEA rising. Moved to
Folfox, Xeloda,Avastin until Feb. 2016 oxilap. Neuropathy returns.
Xeloda,Avastin continues.

eleven11
Posts: 130
Joined: Tue Sep 16, 2014 12:48 pm
Location: Chicago

Re: Pump for pain? MRI vs. C.T. Scan?

Postby eleven11 » Fri Feb 26, 2016 8:01 pm

I am very familiar with pain pumps especially if it isolated to one area of your body (good friend of mine is a pain physician). Certain pain pump companies (Medronic) are MRI/CT compatible, you may just have to have your pain doctor see you after your MRI. The data is very good with the pain pump for cancer related pain. One of the big benefits you have is that there is usually a trial to make sure you benefit well without any side-effects.
11/11 Mom dx @ age 50 T3M0N0
2012 12 tx FOLFOX
12/13 2 lung nodules
1/14 VATS wedge
3/14-present 5FU
4/15 Lobectomy RML

kpjpmom
Posts: 197
Joined: Sat Nov 26, 2011 10:27 pm

Re: Pump for pain? MRI vs. C.T. Scan?

Postby kpjpmom » Sat Feb 27, 2016 5:54 pm

I have done my pain trial and had no side effects. I have to wait to see if my insurance will cover placement. I hope so since I have been in constant pain since rhe trial on Feb. 11th.Thanks for all thu excellent information.
Kpjpmom
DX March 2011 stg 3 cc
Kidney cancer May 2011
Folfox 6months (12 rnds)
It's Back! October 2012 colon resection, kidney removed.FOLFIRI/Erbitux starts Jan.2013
Completed FOLFIRI June 2013, Erbitux continues
March 2015 Met to spine. Radiation 15 treatments
Folfri, 5fu dropped after 3x, Erbitux and Iri continued CEA rising. Moved to
Folfox, Xeloda,Avastin until Feb. 2016 oxilap. Neuropathy returns.
Xeloda,Avastin continues.


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