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My husband has a pain that is dull but does sometimes become…

My husband has a...

My husband has a pain that is dull but does sometimes become acute in the back center area of the pelvis in the area of the anal cavity but not in it or at the cavity. He had prostate removal in 2001. His surgeon that performed it is no longer available and he is going to a different one who says he has cancer again somewhere in his body. He has had bone scans, untrasounds, has gone to a spine specialist who performed a MRI of the lower potion where the pain is, another colonoscopy, saw an oncologist, the bone scan was a nuclear one and showed that the cancer has not mestatisided (cancer only shows up in the PSA, last test showed around 7)takes naproxen, tylenol, ibruprofen, but nothing seems to help and he does not want to take an opioid because he is still working for the dept of homeland security at the fletc campus in Artesia NM. He is 68, weighs 145. We need help and need to know if coming to your clinic might help and if so is there one close to us. We are in the south eastern part of New Mexico. I thank you very much for any help,any suggestions you can give us. Sincerely ***** ***** for Jerry Eickhoff

Doctor's Assistant: Are you keeping a personal medical record while dealing with this?

Blood tests, results of all other tests are with the doctor

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

We have tried to remember everything and shared a lot with all the doctors we have seen

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Answered in 7 minutes by:
3/17/2018
Connie Pennington
Category: Medical
Satisfied Customers: 668
Experience: Colorectal Surgeon at Colon & Rectal Surgery Consutants, PC
Verified

Hi, my name is***** am not sure I can help, but I will try.

Did your husband have any radiation therapy to the pelvis?

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Customer reply replied 4 months ago
We can't remember exactly how many but we believe that it was in the early part of 2005 he had radiation therapy for approx 8 weeks, 5 per week because the PSA had stated to go up and that was with the original doctor who performed the prostate surgery

OK, great, radiation can itself cause some scar tissue that can cause pain syndromes.

He could have what is called "Levator Syndrome"

I am glad he had a colonoscopy.

Did they do a PET scan?

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Customer reply replied 4 months ago
they did a PET scan

Did it show where the cancer was?

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Customer reply replied 4 months ago
No

OK, good. So basically the only indication of cancer is the PSA. Is that correct?

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Customer reply replied 4 months ago
That is correct the PSA has been increasing for the last year and a half, if and when it doubles Dr Wenner wants to run another bone scan. For now we are just monitoring the PSA every 3 to 6 months. He goes back to Dr Wenner June 20 this year and will have another PSA before he goes

An article I found calls this a late chemical recurrence, meaning chemical only, no actual recurrence. The page:

https://www.hopkinsmedicine.org/brady-urology-institute/specialties/conditions-and-treatments/prostate-cancer/prostate-cancer-questions/can-i-stop-psa-testing-10-years-after-radical-prostatectomy

Ok, well now lets address the pain.

When did the pain start? Do bowel movements make it worse or better? Does it ever wake him up at night?

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Customer reply replied 4 months ago
The pain started June 6, 2017. I took him to the ER at Eastern New Mexico Medical Center. Bowel movements--sometimes he thinks it feels better after one and it may just be the position sitting on the potty, and yes it does wake him up at night. The pain is not constant. He may go a week and the pain for a few days, or have pain for one or two days and then goes away for awhile. It does not seem to follow a pattern.
Customer reply replied 4 months ago
i meant to add after go a week without pain and then have pain for a few days

OK, this is a good description of something we call Levator Syndrome. (I am a colorectal surgeon).

Levator Syndrome is a syndrome of pelvic floor muscle spasm. It can happen for a variety of reasons, and is sporadic and atypical. It has more to do with a history of radiation than any type of cancer.

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Customer reply replied 4 months ago
Thank you, It is nice to have someone give us at least the probability of the problem and if possible tell us what might help his pain

Levator Syndrome is also sometimes called non-relaxing puborectalis. Muscle spasm responds best to sitting in hot water. Hot water relaxes muscles. Often it is so sharp and temporary that once you run a hot water bath, it has subsided.

Some people use muscle relaxers (like Robaxin) and pain clinics will even sometimes inject Botox to relax the muscle.

I find deep breathing exercises, relaxation exercises, yoga, meditation, etc to be quite helpful. These things tend to happen to "Type A personalities" who can't quite slow down. It's the body's way of saying slow down, if that makes any sense.

I also check a complete vitamin panel, because low B vitamins, anti-oxidant vitamins, and Magnesium can trigger these things as well. He should be on good supplements.

I hope this helps! Feel free to ask anything else.

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Customer reply replied 4 months ago
Thank you, ***** ***** drink pomegranate juice, broccoli, cauilflower, drinks hot green tea, a lot of things that we look up and check our and our beautiful daughter -in-law (more like a daugher) researches and helps very much. Robaxin is not an opioid is it? Are there any available over counter or is it a prescription, we go to our primary care doctor the end of April.

Robaxin is a prescription non-opioid muscle relaxer. Add a turmeric supplement as well, it helps with pain. I am glad you have awesome support. I really hope this helps. I am sorry he is having such a time.

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Customer reply replied 4 months ago
Thank you very much, If I have further questions can I address them directly to you or whoever is taking calls at that time?.

You are welcome. You can send a request directly to me, or post it for the first professional available. If this was helpful, a 5 star rating would be appreciated. I wish I could do more for your husband!

Connie Pennington
Category: Medical
Satisfied Customers: 668
Experience: Colorectal Surgeon at Colon & Rectal Surgery Consutants, PC
Verified
Connie Pennington and 87 other Medical Specialists are ready to help you
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Customer reply replied 4 months ago
Thank you for your concern.. Thank you for your help, suggestions and interest. This has been a very enjoyable, informative, helpful conversation. YOu have helped me very much and also my husband. I will keep you informed. To let you know I am giving you the excellent 5 star rating. I don't really have the words to express my thanks but I do thank you for your caring. You remind me of our wonderful Nurse Practioner Carol Kaydahzinne and very good friend who was our primary care doctor and she died of cancer 2 years ago. Love, hugs, and prayers, Joy Eickhoff
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