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Rib pain following radiotherapy

Shieldscannylass
Posted by

Could you help please?     Following breast cancer surgery I had 3 weeks of radiotherapy in May which went as well as it could apart from the' roast potato' feeling which after a long time eventually healed  -   am grateful to all the hospital staff for their care and skills.   Just lately though ribs have been hurting, big sharp painful twinges which come out of nowhere.  In the leaflet they gave me after treatment it said this might happen, but nonetheless am curious, what is it that actually happens during the Zaps that causes the ribs to be troublesome?   This would give me a better understanding and peace of mind as am still getting over the very delayed late shock of all that has happened  -  a big thank you in advance.  

Maria  xxx
Kate C - Macmillan
Posted by

Hi

Thanks for your query.  I'm sorry to hear you are getting some pain in your ribs. This is quite common following radiotherapy. A lot of people don't realise that the treatment will catch the ribs, but we need to treat the whole of the chest wall, so that includes the ribs.

The treatment is angled to avoid the lung underneath as much as possible, but that does mean that some of the rib cage is included within the treatment fields. The picture below shows an approximate treatment field.  The black area is lung and the little white oval shapes going along the edge are ribs so you can see that the ribs do get some dose. The white oblong just above the heart is the sternum, and to the right of this will be cartilage which is included within the radiotherapy field. 

The posh name for the rib pain you are getting is 'costochondritis' and people can get it without having had radiotherapy to their breast.  It basically means that the cartilage that sits between your ribs and your sternum has become inflamed and this causes that sudden painful twinge. Radiotherapy causes inflammation of that cartilage and this can still be present months after treatment has finished - that's what will be causing that pain. As cartilage doesn't have a blood supply, it takes a lot longer for that inflammation to go down so it feels like the pain and discomfort is hanging around for  along time. 

It should settle but it's hard to say how long it will take.  Ibuprofen can help with the discomfort (if you can take ibuprofen with no issues).   If it's really causing you some bother, then a course of oral steroids from your GP can reduce the inflammation and help control the discomfort. 

Having these side effects popping up can really make you feel like this is a never ending journey, but things will slowly get better and you won't feel quite so shell-shocked by it.  It's so very common to feel overwhelmed after all the treatment has finished, because you finally have time to get of that rollercoaster and reflect on everything that has happened to you.  Make sure you talk about how you are feeling with your friends and family - recovery from a cancer diagnosis does not stop the minute treatment finishes. Often the emotional impact of your diagnosis can last far longer than the physical effects so it is important that you ask for help if you need it. 

I hope that has given you a little peace of mind about your rib pain. 

My best wishes to you, 

Kate 

Remember you can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or by email.  

Shieldscannylass
Posted by

A big thank you Kate for such a detailed reply, I'm very grateful.    Looking at the treatment picture has given me a better insight as to what is happening 'inside' and I feel a some weight has been lifted off my shoulders.   As I have few friends (hubby distant, helps with house chores to be fair but sharing medical stuff makes him a bit uncomfortable tbh) and family live hundreds of miles away and not seen for years its been a lonely journey on top of the diagnosis etc but all hospital staff were brilliant  :)    You've taken the time to give a comprehensive warm reply - hugs and thanks again.    

Maria  xxx
Leolady56
Posted by

Kate

Sorry tagging not playing fair tonight

 I’ve been awaiting this reply and also thank you for such an amazing and comprehensive reply . I had 15 RT doses and 5 deeper RT’s . I literally have a place I can press and it relieves the pain. I now realise what this is due to your reply to 

Also as a Champ I can now pass on this info. If you have a good link to any info I’d be grateful . As BC ladies obviously RT hits this area

Many thanks

Leolady56

Life is like a boxing match, defeat is declared not when you fall ..... But when you refuse to stand up again ....... So, I get knocked down but I get up again. x

Kate C - Macmillan
Posted by

Hi

I'm glad to be of help. It can be a very lonely time going through treatment especially when your family is a long way away. A lot of men are uncomfortable with discussing 'hospital stuff' and they want to shy away from the reality that you're going through this to begin with.  Not helpful for you, but quite a common coping strategy for chaps!  That's why the community boards are  a fantastic place - I really hope you are finding friendship and support through using them.  Breast Cancer Care also have forums you can join for some extra support, and Facebook has all kinds of supportive breast cancer groups. 

Best wishes, 

Kate

Remember you can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or by email.