urethral/bladder pain following chemo

[Geeba]

B.C. patient having continous pain in urethra & bladder that began with 1st round of chemo. My ? is, can chemo cause an inflamation of the urethra that is permamnent? I am a 58 yr. old female, had partial mastectomy 11 mo. ago, adriamycin, cytoxan chemo every 2 weeks 4 rounds, 33 rads, 9 Herceptin infusions (every21 days) that I have stopped & am struggling with whether to continue.They want a full year.(have had 7 months) Have had Ext. & int. ultrasounds of entire pelvic region& kidneys, dozens of urine & blood tests, biopsies of uterus & a cervical polyp, all negative, then finally a cysto that showed irritation/inflamation of urethra & bladder, but still not testing positive for infection.Have no discharge or itching, just pain.Was put on presc."just in case it is an infection that is not showing up on tests", Cipro,Zithromax,Doxycycline,(1 at a time)did not help, & Detrol which helped a little with night time frequency & slight diff. in level of pain.Pain is constant & is much worse after each treatment.During AC had nosebleeds, bleeding from urethra , rectum, (not profuse, just small amount) for 3-4 days after each, & mouth sores, definately irritating.as it went thru me. Had invasive ductal carcinoma, 1.5 cent.,stage 1, sentinal node biopsy negative, clear margins, Her2+ER+PR+grade was "between 2&3". In otherwise good health. Pain is affecting QOL. Will it ever go away?Has been 8 months since the AC ended, but feel the Herceptin is irritating & not allowing it to heal? Thank you for any advice.

[Geeba]

Thank you for your posts. I since have had a lower spinal MRI & exrays & they now think that my pain is being caused by a nerve being "compressed" or "pinched" in my spine, from a disc out of line, "spinal stenosis" , nerves that go out from the spine & curve around toward the front & branch out into smaller nerve "roots" that go into these areas that I'm feeling the pain. Looked up on the internet what nerves come out at that level of spine, (4th.& 5th vertebra) & found info on Pudendal nerve entrapment & cried when I read it. Fit my symptoms to a T., so I think we are on the right track now. They are trying me on Lyrica for nerve inflamation (& it is helping a great deal) & I'm sched. to have a spinal epidural injection of steroid next week.May need several more of those. If does not help, then maybe back surgery, but they think these treatments will relieve the pain.Telling me that this thing was probably there for a long time but that the chemo is hard on the body & could have excerbated it or made it worse, but not caused it.  Re-starting me on Herceptin. Also,  got a special foam seat cushion with a cutout in center back,(thru Harriet Carter) that's for people with lower back problems (which I didn't know I had) & that reduces the "pressure" feeling somewhat. Other things that reduce my pain temporarily is sitting on the toilet, pouring 2 gallons of very warm water slowly over the "front "private parts, or standing in a very warm shower bending slightly forward with the water hitting my mid- and lower back, or sitting or laying on a warm (not hot) heating pad on the lower back.   Hope this helps someone.
                                                         Geeba

[Sara22]

Hi ladies,

Have either of you received any relief from your symptoms since you wrote to this List?
If so, I would be interested to know of anything at all that may help.

Thanks,
Sara22

[Sara22]

Hi there,

Well, I'm thankful someone else has been suffering the same symptoms as I have, these past couple of weeks.  I am on Herceptin/Taxol weekly for 12 weeks.  I started first week Herceptin alone, no trouble, then on to the cocktail and I have been suffering pelvic bladder pain, raw is a good word, discomfort pressure in the female area too.  Had Urine tested just in case an infection, but nothing.  Then thought there may be a problem in the vagina, but no itching or discharge.  Saw GP who said take cranberry juice.  Oncologist said may disappear as my treatment goes along.  But it is very disturbing and uncomfortable.
Does anyone have any suggestions as to how to get rid of these symptoms??

[Rosalia2]

Hi, I too am dealing with the samething.. I'm 38yrs old with Breast Cancer. On chemo for 12 weeks once a week then surgery on number 6 now... Treatmenst are with Herceptin and Taxol. I have been suffering with pevic bladder pain for the last two weeks. Raw, discomfort pressure in the female parts, Took Cipro nothing, then Batrum nothing still dealing with the pain- buring.. I wonder if the chemo is killing all the cells or had made it tender in the bladder area?

[bhumi123]

Hi,
The cytoxan could be the cause of the symptoms you mention. You should discuss with your treating physician the option of an alternative drug or stopping cytoxan for some time to see if the symptoms go away. Cytoxan or cyclophosphamide can cause urethritis and the other symptoms you mention. Discuss patiently with your physician the options you have and whether taking you off cyclophosphanide would be a good idea keeping in view the clinical features you have. Herceptin causes other side effects but none amongst the ones you mention. Even adriamycin is known to cause mucositis but that usually involves the gastrointestinal tract and especially the caecum and not the genitourinary tract.