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Tuesday, November 30, 2021

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    Unrelenting back pain was a red flag symptom of cancer return

    Dear Dr. Roach: My father died two years ago at age 73. For about six months, he had been experiencing excruciating back pain, which surgery didn’t help. A few years earlier, he had been treated for bladder cancer. He was due to have a follow-up appointment with his cancer specialist but didn’t because he was overwhelmed with the back pain and didn’t want to think about cancer, too. Well, eventually he ended up in the hospital, and it was found that cancer had spread throughout his body. He died a month later.

    My question is whether his back pain was a symptom of the cancer. Should back specialists be alert to the possibility of cancer if their standard treatments don’t work? Should people with severe back pain be proactive and ask for further tests?

    I’m guessing that if his back specialist had been more alert, he would not have had to suffer in pain for so long, nor would his cancer have been allowed to progress beyond treatment. If that’s true, then other doctors (and other patients) need to learn from his death.

    — S.L.

    Dear S.L.: I am very sorry about your father.

    New onset of severe back pain in any person with a history of cancer, especially recent cancer, is a very concerning symptom and requires urgent evaluation.

    Bladder cancer has a propensity to spread to bones, along with lung, kidney, breast, prostate, thyroid and others. These should lead the doctor – whether primary care or specialist — to be alert to the possibility of the bone pain being due to cancer.

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