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Bone Pain

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Hello wonder if you can give me advise ,I have been on Dasatinib for 2 weeks ,apart from headaches the side effects have been ok until the 3 days ago ,I have had pain in my left hip going down my left leg really strong pain too, I had a hip replacement some 6 years ago with no issues ,I was diagnosed with CML 2 years ago but was taken off Imatinib as I said 2 weeks ago.

Wondered if this could be a side affect or the replacement hip having a issue with these tablets, could do with some advise because this is very painful and not sure how much longer I can put up with this.

 

Regards Garry Walker-Eyles

Hi Gary and welcome,

I am not sure that changing TKI from imatinib to dasatinib would effect your replacement hip. TKIs work in a very selective way and only target the abnormal cells by shutting down the signalling protein Bcr/Abl that is produced by PH+ cells. It may be that this pain in your leg is a symptom of pressure on your sciatic. nerve which runs right down the back of your buttocks to your foot.... Sciatica?

You describe the pain as quite severe and going down your left side so this sounds like you may have unconsciously moved and misplaced a muscle/ligament that has in turn 'pinched' you sciatic nerve. My father did this recently when he mowed the lawn when he was in a bit of a hurry and ended up in A&E in some significant pain. If you think this may be the cause (pressure on you sciatic nerve) you would do well to talk with your doctor and perhaps arrange some physiotherapy which hopefully would realign your joints/muscles etc and relieve the pressure on the nerve. Otherwise you could try visiting an osteopath or chiropractor? 

If you are still worried about side effects than do talk with your clinician about a possible reaction to dasatinib but I am not sure there would be a connection.

hopefully this is helpful advice, sciatic pain is quite distressing but does respond to painkillers... although not advisable long term which is why I suggest physiotherapy or osteopathy.

best wishes,

Sandy

I was suffering from sciatica, too, and my GP recommended Pilates as an alternative to physio.  For me, it works a treat - and I didn't have the 12-week wait for NHS physio which is the case here in Edinburgh.  The pain was certainly very bad, but after about a month of weekly Pilates it began to get better, and now I can say "What sciatica?".

Good luck with whatever method you choose.

Olivia

Hi Garry,

Though of course as others point out, not every ailment can be CML or TKI related I do have some experience in this regard that was very much related.

A few years back, when I was diagnosed, I was put on imatinib and quickly got sever bone and nerve pain (Grade 3/4) down both legs, and to a much lesser extent arms too. It was really, really bad and the low point was not being able to make it to the gate at the airport and needing to use the airport assistance to pop me in a wheelchair and get me on the plane back home to see family.

My doctor wasn't convinced it was TKI related, but we agreed to stop taking imatinib for 2 weeks (as that is about how long it takes to flush out of your system) to see what happens. Lo and behold, things cleared up completely in that time. So, I started taking dasatinib instead and the problems never returned.

As I understand it, it's an unusual side effect of imatinib and I am very pleased there were more options available to me. Had imatinib been the only game in town I think I'd have had some serious thinking to do but thankfully didn't have to.

Now, bone pain is documented as a possible side effect of dasatinib so whilst I am not saying that it's causing your problems, and there may be other more likely and mundane causes, I wouldn't completely rule dasatinib out as a cause.

David.

Hi Garry,

Yes have had a number of episodes like this and have been on Glivec for over ten years.First some years ago  it was drug interaction Glivec and antibiotic Ciprofloxacin but it  has flared up since then on several occasions.

Suggest you check whether the posterior muscles to the hip joint are swollen and inflamed as I found this to be the case and the pain is transmitted down the femur to the knee and below.You might try one of those heat pads that are sold as neck warmers-they are full of wheat or similar and you heat it  up in the microwave for a short period-apply it to the hip and the leg knee etc.I found that this was the only way to relieve the dreadful pain. Look on Amazon as there is a selection of these pads offered or I have seen them on offer near the pharmacy in Sainsbury. .Ice and cold would make it worse.Try massaging in Voltarol or similar to relieve the pain.Medium term yes physio will help but it is a long process to get back to normal.If the hip muscles are badly swollen then cortisone injections  in to the hip might relieve the inflammation.If you feel like it it try to do some stretching on the floor or lean against the wall at 45 degrees and try to strengthen your leg or use the stairs to strengthen the leg.Pilates type exercises would help.

I agree with the other posts that it may or may not be a TKI related side effect.I saw a spinal specialists and he found a trapped nerve in the spine and offered some spinal injections but am shying away at the moment.He said side effects from statins might cause similar effects.Eventually we found my problems were  more likely related to myositis or inflammation of the muscles and joints and that is drug related.Suggest you ask your doctor for the simple blood test to see if your CK -creatine kinase is elevated.If is normal  your case might point away from being a drug side effect but if abnormal  for sure would point towards a side effect of the tki. Perhaps it would useful to have your calcium and magnesium checked as well to see if there any deficiencies in these areas;if magnesium is the issue suggest you try a magnesium spray onto the leg- a so called transdermal approach.

Trust this helps

Best wishes

John