Painful big toe

I had 6 cycles of Chemo August to December last year along with Phesgo after a diagnosis of Stage 4 breast cancer metastasised to my spine. The Phesgo has continued and since September this year I have been struggling with an extremely painful ( and I don't use that term lightly) big toe on my right foot and I have peripheral neuropathy in my feet and hands generally. I am prescribed slow release 40mg of Morphine twice a day and 900g of Gabapentin 3 times a day for pain along with other meds and supplementary ormorph and paracetamol but it doesn't help my toe and the pain is so bad I can't walk easily and can only suffer one pair of loose fitting shoes or toeless sandals if I go out. I have seen my GP, the podiatrist and a private podiatrist, thinking it was an ingrown toenail after the nails had all fallen off and started growing back again after Chemo. 

This week my GP agreed on a blood test for Uric acid to rule out Gout.

I have tolerated the pain of fractured ribs and several fractures in my pelvis in the last year, so I can cope with pain but this is bad and it has gone on so long.

The tip of my toe is particularly sensitive so I can hardly bear my sock or the duvet at night touching it. Any pressure however slight makes me feel faint.

I'm so distraught. I am beginning to give up. No one seems to be able to offer me any explanation, let alone a solution. 

Is it caused by chemo or Phesgo? Is there a test an/or any treatment that can help? Would I need to stop treatment? I'm concerned it could be cancer in my toe?

Please help.

  • Hello Hawkhead

    If your big toe is also red and swollen you are describing the classic symptoms of gout. I suffer from this occasionally the pain is excruciating. Your GP will be avle to diagnose this and offer you treatment. An episode of gout usually lasts a week to 10 days before subsiding.

    Ed

  • Hello and thanks for your post,

    I am really sorry to hear about your situation and the very difficult time that you have been having.

    We have a page on our website about trastuzumab, pertuzumab and phesgo. It does sound like one of the side effects is bone pain and pins and needles is another common symptom. It is very difficult without being involved in your care to be able to advise you. You don't mention what input you are having from the hospital or your specialist nurse.

    We have a list on our website about different types of pain killers which you might find helpful to look at.

    Some hospitals run pain clinics and it might be helpful to get in touch with your oncologist to see whether they can suggest something to help with the symptoms. The option maybe to stop the drug but you would probably want to know whether there was an alternative that you could take.

    Breast Cancer Now have more information about phesgo which you might find helpful to read. You may also find it helpful to ring the Breast Cancer nurses at Breast Cancer Now as they may have had a recent experience of treating women with this painful side effect. Their helpline number is 0808 800 6000.

    You are also welcome to ring the nurses on our helpline. The number to ring is Freephone 0808 800 4040 and the lines are open Monday to Friday 9 am to 5 pm.

    All the best,

    Catherine