Home Forums Melanoma Diagnosis: Stage IV Please help! Pain management in case of brain tumors

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    Dear all, I posted some time ago about my sister condition. She was on zelboraf 8 months but then melanoma has progressed. These days she just has finished the treatment with impilimumab (yervoy) and radiotherapy for the limphnodes and her left arm tumor. We were optimistic about enrolling in a anti PD clinical trail in essen, but recently she developed in tumor in her brain. Yesterday she was treated with Gamma Knife in Bucharest (Ro) and we hope the tumor will stabilize.

    We are waiting now to see if she responds to yervoy therapy but meanwhile her pains in the left arm (where the biggest tumor is located) increased considerably. Her doctor advised her to use opioids (e. g patches with fentanyl), but she just read that they are not indicated when a brain tumor is present.(!?). Now she is on paracetamol and diclofenac , but this are too weak for her pains.

    What to do, what to take? In Romania there is not a lot of knowledge in pain management. I am thinking we have to call a clinic from abroad to ask for a phone appointament and to hope they are able to help by phone..

    Any advice and experience with this? How are you managing your melanoma pains when also a tumor brain is present?


    Violeta – my husband has been treated for two brain mets with gamma knife and has also been using a fentanyl patch to manage his pain. His palliative care dr. has not expressed any concern about using this type of pain management while being treated for brain mets. Prior to using the fentanyl, my husband used oxycodone but has found much better relief since switching to the patch.


    Catherine Poole

    Please see our webinar on pain management: http://melanomainternational.org/webinar/2012/03/strategies-for-pain-management/#.UmPLrmbD_84

    I hope this might help with your dilemma.


    Thanks Marta, thanks Catherine. I listened carefully the webinar, indeed I have found out a lot of good info. However the speaker is not unfortunately specifying if there are any contraindication of using opioids for pain management in case of brain tumors. Indeed in the prospect of almost opioids is written to not be administrate or to take precautions in case of brain tumors, but looks that opioids are efficient and commonly used irrespective of having brain tumors or not! These and inflammatory drugs and antidepressants (e g amytriptilina)..

    I spoke again with my sister about these concerns.Pains are growing and I am upset she is so stubborn to suffer..Is hard. I think for now she is convinced to begin with some low doses of fentanyl patches. So..the info which I got from you help me to convince her to use these drugs. I hope she will fell better. Thanks again.


    Hi there,

    I have been using the Fentynl patch for several months. I have had brain tumors (had gamma knife twice).

    Hope this helps,


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