- With Mayo Clinic medical oncologist
Timothy J. Moynihan, M.D.
read biographyclose windowBiography of
Timothy J. Moynihan, M.D.
Timothy Moynihan, M.D.
"As a practicing medical oncologist, I meet with patients and families every day to help manage their course through this disease called cancer. This experience provides unique insight into the needs of cancer patients, their families and loved ones and brings into sharp focus the need for reliable information to be readily available in terms that can be easily understood." — Dr. Timothy Moynihan
Dr. Timothy Moynihan believes that providing consumers with accurate, timely information on the broad, complex topic of cancer is the biggest challenge facing medical websites. As the guiding force behind our cancer content, he makes sure Mayo Clinic meets the test.
Dr. Moynihan, born in Las Vegas, N.M., and raised in Denver, is a consultant in medical oncology at Mayo Clinic and an associate professor at Mayo Clinic College of Medicine, Rochester, Minn. He's board certified in internal medicine, medical oncology, and hospice and palliative care medicine.
He did his medical oncology training at Johns Hopkins Hospital in Baltimore, and then went on to the University of Minnesota and St. Paul Regions Medical Center for seven years before moving to Mayo Clinic in 1999. Dr. Moynihan is medical director of the Mayo Clinic hospice.
Dr. Moynihan serves as the education chair for the Department of Oncology and the fellowship program director. Four times he has been selected as Teacher of the Year in medical oncology and elected to the Teacher of the Year Hall of Fame.
Past honors include distinguished clinical teacher at the University of Minnesota Medical School, best internist at the Medical College of Wisconsin and recipient of the Upjohn Achievement Award for Excellence in Medicine. Dr. Moynihan serves on several national committees for the American Society of Clinical Oncology.
"The Internet provides a ready source of information on a wide range of topics of interest to those affected by cancer," Dr. Moynihan says. "The difficulty is trying to decide which sites provide reputable information and which information is relevant to each individual patient. The long history and tradition of excellence associated with Mayo Clinic assures you that information provided will be reliable, up-to-date and comprehensive."
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Question
Coping with pain after breast surgery
Is it normal to have pain after breast surgery. I had a mastectomy two years ago. How can I cope?
Answer
from Timothy J. Moynihan, M.D.
You're not alone in having pain after breast surgery. One study of women who had a variety of breast cancer operations found that nearly half of the women reported some level of pain after breast surgery two to three years later.
Breast cancer surgery can be complicated and nerve damage may occur. This can lead to chest pain, including phantom breast pain and supersensitivity to pain (hyperalgesia). Normally painless stimuli may now be perceived as painful (allodynia). Neuromas — abnormal nerve growths in an area where scar tissue and nerves grow together — can give rise to allodynia. Sensations of burning and constricting or lancing-type pain also may occur, as can a loss of feeling in the area of the surgery.
Treatment for breast pain after surgery depends on the type of pain you're experiencing. Nerve-related pain may be treated with over-the-counter or prescription pain medications, including painkillers or medications used to treat seizures. Inflammation of the skin may be treated with topical pain medications, such as capsaicin, which has been effective in treating jabbing pain. Muscle spasms have been effectively treated with injections of onabotulinumtoxinA, the same substance used to reduce wrinkles. Local anesthetics may help relieve pain due to nerve damage.
Alternative therapies including acupuncture, acupressure, transcutaneous nerve stimulation, relaxation training, biofeedback, hypnosis and yoga also may be of benefit in reducing pain. Talk with your doctor about what may offer you the most relief.
- Gartner R, et al. Prevalence of and factors associated with persistent pain following breast cancer surgery. Journal of the American Medical Association. 2009;302:1985.
- Loftus LS, et al. Evaluating patients with chronic pain after breast cancer surgery: The search for relief. Journal of the American Medical Association. 2009;302:2034.
- Kehlet H, et al. Persistent postsurgical pain: Risk factors and prevention. Lancet. 2006;367:1618.
- Vitug AF, et al. Complications of breast surgery. Surgical Clinics of North America. 2007;87:431.
- Vadivelu N, et al. Pain after mastectomy and breast reconstruction. The American Surgeon. 2008;74:285.
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