Hi.
At this stage of the disease, I believe that the treatment options and decisions should be based on one of the fundamental principles of palliative care, which is pain control. The achievement of this goal would require good communication between her doctors, and writing notes may not be sufficient.
The pain specialist may be correct in avoiding epidural injections due to the fear of cancer spread, but as I have mentioned, pain control may be more of a priority than the risk of cancer spreading. This also goes true with the tens and ultrasound treatment. While the PT fears the cancer may spread, this fear may take second priority to cancer pain relief. If you and your mother are willing to take some risk of cancer spread to address the pain, then all these treatment options may be feasible.
I suggest you ask your doctors regarding pain prioritization and also call for a more effective means of communication.
Regards.
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