Controlling Cancer Pain

The Pain caused by cancer usually falls into one of two categories:

Nociceptive Pain and Neuropathic Pain.

Nociceptive pain is caused by damage to tissue. It is usually described as sharp, aching, or throbbing pain. It is often due to tumours or cancer cells that are growing larger and crowding body parts near the cancer site. It may also be from cancer that has spread to the bones, muscles, or joints, or caused a blockage of an organ or blood vessels.

Neuropathic pain happens when there is actual nerve damage. It may be caused by a tumour pressing on a nerve or a group of nerves. People often describe this pain as a burning or heavy sensation, or numbness.

If you have been diagnosed with cancer pain, talk to your doctor to learn whether you may be a candidate for pain-control pump (intrathecal drug delivery). Your doctor (or a doctor to whom you are referred) will put you through a screening process to determine if these treatments may benefit you. Results vary; not every result is the same.

Key messages about cancer pain

The experience of pain will be different for every patient.

? Pain does not always get worse. The level of pain experienced may remain unchanged, or may increase or decrease. In any situation medication can be adjusted to ensure pain relief.

? Pain is not related to the extent of the cancer. Experiencing pain does not necessarily mean that the cancer is more serious than if you had no pain.

? Take action as soon as the pain starts. Take pain relief when you first start to feel uncomfortable. It is harder to ease pain once it has taken hold. Taking medication for pain relief when the pain is bearable will not make the medication less effective later. The aim is to prevent pain. If you wait until the pain comes back you will suffer from unnecessary pain.

? When pain relief is taken regularly or 'by the clock' (such as every 4 hours), there is little danger that you will become addicted to these drugs. Addiction to pain killers is very rare in women with metastatic breast cancer. The dose can be tailored to your needs. Doses are increased or decreased according to the severity of your pain.

? Drugs for pain do not usually make you feel drowsy after the first or second day. Drowsiness can occur with strong pain relief drugs like morphine. However, the drowsiness usually passes in one or two days. People vary in how the medication affects them. You should ask your general practitioner about whether you can drive or work with machinery, and the effect of drinking alcohol with your medication.

? If one drug does not effectively help your pain, many other drugs or combinations of drugs can be used to give you pain relief. There is a large range of effective drugs for pain of all types and severity. It may take time, in consultation with your doctor, to establish the drug or drug combination that is right for you.

? Any pain can be difficult to cope with. However, pain is more difficult to cope with if you are also experiencing anxiety or depression. Also, being in pain can make you more likely to be depressed or anxious. If you are concerned by the feelings you are experiencing, it is important that you talk to your doctor as soon as possible.

Why Do People Suffer With Pain?

Many people suffer with chronic pain because they are unaware of treatment options that can help them live more normal lives. Others have fears that prevent them from talking about their pain, which in turn creates barriers to seeking adequate relief. (Not all treatment options are applicable to your type of pain.)

Read the following to see if you fall into one of these categories. If you can relate to these fears, remember that help and relief are possible, but only if you discuss your symptoms with your doctor.

? Fear of being labelled a "bad patient." You won't find relief if you don't talk with your doctor about your pain.

? Fear that increased pain may mean that your disease has worsened. Regardless of the state of your disease, the right treatment for pain may improve daily life for you and your family.

? Fear of addiction to drugs. Research shows that the chance of people with chronic pain becoming addicted to pain-relieving drugs is extremely small. When taken properly for pain, drugs can relieve pain without addiction. Needing to take medication to control your pain is not addiction.

? Lack of awareness about pain therapy options. Be honest about how your pain feels and how it affects your life. Ask your doctor about the pain therapy options available to you. Often, if one therapy isn't effectively controlling your pain, another therapy can.

? Fear of being perceived as "weak." Some people believe that living stoically with pain is a sign of strength, while seeking help often is considered negative or weak. This perception prevents them seeking the best treatment with available therapies.

Management of Pain and side effects

You may experience acute pain due to your illness or after surgery. You do not need to put up with this pain, your health care team can work with you to prevent or control just about any kind of pain. A combination of pain control methods may be used to give you greater relief from pain.
Don’t let pain control you! Because there are many new ways to treat pain, it is important that you speak openly and honestly with your doctor or with a doctor who specializes in treating chronic pain.

Terry O’Brien
BackTrouble UK.

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