HealthCommentary

Exploring Human Potential

What You Need to Know About Cancer Pain

Mark Lema

American Society of Anesthesiologists

Pain has and impact on many types of people – the elderly, the young, those who are healthy and those dealing with chronic conditions and illnesses, such as cancer. While novel cancer treatments have greatly improved survival rates in recent years, approximately one-third of adult cancer patients actively receiving treatment experience pain.1 

The American Society of Anesthesiologists (ASA) has developed a number of resources–including a list of tips – to help ensure pain sufferers are informed about their treatment options and to encourage them to take an active role in their treatment. These resources can be found on www.LifelinetoModernMedicine.com. 

I recently answered some frequently asked questions about cancer pain, which can be found below. 

What types of pain do cancer patients typically experience?
The nerves in the skin and deep tissues, as well as internal organs of the main body cavities send pain signals to the brain. Perhaps a tumor is growing and pressing on organs or nerves in other areas of the body, causing pain. This pain tells us that there is something wrong inside the patient. In fact, pain can be an important diagnostic tool for physicians. 

Do cancer patients experience different types of pain?
Yes. Cancer patients may experience acute pain after surgery and/or chronic, long-term pain. As a pain medicine specialist, I help patients manage all types of cancer pain. Pain can also be persistent pain or breakthrough in spasms. While persistent pain is ongoing, breakthrough pain is shorter (lasting a few minutes or hours), and the level of pain may be severe. Patients need to communicate with their pain medicine specialist when breakthrough pain occurs. It can be managed along with acute and persistent pain. 

What causes cancer pain?
Cancer pain often results from the cancer itself, as it grows into or destroys nearby nerves and tissues. Tumors exerting pressure on nerves, bones or other organs may also cause pain, in addition to blocked blood vessels causing ischemia, infection and inflammation. Pain may result from cancer treatment, as well. Cancer treatments such as chemotherapy, radiation and surgery almost always have potentially painful side effects. Procedures such as biopsies, spinal taps and bone marrow tests may also cause some level of acute pain. 

How many cancer patients experience chronic pain?
The prevalence of chronic pain (pain that lasts more than three months) is 30-50 percent in cancer patients undergoing active treatment for a solid tumor (an abnormal mass of tissue). The prevalence of chronic pain in patients with advanced cancer – that which has spread to other parts of the body and usually cannot be cured – is 70-90 percent. 

How is cancer pain treated?
Chemotherapy, radiation and surgery treat the cancer itself. Additionally, various analgesics can relieve the pain associated with these procedures.
Some other options include: 
Nerve blocks: the injection of anesthetic medication into specific areas of the body where pain is experienced, notably the nerves
Spinal cord stimulators: implanted electrical devices that send signals to certain nerves that can calm the painful sensations
Implantable catheters: catheters that enter the spinal canal or reside close to affected nerves in other parts of the body that deliver a variety of medicines that reduce the pain sensation via continuous infusion of medicine
Drug therapy: For mild to moderate pain: non-opioids such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs). For moderate to severe pain: longer acting opioids containing morphine, fentanyl, hydromorphone, oxycodone and codeine
For breakthrough pain: rapid-onset opioids such as fast-acting oral morphine or hydromorphone. For tingling and burning pain: antidepressants and anti-convulsants like neurontin. For pain caused by swelling or pressure: steroids, alternative treatment methods. 

Do these medicines often cause addiction?
No. Patients in pain who follow their physicians’ dosing instructions rarely become addicted. Remember that physicians are experts who give patients medications designed to provide an appropriate level of relief. 

What are some side effects of chemotherapy and radiation?
Pain is one of the potential side effects of chemotherapy. Specifically, patients may experience nausea, diarrhea, mouth sores, fatigue, infection and nerve damage, while radiation may leave behind a burning sensation or painful scars. Please talk to your pain specialist if you are experiencing pain due to the side effects of treatment. We can help. You don’t have to suffer. 

IN SUMMARY:

If you are battling cancer and are trying to deal with the pain without seeking treatment, it may have a negative outcome on your recovery. As a cancer patient, you deserve complete treatment of your disease. Please talk to your oncologist about engaging a pain medicine specialist as soon as possible. You can find relief. You don’t have to suffer.

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