About Pain
Acute pain is severe but lasts a short time. It's the kind of pain
you get when you're injured. Chronic pain can be mild or severe.
It persists for a long time.
People with cancer get pain from several sources. For some, the cancer
itself is painful. Surgery, diagnostic procedures, and other treatments
can also be painful. Other pain is caused by spinal cord compression or
by maladies that have nothing to do with your cancer.
Pain Treatment
Aside from your cancer treatment, your doctor may attempt to treat you for pain. There are many possible treatments including relaxation, biofeedback, imagery, and medications. Medications can be over the counter drugs you can purchase at a drug store or prescription drugs.Often cancer patients are served better if their family or friends talk to the doctor about a pain management program. Doctors have many techniques available, but they sometimes forget to address the patient's pain when they are working on the cancer. A pain management plan, including charting of the pain level and the effectiveness of various remedies, can be a valuable part of improving the life of someone with cancer.
Myths about pain management
Many people are not aware of the advances in pain treatment in recent years. Myths continue to persist. Some of the most common are:- Pain doesn't matter. Working on eliminating or living with my cancer is all that matters. Pain is a major part of many cancer cases and should be treated, just as the tumor is treated.
- They can't do anything for this pain anyway. There are many pain treatments, some involving drugs, some not. Doctors have learned more about pain in recent years. Even if it can't be eliminated, most pain can be lessened through safe procedures.
- Complaining about pain is a sign of weakness. No, it isn't. Sharing information with doctors about what is painful, where it is painful or when it is painful can often provide them with valuable information about your condition.
- I might get addicted to the pain relief drugs. Some pain medications are addictive, but that's part of the reason they are prescribed by doctors and used only while the patient is under medical care. Most people do not get addicted to prescribed medications. Further, different people have differing reactions to addictive drugs and at different levels.
- The pain medication will make me woosy. Some medications may cloud your thinking, but not all will. And the effects of any treatment vary from person to person.
- The side effects from strong pain medication are intolerable. Again, the type and severity of side effects differs from person to person. But most patients can get pain relief without intolerable side effects.
Much pain can be relieved with over-the-counter analgesics such as aspirin, acetaminophen (the ingredient in Tylenol), and ibuprofen (the ingredient in Advil). Because these medications may have more severe side effects than usual in people undergoing chemotherapy, those patients should consult their doctors before using these medicines.
Opioids (or narcotics) are powerful pain relievers prescribed for pain relief, although they can be addictive. These drugs include morphine and codeine and they should be used only under strict supervision from a doctor. Opioids can have some severe side effects.
Other medications that may also be used to treat pain include steroids, antidepressants, and anticonvulsants.
Drugs can be administered:
- Orally (as pills or tablets)
- Skin patch
- Rectal suppositories
- Injections
- Pumps - allow patients to control the rate at which drugs are delivered.
Most over-the-counter pain relievers, or analgesics, are designated as NSAIDs. This stands for nonsteroidal anti-inflammatory drugs. NSAIDs include aspirin, ibuprofen, and naproxen. Sometimes acetaminophen is classified as an NSAID also. These drugs are used to relief pain all over the body. They are sold under many trade names, including Tylenol, Bayer, and Advil.
Opioids
Generic names include fentanyl, oxymorphone, morphine, levorphanol, and codeine. Sometimes opioids are combined with NSAIDs.
Opioids are powerful drugs and should only be taken under strict doctor's instructions and under the continuing care of a doctor. Patients often build up resistance to the drugs, in which case the pain-relieving effects wear off. This may not happen to you, but if it does, be sure to alert your physician. The doctor may increase the dosage. Be sure that all the doctors you see know what medicines you take. An overdose of any medication, but especially an opioid, can be very dangerous.
Some drug companies have also introduced medicines in extended-released form. These medications release the drug to the body more slowly, and provide longer relief than the original drug formulations did. The extended-release medication may in the form of a pill or a skin patch. These methods have helped many people get effective pain relief without using any more of the medication than necessary. Check with your doctor or nurse to see if extended-release formulations are available for your prescription.
Potential side effects of opioids include drowsiness, constipation, nausea, and vomiting. Side effects differ from person to person, and with the dosage. Patients who stop taking opioids are usually taken off of them slowly. Stepping down the dosage over time helps the body readjust to the absence of opioids.
Radiation and surgery
These techniques are used to remove or shrink tumors, and if the tumor is causing the pain, they will effectively reduce the pain level. For patients with severe chronic pain, there is a type of surgery that cuts nerves to permanently relieve pain. Similarly, doctors can use nerve blocks - local anesthetic perhaps combined with a steroid - to deaden the pain in one part of the body. For terminally ill patients judged to be near the end of life, doctors can take more extreme measures, even those that might be irreversible.Non-drug Pain Treatments
Methods include:- Acupuncture - an ancient therapeutic discipline useful for many cancer patients
- Transcutaneous Electric Nerve Stimulation - this involves application of mild electric currents to the patient's skin
- Menthol rubs - available as creams, gels, or lotions
- Cold or heat - time honored ways to relieve pain
- Pressure
- Vibration
- Massage
- Relaxation
- Hypnosis
- Biofeedback.
Emotional Support
Friends and family members that provide emotional support also can contribute to pain relief. Professional counseling also helps many people. If people with cancer feel anxious or depressed, the pain may seem worse. And the pain can cause people to lose hope or feel angry or isolated leading to a viscous cycle. A combination of medical pain relief and a good counselor can help break the cycle and improve the lives of people with cancer.It is not a sign of weakness to search out professional help. Your family has probably never encountered cancer before, and a counselor can probably help. Counselors have worked with other families and may be able to guide your's to a way to manage this situation.
Doctors, nurses, clergy, and friends can all be sources of recommendations for counselors. When choosing a counselor, be sure to inquire about fees and estimated time.
Many cities also have support groups where people with cancer meet and talk about living with the disease.
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