Cancer Pain
(Oncological Pain)
In this condition factsheet:
Diagnosing Cancer Pain
When a person sees their doctor to report pain, the focus will be on identifying its cause and developing a pain management plan. A physical exam and medical tests are required to help determine the origin of the pain.
The description of the pain is very important to a doctor's understanding of its intensity and character (e.g., is it dull, sharp, achy, or shooting). The patient may be given ways to explain or rate the pain, such as a questionnaire or a pain intensity scale. The doctor may ask the patient how they cope with stress and pain, and inquire about their lifestyle.
Treating and Preventing Cancer Pain
Pain control is always essential. Unrelieved pain causes unnecessary suffering and further weakens someone with cancer. Whenever possible, pain is best relieved by treating the cancer. Pain may decrease when a tumour is removed by surgery or shrunk by radiation or chemotherapy. However, other pain relief treatments are generally needed. Most doctors will ask people to use painkillers on a regular basis and not on an "as needed" basis. This avoids causing people anxiety from delaying the start of pain relief and ensures consistent pain relief with fewer fluctuations in pain control.
When the pain is mild to moderate, pain relievers like acetaminophen* may work well. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are effective on bone pain.
If pain is severe, an opioid analgesic (strong painkillers from the medication family that includes morphine and codeine) may be prescribed. People will often continue to use acetaminophen in addition to opioid analgesics. Longer-acting opioids are often prescribed because they provide more hours of relief and are taken on a regular basis. Faster-acting opioid analgesics are taken on an as-needed basis and are used for pain that may break through the relief provided by longer-acting opioids.
Whenever possible, opioids are taken by mouth. However, some people are prescribed skin patches that deliver opioid analgesics through the skin. Others are given as injections or through a continuous infusion pump that's connected to a catheter placed in a vein or under the skin. Some infusion pump systems allow the patient to control the release of the medication by pressing a button.
Opioid analgesics do have some side effects such as nausea, itchiness, drowsiness, and constipation. If these side effects are bothersome, they can be managed – sometimes with other medications. Nausea and drowsiness will usually decrease as treatment continues. However, most people require medications to help with constipation.
Over time, some people need bigger doses of opioids to control pain because the pain has gotten worse or they've developed tolerance to the medication. However, there is no maximum dose of opioid medications for treating cancer pain. If tolerance develops, the opioid dose can be increased. Cancer pain is often inadequately treated. Some reasons for this include reluctance of the patient to bring up the pain (perhaps for fear of "bothering" their doctor or that their condition is worsening), reluctance of the doctor to inquire about pain or prescribe opioids, and fear of addiction. Addiction can occur for people receiving opioids for cancer pain. When opioids are being considered, doctors should assess every patient for risk factors for addiction, and carefully prescribe based on their clinical judgement.
Other mediations may also be helpful, especially for neuropathic (nerve) pain. These may include antidepressants, anticonvulsants, and muscle relaxants. Nerve blocks, where a local anesthetic is injected onto or near nerves, may also be used. For severe cases of pain related to cancers of the bone, medications called bisphosphonates may also be prescribed.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Cancer-Pain
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