Is it Possible to Treat Pain in Cancer Patients?
Cancer is never a diagnosis you want to receive, but it is all too common in our world. Despite the many medical breakthroughs in recent years, millions of people still develop cancer. The reasons why include longer life expectancies, an epidemic of obesity, and continued high risk behaviors like unprotected sex and suntanning.
Cancer can, of course, be treated, making it a manageable condition rather than the death sentence it once was, but there are still some serious side effects. The pain that is associated with cancer and some cancer therapies can be quite intense which is why pain management is a high priority in any cancer case.
Cancer in America
Although considerable headway has been made in the fight against cancer, this is still a major public health concern. In 2018, almost 1.7 million Americans were diagnosed with cancer and 600,000 died from it. Among the most commonly diagnosed kinds of cancer are
- Breast cancer
- Lung and bronchus cancer
- Prostate cancer
- Colorectal cancer
- Skin cancer
- Bladder cancer
- Non-Hodgkin lymphoma
The incidence rate of new cancer cases is about 0.4 percent annually, while the cancer mortality rate is almost 0.16 percent annually. About 38.4 percent of all Americans will be diagnosed with cancer at some point in their lives.
Cancer mortality has fallen in the U.S. since the 1990s. Between 1991 and 2015, the cancer death rate fell 26 percent. The primary reasons for this are a fall in the number of smokers and improved early detection.
The Truth about Cancer Pain
One of the most frightening aspects of facing cancer can be the pain involved. You should know that there is the potential for pain, but not every cancer patient may experience pain. Most pain from cancer is a result of a tumor pressing on nerves, bone or organs. The severity of your pain may depend on the kind of cancer, its location, its stage and how it is interacting with surrounding nerves and tissue.
Some pain may also come from the therapies you receive. If you have surgery to remove a cancerous growth, you will likely experience some post-operative pain for days or weeks. Chemotherapy or radiation treatments can also produce pain symptoms that include peripheral neuropathy, mouth sores, or skin burns.
How to Treat Cancer Pain
If you experience pain at any point after your cancer diagnosis, you should discuss it with your doctor. Almost all kinds of cancer pain can be mitigated or managed. Your medical care team may try one or more of the following pain management techniques.
- Surgery—a procedure to remove some or all of the tumor may provide some immediate pain relief by reducing the pressure on nerves or tissue. Although there may be some pain following the procedure, new minimally invasive techniques have helped limit this.
- Chemotherapy—this drug therapy may shrink tumors and provide pain relief, but chemotherapy may produce its own pain conditions. This treatment may cause nerve damage which become a chronic pain condition that remains even after the cancer has disappeared.
- Radiation therapy—this therapy uses high-energy beams to kill cancerous cells which may be causing pain. In most cases, there is no pain during the procedure, although some patients may have some skin irritation.
- Pain medications—your physician may prescribe a variety of drugs from over-the-counter pain relievers to powerful opioids to help manage pain symptoms. What kind of medication and the dosage will largely depend upon the severity of the pain symptoms.
- Nerve block—if your pain can be localized to a cluster of nerves, then your doctor may recommend a nerve block which involves an injection of anesthetic into the area to incapacitate the nerves.
- Adjuvant analgesics—many cancer patients respond well to non-pain drugs like antidepressants, anticonvulsants or steroids which can relieve types of pain like burning, inflammation or tingling.
- Spinal pumps—for cancer patients with pain too widespread for a nerve block, an epidural or intrathecal pump for pain may help. These pumps are implanted near the spine and deliver pain medication continuously.
- Cordotomy—this surgical procedure neutralizes sections of the spinal cord by radiofrequency ablation. This a high-risk procedure that is typically reserved for only cancer patients with a limited life expectancy.
- Psychotherapy—cognitive therapies may provide important pain coping skills. Modalities like guided meditation, biofeedback and behavior modification can help minimize the intensity of pain symptoms.
Why You May Not Be Getting Enough Pain Relief
If you are still struggling with pain during your cancer recovery, you should keep some things in mind. First of all, you should know that cancer is a progressive disease that may spread during treatment and create new areas of pain. So your doctor may treat a certain area only to have a new problem area arise.
Second of all, your physician may not be taking enough interest in your pain symptoms. This is not due to professional incompetence usually, rather it is often related to intense focus on the treatment of the cancer. Additionally, many physicians have limited training in pain management, so they tend to de-prioritize this issue.
Thirdly, you as the patient may not be completely forthright with your medical care provider. Many patients feel uncomfortable “bothering” their doctor about pain issues while they are busy trying to save their lives, or they fear that pain may be an indication of a worsening condition. Others may have fears of dependency upon powerful opioid drugs—if you are actually complying with doctor’s orders, the risk of addiction is fairly low—or are worried about the cost of drugs.
Regardless of the reason why you are not getting enough pain relief, if it is a problem for you, then you should bring it up with your doctor. There is no reason why you should be in severe pain even if you have a serious condition like cancer. If you find that your current physician is not responding to your concerns, then find a pain specialist who will.
Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care
M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees. The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship. Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA and you should not post any of your private health information