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Cancer Pain Management
Additional Information
Causes of Cancer Pain
Most cancer pain is caused by the tumor pressing on bones, nerves, or other organs in your body. Sometimes, pain is related to your cancer treatment. For instance, certain chemotherapy drugs can lead to numbness and tingling in your hands and feet or a burning sensation at the injection site. Radiotherapy may cause skin redness and irritation.
It's important to note that some pain may not be related to your cancer at all. You might experience general aches and pains that everyone encounters from time to time.
Types of Cancer Pain
Cancer pain can be categorized as acute or chronic. Acute pain results from damage due to an injury and typically lasts for a short duration. For example, pain after an operation is acute and usually subsides once the wound heals. In the meantime, pain relief medications can help manage this pain effectively.
Chronic pain, on the other hand, arises from changes to nerves. These nerve changes may result from cancer pressing on them or due to chemicals produced by a tumor. Additionally, cancer treatments can lead to nerve changes. Chronic pain persists long after the injury or treatment has concluded and can vary from mild to severe. This type of pain is often referred to as persistent pain. Chronic pain management can be challenging, but pain relief medications or other methods can effectively control it in about 95 out of every 100 individuals.
The level of pain you experience with cancer depends on several factors, including:
- The type of cancer you have
- The location of the tumor
- The stage of your cancer
- Whether the cancer or treatment has caused any nerve damage
Other factors such as fear, anxiety, depression, and lack of sleep can also influence how you perceive pain.
If you are experiencing pain, it is crucial to inform your pain physician immediately. Trying to endure the pain could lead to nerve changes, making it harder to manage pain in the future.
Cancer Pain Treatment
Oral Medications: Pain relief medications are effective in controlling cancer pain for most individuals. The key to managing cancer pain is to take your medication on a regular schedule and not wait until the pain becomes severe. Pain is easier to control when addressed promptly after it begins.
Exercise caution when taking nonprescription medicines. Always consult with a pain physician before using these medications, especially if you have a fever or have experienced kidney or liver disease, gastrointestinal bleeding, or a stomach ulcer. Prescription medicines may be used alone or in combination with other medications. Depending on your specific pain, some of these options may work better than others. Prescription options include:
- Opiate pain relievers, such as fentanyl, hydromorphone, methadone, morphine, oxycodone, and tramadol.
- Additional medications that may be used alongside opiate pain relievers to enhance effectiveness or to treat specific symptoms, such as:
- Anticonvulsants for controlling nerve pain like burning and tingling.
- Antidepressants to relieve pain and improve sleep.
- Anti-inflammatory drugs and corticosteroids (e.g., prednisone or dexamethasone).
- Bisphosphonates, like pamidronate and zoledronic acid, to alleviate bone pain.
- Local anesthetics, such as skin creams with capsaicin or lidocaine, for pain relief in the skin and surrounding tissues.
Nerve Blocks: Nerve blocks are injections containing potent anti-inflammatory agents aimed at a specific nerve or group of nerves, intended to reduce inflammation and relieve pain.
Intrathecal Pump: Also known as infusion pain pumps or spinal drug delivery systems, this procedure involves creating a pocket under the skin to accommodate a medicine pump. The pump is typically about one inch thick and three inches wide. A catheter is inserted to carry pain medication from the pump to the intrathecal space surrounding the spinal cord. This method delivers medications directly to the spinal cord, where pain signals travel. Consequently, intrathecal drug delivery can provide significant pain control with a fraction of the dosage required for oral medications, resulting in fewer side effects.
Radiofrequency Ablation: Radiofrequency ablation (or RFA) is a procedure designed to reduce pain. An electrical current generated by a radio wave heats a small area of nerve tissue, thereby diminishing pain signals from that specific location. RFA is effective for patients with chronic cancer pain and has proven to be safe and well-tolerated, with minimal complications.
Cancer Pain Treatment options available at our clinic include:
- Oral medications
- Oral morphine therapy
- Psychological and lifestyle counseling
- Fentanyl patches
- Nerve blocks
- Alcohol/Phenol Neurolysis