Cancer Pain Management
Cancer Pain Symptoms:
Symptoms experienced by those with cancer pain vary from person to person and can be mild and occasional symptoms to severe and constant pain. Cancer pain can be described as dull, achy or sharp in quality. A number of factors play into an individual’s cancer pain symptoms: type of cancer, stage, extent of disease, and tolerance level of pain. Cancer pain also may not necessarily be limited to where the original cancer tumor is located, as cancer can spread (metastasize) to other parts of the body, causing additional pain in these areas.
Cancer Pain Causes:
It is not uncommon for patients suffering from cancer to feel pain. Pain can be caused from the cancer itself, or from the treatments used to battle cancer, like chemotherapy treatment, radiation therapy and surgery.
Cancer can cause pain as it grows by destroying or pressing on nearby structures inside the body, such as nerves, organs and bones. Cancer that spreads from its original site (primary tumor) can travel to other parts of the body (metastasis) causing injury to these other sites by growth and damaging nearby structures here as well.
Not only can the cancer itself cause pain, but the treatments used to treat cancer can also cause pain. Surgery is done by a cancer specialist to remove all or as much of the cancer as possible. The recovery from surgery can be painful and takes time to heal and recover.
Radiation and chemotherapy can also cause pain after treatment due to injury to nearby structures. Some of the common side effects from these cancer treatments can include:
- Mucositis – painful sores around the mouth.
- Peripheral neuropathy - numbness and painful sensations in the feet, legs, fingers, hands and arms
- Nausea and vomiting
- Abdominal cramps
- Bone and joint pain
Cancer Pain Risk Factors:
Those who have been diagnosed with cancer or undergoing treatment for cancer are likely to experience painful side effects.
Although not specifically risks, cancer pain may not be appropriately treated by other factors leading to undertreated pain.
Some healthcare specialists and clinic doctors may not be asking you specifically about your cancer pain or ask about it routinely during your clinic visit with them. This may be due to the specialist's lack of experience dealing with this type of pain and proper cancer pain treatments. This is when a referral to a cancer pain specialist may be beneficial to both you and your doctor in helping to treat your pain. There also is the perception that prescribing pain medication can lead to abuse of these medications.
Sometimes, cancer patients themselves do not speak up about the pain they are in and this can also lead to less optimal treatment of your cancer pain. This can be because of the false perception that nothing can be done and cancer patients have to deal with the pain. Also, some patients feel that they may appear as narcotic seekers or complainers. Your cancer pain specialist wants to know how you are doing and speaking to your specialist about your cancer pain is both appropriate and helpful in controlling your pain.
There is also fear among some cancer patients that they will become addicted to pain medications. Typically, cancer patients who take medications prescribed by their cancer specialists for their pain do not get addicted. Patients, who use their pain medication inappropriately, such as taking it without pain, can become addicted. Also, cancer patients can develop tolerance to their pain medications, requiring changes in dosing, as deemed necessary by their cancer pain specialist. Tolerance, however, does not mean addiction, as we all can develop tolerance when we have been taking pain medications for some time. But this is variable between cancer patients by working closely with a cancer pain specialist, you can work to improve pain with the least amount of narcotics needed.
Another concern is the fear of side effects from pain medications. Some may be afraid of being overly tired and not being able to function as they “normally do”. Others also fear the stigma attached to taking pain medications. Using strong pain medications can cause fatigue and tiredness, but this does improve once you are using them regularly as prescribed. Used appropriately and at the correct dose for you, pain medications can be one tool to help you control your cancer pain.
Cancer Pain Testing:
There are no specific ways to test for cancer pain. However, anticipating patient needs for cancer pain management while undergoing cancer treatment can help to reduce acute pain and even prevent chronic pain.
Cancer Pain Treatment Options:
Some treatment options for cancer pain use pain medications. However, certain side effects like nausea, tiredness, fogginess and the inability to think and act as they normally do may make using them less tolerable to some cancer patients. There are a number of treatment options offered by the cancer pain specialists at Advanced Pain Management that can help reduce or eliminate the need to take oral medications while still relieving the cancer pain. Some of these are listed below and more information can be found on the related links.
- Celiac Plexus Block
- Peripheral Nerve Blocks
- Lumbar Sympathetic Block
- Intrathecal Pump Implant
- Hypogastric Plexus Block
At Advanced Pain Management our cancer pain specialists value the importance of an interdisciplinary approach. For those treatments not offered by APM, we are able to refer you to other cancer pain clinic specialists.
Last reviewed July 2013 by APM's Medical Executive Committee.