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Managing Cancer-Related Pain
Approximately one-third of people undergoing cancer treatment experience some degree of pain. This pain may be short-lived or long-lasting, mild or severe. Cancer pain has several causes. Most results from a tumor pressing on bones, nerves, or organs; however, pain can also result from chemotherapy, radiotherapy, or surgery. Treatment for cancer-related pain varies from patient to patient. Since every cancer patient’s pain is unique, effective pain management must be tailored to the individual’s specific needs. The good news is that the vast majority of patients can find relief using one or more medications. Taking medication for pain relief is not a sign of weakness or the first step to addiction. Unfortunately, some patients do not seek treatment for their pain because they believe it is a normal part of their disease. Others are afraid that if they report their pain, their doctors will stop treating their cancer. And still others fear that pain is a sign that their cancer is spreading or believe that pain medicines cause addictions and disabling side effects. In fact, these are myths that can prevent patients from getting the help they need. Taking control Controlling pain is a part of effective cancer treatment. Here are some steps you can take to ensure that you get the best pain relief:
Available medications Many medicines are now used for managing cancer pain. Some drugs are general pain relievers, while others target specific types of pain. Physicians typically use one group of drugs for mild to moderate pain, another for moderate to severe pain, and others for tingling and burning pain or for pain caused by swelling. For mild to moderate pain, your doctor may recommend non-opioid pain medications, which include such familiar over-the-counter drugs as acetaminophen and nonsteroidal anti-inflammatory drugs (for example, aspirin and ibuprofen). For moderate to severe pain, opioids are often prescribed. These include morphine, hydromorphone, oxycodone, hydrocodone, codeine, fentanyl, and methadone. For tingling and burning pain, your doctor may prescribe an antidepressant or an antiepileptic drug. Such drugs are used in these instances to control pain rather than for depression or epileptic seizures. Antidepressants that may be used include amitriptyline, imipramine, doxepin, and trazodone. An antiepileptic drug that may be prescribed is gabapentin. Steroids, such as prednisone and dexamethasone, can help combat pain caused by swelling. Use as directed Most pain medicine is taken by mouth, but sometimes pain drugs can be administered with rectal suppositories, transdermal patches, or injections. It is important to take your pain medicine exactly as your doctor prescribed. Never skip a dose or wait until your pain gets bad to take your medication. The best way to control pain is to stop it from starting or to keep it from getting worse. Be sure to tell your doctor about any other medications you are taking, including any over-the-counter medicines or alternative remedies, as these may interfere with your pain medicine. Also tell your doctor about any new symptoms that occur once you begin taking pain medicine. Some pain medications have side effects that are easily treated, such as constipation. Call your doctor right away if you have trouble breathing, are suddenly dizzy, or develop a rash after taking your pain medication. You may be having an allergic reaction. Sometimes, after you have been taking a pain medication for a while, the drug becomes less effective. Your doctor may then increase your dose, add a new kind of medicine, or change your pain medication. Medicine tolerance is not the same as addiction, and increasing the dose to overcome tolerance does not lead to addiction. Additional treatments Your doctors and nurses may recommend non-drug treatments such as biofeedback, massage, or transcutaneous electrical nerve stimulation as a supplement to pain medication. When pain medications fail to relieve a patient’s pain, doctors may recommend procedures such as nerve blocks, radiotherapy, or surgery. Above all, remember that your cancer pain can be managed. For more information on this topic or for questions about MD Anderson’s treatments, programs, or services, call askMDAnderson at (877) MDA-6789. Other articles in OncoLog, October 2010 issue:
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For many cancer patients, pain is a distressing symptom of their disease. Yet, thanks to advances in pain management, cancer-related pain is now very treatable. 
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