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From OncoLog, September 2013, Vol. 58, No. 9

House Call: Myths and Facts About Pain and Cancer
Patients have options for pain treatment


About 7 in 10 cancer patients experience pain at some point during cancer treatment, but some patients are hesitant to take medicine for their pain—often because they have been misinformed.

The following are common myths—and the facts that prove them wrong—about cancer pain and its treatment.

MYTH: All cancer patients live in pain.
FACT: Most cancer-related pain can be treated. Doctors can prescribe narcotics (such as morphine, fentanyl, or hydrocodone) and anti-inflammatory, antiepileptic, and antidepressant drugs to relieve pain. These medicines are available in many forms such as pills, liquids, and patches. If medicine alone does not work, nondrug treatments such as massage, hypnosis, and breathing and relaxation exercises can help. For patients with pain that cannot be treated with medicine, other treatments like radiation therapy, nerve blocks, and surgery are sometimes used to relieve pain.

MYTH: Pain means the cancer is getting worse.
FACT: Pain can occur for many reasons. Although more than half of cases of pain in cancer patients are tumor related, treatments like chemotherapy, radiation, and surgery can cause pain. In addition, pain can have a cause that is not related to the patient’s cancer. Don’t forget, people without cancer also have pain.

MYTH: Patients who tell their doctor they are in pain may not receive their desired cancer treatment.
FACT: Doctors need to know all of a patient’s symptoms—including pain—to provide the best treatment. Pain that goes untreated can delay a patient’s cancer treatment because a patient who has pain may need to visit the emergency room or be admitted to the hospital to control the pain.

Uncontrolled pain can also delay a patient’s recovery. This delay happens because pain causes stress, and long-term stress causes the body to produce hormones that weaken the body. In addition, untreated pain causes unnecessary suffering. Patients should tell their doctor if they are in pain and describe their symptoms as specifically as possible to receive the best treatment.

MYTH: Pain medicines will erase all pain.
FACT: Although doctors hope to relieve all of a patient’s pain, the patient should not expect a complete absence of pain. Doctors strive to relieve enough of the patient’s pain so that the patient can go about daily activities and have the best quality of life possible. Managed pain allows patients to spend less time in the hospital and more time at home with loved ones.

MYTH: Patients become addicted to strong pain medicines.
FACT: Cancer patients who take narcotics to treat pain have a very low risk of drug abuse and addiction. Only patients who abused drugs before they had cancer have a high risk of becoming addicted.

Doctors will monitor patients very closely during treatment with narcotics. Patients should never take any pain medicine without consulting their doctor.

MYTH: Pain medicines lose their effectiveness.
FACT: Over time, a patient’s body will become used to, or tolerant of, a drug. Drug tolerance is a normal reaction, and doctors can easily increase the dose of many drugs to control a patient’s pain. If a patient is already taking the highest safe dose of a drug, doctors may need to switch to a different drug.

MYTH: Pain medicines have uncontrollable side effects.
FACT: If patients have side effects from pain medicines, other medicines or therapies can be given to treat those side effects. For example, a common side effect of narcotics is constipation, which can be easily corrected by adding laxatives or stool softeners to the patient’s medicine regimen.

Cancer patients can avoid living in unnecessary pain. Pain treatment options are available for patients with all types and stages of cancer.

“There is no cookie-cutter pain regimen. Each patient is an individual,” said Rob Yates, a physician assistant in the Department of Pain Medicine at The University of Texas MD Anderson Cancer Center. Patients should consult their doctor to learn how to manage their pain.

— C. Wilcox

For more information, talk to your physician, visit www.mdanderson.org, or call askMDAnderson at 877-632-6789.

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