Introduction To Cancer Pain

Patients often worry about having pain from cancer.

* Most pain can be controlled. * Communication is important. * Pain can be measured. * You and your health care providers can work together to control pain.

One of the most important parts of treating your pain is good communication with your doctors and nurses. Sometimes patients are afraid to talk about pain, or are worried they are being a bother. Only you know how much pain you feel. It is important to share this information with your doctor and nurse to help them decide the best ways to control your pain.

Your doctors and nurses are also interested in your mood. Tell your doctor and nurse how your mood has been.

Gathering Information:

Your doctor and nurse will try to find out why you are hurting. To do this they will gather important information. One of the first steps they may take is to ask you questions about your pain. For example, they may want to know where it is. Does it stay in one place, or does it move around? They may ask you to tell them how your pain feels. Does it feel dull, aching or burning?

You may also be asked how strong your pain is. There are several ways to measure your pain. One way is by selecting a number on a scale from 0 to 10. This scale is called a pain rating. 0 means no pain, and 10 means you have the worst pain imaginable. Which number between 0 and 10 best describes the pain you are feeling?

It is important for you or a member of your family to keep a diary of your pain. You should share all of the important details with your doctor. For example, in your diary, you could write down the date, time of day, a pain rating, and things you did to make the pain better.

Note: After the doctor has asked you questions about your pain, he or she may need to gather more information about what is causing it. You may be examined or asked to have an X-ray or a scan of the areas where you hurt.

Since pain can be caused by many things, such as tumor in the bones or tumor pressing on a nerve, it is important for the doctor to find out the reason for your pain. Your doctor and nurse will combine the information they have gathered and plan how to make you more comfortable.

Medicines:

Medicines are one of the most common ways to control your pain. Most pain from cancer can be simply treated using medicines taken by mouth. The doses of these medicines often need to be changed to make you feel better.

Pain medicines can be divided into three groups. The first group is for mild pain. You may have used some of these medicines in the past for problems such as headaches or sore muscles. Aspirin, Tylenol® and Advil® belong to this group.

The second group of medicines is for more severe pain. You may have heard them called narcotics or opioids. Examples include codeine, oxycodone, morphine, and hydromorphone. Many patients are afraid to take opioids because they think they may become "hooked" or addicted. This problem is very, very rare, occurring in about 1 in 10,000 patients. You will not become addicted if you take opioids for pain relief. If you are worried about addiction, talk to your doctor, nurse, or pharmacist.

Patients also worry about using strong pain medicines too soon. They fear that if the pain really gets bad, there may not be a medicine to use later to control it. In fact, it is best to treat your pain when it begins, even if strong medicines are needed. This will make it easier for the doctors to control your pain later.

Some patients also worry about side effects of medicines. Some side effects are very common but can be treated. These include sleepiness, nausea, and constipation. You should tell your doctor, nurse, or pharmacist if you are having these problems.

You have learned about two groups of medicines. The third group is usually used to treat other medical problems, but is also effective for treating cancer pain. For example, if you describe your pain as burning or tingling, you may have an injured nerve. Medicines used to treat depression or seizures may be helpful for this kind of pain.

What are some important things to remember about pain medicines? Nearly all of them can be taken as a pill or a liquid. If you are not able to take medicines by mouth, you can always receive them in other ways. These include:

* a patch placed on the skin * a needle put under the skin or into a vein * a suppository placed into your rectum, or * a very small tube put into your spine.

When taking your medicines, always follow the instructions given to you by your doctor, nurse, or pharmacist. You should take your medicines on time. Tell your doctor or nurse if you don’t think the pain medicine is helping, or if you are having side effects. Your pain may get worse from time to time, such as when you are more active. Doctors often prescribe extra doses of pain medicines for you to take at these times.

Other Methods to Control Pain:

You have learned about the use of medicines to control pain. What are some other ways to control pain?

Treatments such as radiation therapy and chemotherapy can reduce pain by shrinking some tumors. This relieves pressure on bones, nerves, or other parts of the body. For some types of pain, your doctor may suggest a nerve block to help you feel better. If this is needed, a specially trained doctor will use a needle to place medicine directly near a nerve. This blocks or deadens the nerve so you do not feel the pain.

There are other simple treatments that do not involve medicines. These include enjoyable activities such as: listening to music, receiving a back rub, taking a warm bath, or even watching television.

Review:

* With your help, your doctor and nurse will try to find out why you have pain and the best way to treat it. * Most pain from cancer can be simply treated using medicines taken by mouth. * The dose of these medicines often needs to be changed to get your pain under control. * Becoming addicted or hooked is rarely a problem. * And finally, there are things you and your family can do to help your pain that do not involve medicines.