It needs to be understood that pain is a natural outcome of cancer, and dealing with it can be taxing on the mind and the body. Dr Uma Dangi, consultant medical oncology, Fortis Hospital Mulund & Hiranandani Hospital, Vashi, explains that cancer pain can take many forms — it can be dull, achy, sharp or burning, or constant, intermittent, mild, moderate or severe. “How much pain you feel depends on several factors, including the type of cancer, its stage, where it is situated and your pain tolerance. Cancer pain is manageable, and controlling pain is essential to achieve fruitful treatment,” she tells indianexpress.com.
Pain management choices
The doctor explains that there are various strategies for managing cancer-related pain. “This broadly depends on the severity and the cause of the pain, like any injury to any organ or nerve pain. Also, it is important to understand if this is an acute or a chronic form of pain.”
While making a treatment choice, therefore, it is important for the patient to remember that if the pain interferes with your life or is persistent, it needs to be reported.
Keeping a track of the pain can help:
– How severe is it?
– What type of pain do you have (stabbing, dull, achy)?
– Where do you feel it?
– What triggers it?
– What makes it worse?
– What pain relief measures you use — medication, massage, hot or cold packs — and how do they help? Do they cause any side effects?
Dr Dangi explains that there are [pain relief] options that range from simple drug formulations, which can be tablets or injections, or simple patches which can be applied on the skin.
“These patches contain the drug which is absorbed by the skin into the blood. Drugs can be simple paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), to opioids in severe cases. If there is severe or acute pain, treatment can include radiation to the most painful area depending upon the site of pain. In case of fracture in spine, procedures like vertebroplasty can enable dramatic pain relief.
“In some cases, nerve blocks can be considered to alleviate the pain. While there are therapeutic ways to alleviate pain for cancer patients, caregivers play an important role in facilitating these,” she says.
The role of caregivers
Caregivers form an important part of pain care, says the doctor. “They need to understand the severity. It is important to give analgesics in adequate doses after consultation with the doctors. Other relieving measures like hot or cold fomentation can be tried or local application of analgesic gels can be tried.”
“Taking painkillers may mask pain, which may be a symptom of disease progression. Your physician will be assessing the disease status clinically or with scans periodically. In addition, the requirement of painkillers may reduce if the cancer comes under control. It is important for the patient’s quality of life and general well-being to control pain adequately.
“Be careful while consuming painkillers or any drugs. Some drugs like opioids, when taken regularly in large doses, may cause drug dependency. It is important to be in constant touch with your physician for them to evaluate the need for painkillers. In case of advanced malignancy, pain control is more important than drug dependency,” the doctor explains.
Can one switch to opioid medications?
Dr Dangi says not all patients with pain need treatment with opioids. In patients with severe pain, opioids may be used for a short duration till the disease comes under control after which the patient may not require them. In advanced cases, where pain is not controlled with other drugs like NSAIDs, opioids are required.
“At the end of the day, every cancer patient should get adequate pain treatment. For this, speak with your doctor first. Your doctor can set a goal for pain management and monitor the success of the treatment.”