Introduction
When we talk about cancer, people usually get frightened and they do not leave any stone unturned for the treatment of cancer. But many a times, patient ignore the management of cancer-related pain. They have lots of myth associated with it. In up to 70% of cancer patients, when the diagnosis is made, the disease is not localized and the cancer would have reached Stage 3 or 4 which means advanced stage, which is really unfortunate.
And interestingly, in more than 75% patients, the first presentation of cancer is pain. In advanced stage of disease, around 85-90% patients experience pain and roughly 50% experience moderate-severe cancer pain. The pain arising from cancer or cancer treatment can be very severe affecting sleep, mood, food intake and relationship with others. Another irony is that many a times, cancer pain is poorly recognized and undertreated because the focus has always been treating the disease process. Another reason is lots of myths and misconceptions among family members towards the disease.
Having said this, cancer pain can be treated in around 85% patients effectively with medicines which can help patients lead happy and dignified life. With the advent of modern medicine and technology, there are multiple options for treatment of cancer pain. Patients and family members need to visit a “Pain & Palliative care Specialist” or request their cancer doctor to refer them to such kind of doctors.
Why Pain Occurs in Cancer
- From cancer itself- which can cause compression, squeezing of organs and capsular distension
- Cancer treatment like surgery, chemo and radiotherapy in certain instances can cause neuropathic pain
- Pre-existing disease like arthritis, spine problem or neuropathic pain
- Cancer-related debility
Treatment of cancer pain
A vast majority of cancer pain can be treated effectively with medication and if needed with interventional pain management strategy. Typically, we follow WHO analgesic ladder which is a simple guide for step-wise management of cancer pain. Opioids like morphine can help a vast majority of patients suffering from severe cancer pain. This medicine is different from other pain killers and is a regulated medicine specifically used for severe cancer pain.
There are other options like nerve or sympathetic chain blocks or neurolysis which interrupt the pain signal patients do not experience pain for a long period. These procedures are typically done in OT under fluoroscopy guidance.
So, to conclude, cancer patients should also request their treating doctors to send them to a “Pain & Palliative Medicine Specialist” for early and appropriate treatment of pain and other symptoms for better quality of life and good outcome.
