Cancer pain is one of the most feared entities in pain management. Around 75% of patients with cancer suffer some type of pain. Cancer pain management is difficult, as it often involves incidental pain, episodic pain, neuropathic pain, and impaired cognitive skills.
What causes cancer pain?
Cancer pain shares the same pathology as non-cancer pain. Cancer pain is associated with a process called “nociception’, which involves activation of the sensory afferents by persistent stimuli. The pain from cancer is directly related to tissue injury, which is activated by primary afferent neurons (nociceptors), which are located in the skin, joints, muscle, and visceral organs.
One major type of cancer pain is spinal cord compression. This usually leads to neck and back pain from cord compression, and can also contribute to weakness of an arm or leg, as well as numbness of an extremity. This compression is treated with interventional measures, which can alleviate nerve irritation and inflammation. Another kind of pain is bone pain, which occurs when cancer spreads to the bones. External radiation is used to treat weakened bones. Radioactive medicine is given to treat affected areas of the bone and make them stronger.
Pain is an unfortunate experience for many patients. With advanced stages of cancer, 50% of patients’ report severe pain. There are usually two sources of cancer pain:
● Tumor involvement – As a tumor grows in size, it can put pressure on surrounding tissues and organs. This presses on nerve endings and leads to bone pain, muscle pain, and headaches.
● Response to anti-cancer treatments – Surgeries, radiation, biopsies, injections, and other procedures can lead to significant pain.
What are the various types of pain?
Some cancer can produce:
Neuropathic pain – This is nerve-related pain that is associated with burning, tingling, and itching sensations.
Breakthrough pain – Often called flare pain, this occurs when you take medicine regularly for chronic pain. Breakthrough pain occurs in conjunction with chronic pain that is managed by medications.
Chronic pain – This is pain that persists for six months or more.
What is the treatment of cancer pain?
Around 80% of cancer pain is relieved with opioid-based analgesics. Opioids are given orally or intravenously in a continuous pain pump. Options include hydromorphone, morphine, oxycodone, methadone, and fentanyl. Rescue doses of normal-release opioids should be provided for intermittent pain. Breakthrough pain is often treated using a different opioid.
Physical therapy is used to reduce pain levels. This can involve massage, electrical stimulation, and ultrasound therapy for pain reduction. Procedures are used to alleviate certain types of pain. Trigger point injections are used for painful trigger regions associated with cancer pain. In addition, an epidural steroid injection can be given when the pain is associated with a tumor pressing on a nerve root or other issue.
Does cancer pain treatment work?
Cancer pain can almost always be relieved. The pain management specialists will work with you to administer interventional procedures, medications, and surgical techniques that relieve pain. If you are in pain, discuss your options with the pain care specialist. Controlling pain is part of overall cancer treatment. Discussion about pain with your doctor can assure that your pain regimen works. Remember, prevention of cancer pain is better than treatment.