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PAIN MANAGEMENT:

What is Pain?

Pain is a sensation of discomfort, distress, or agony. It may be acute or chronic. Acute pain is moderate to severe and lasts a relatively short time. It is usually a signal that body tissue is being injured in some way, and it generally goes away when the injury heals. Chronic pain may range from mild to severe, and is present to some degree for longer periods of time. Because pain is unique to each individual, a person's pain cannot be evaluated by someone else.

With cancer, will I have pain?

Many people believe individuals with cancer must be in pain. This is not necessarily the case. Further, if it could not be prevented, when pain is present, it can often be reduced or alleviated. Pain management is an important topic discuss with your physician as soon as a diagnosis of cancer is made or suspected.

Pain may occur as a result of cancer or other reasons. it is normal to have occasional general discomfort ,pain, and muscle strains in daily life, even without cancer. But even after a cancer diagnosis, not every pain is related to or caused by cancer. Cancer pain may depend on the type of cancer, the stage of the disease, and and individual's tolerance for pain.

What should I do if I am in pain?

A test cannot be preformed to measure different levels of pain. So that any pain you may be experiencing can be reduced or eliminated. you will need to talk to your physician about the pain and provide specific details about your level of discomfort.

The following questions may be asked of you to more accurately evaluate your condition.

  • Can you describe the pain and what it feels like?
  • How would you rate the pain? To accurately answer this, your physician may ask you to rate your pain using a scale from 0 to 10 "o" is absence of pain and "10 is extreme pain.
  • when did the pain start and how long does it last?
  • Is the pain worse during certain times of the day or night?
  • Can you show exactly where on your body you are having pain?
  • Do the pain move or travel? If yes, can you show how and where?
  • Have you taken any medications to relieve the pain, or tried any other approaches to reduce the pain? Have you had any relief?
  • have you noticed particular activities or positions that aggravate the pain?

The National Cancer Institute suggests that you make some notes so that when your physician asks specific questions about your pain you will be able to provide accurate answers. Write down the details of any discomfort you might have be having so you will not forget to tell your doctor. Try keeping a diary of your pain, or ask a friend of the family member to help track your symptoms. Here are a few things you might want to keep note of in your diary.

  • Date
  • Time
  • Pain scale rating
  • Type and dose of medication
  • Time pain medication was taken
  • How well pain responded to medication
  • Any other pain relief methods attempted

Your doctor my need to look at your diary when making a plan to help with your pain and make you more comfortable, so make sure you bring along your pain diary to your appointments.

How can I describe my pain?

When your doctor or nurse asks your pain level, you will need to let them know how your pain feels as specific terms as possible. Here's some helpful answers

  • Dull pain-a slow or weak pain, not ever sudden or strong.
  • Throbbing pain-a pain that surges, beats or pounds.
  • Steady pain-a pain that does not change in its intensity.
  • Sharp pain-pain that causes intense mental or physical distress.
  • Acute pain-severe pain that lasts a relatively short period of time.
  • Chronic or persistent pain-mild to severe pain that is present to some degree for long periods of time.
  • breakthrough pain-when you are taking medication for chronic pain, moderate to severe pain that occurs between doses.

what causes pain with cancer?

Cancer pain that lasts several days or longer may result from one or more of the following and should be evaluated right away.

  • pain from tumor that is pressing on body organs, nerves or bones.
  • poor blood circulation.
  • blockage of an organ or canal in the body.
  • metastasis (cancer cells that have spread to other sites in the body).
  • infection or inflammation.
  • side effects from chemotherapy, radiation therapy, or surgery.
  • stiffness from inactivity
  • psychological responses to tension, depression, or anxiety.

Treatment for pain:

Specific treatment for pain will be determined by your doctor based on the following:

  • your age, overall health, and medical history.
  • type of cancer.
  • extent of the disease.
  • your tolerance for specific mediations, procedures, or therapies.
  • expectations for the course of the condition.
  • your opinion or preference.

Methods for reducing pain are classified as either pharmacological or non-pharmacological.

What is pharmacological pain management?

Pharmacological pain management for cancer refers to the use of pharmaceutical medications. Oncology clinics usually offer several pain management options for an procedure that maybe painful, such as a bone marrow aspiration or lumbar puncture. There are many types of medications and several methods used for administration, from very temporary (10 minute) mild sedation, to full general anesthesia in the operating room.

Pain medication may be given in one or more of the following methods:

  • by mouth (orally-in pill form or liquid)
  • with an inhaler
  • through a needle in a vein (IV)
  • with a special catheter in a space around the spinal column (epidural)
  • through a patch on the skin
  • through implanted methods (such as a pump that is implanted in the body)
  • by inserting rectal suppositories

Examples of pharmacological pain relief include the following:

analgesics (for mild to severe pain relief)

sedation (usually given for relief of pain during a procedure)

anesthesia (usually given for relief of pain during a procedure)

topical anesthetics (cream, gel, or liquid applied to the skin to numb the area)

other pain relievers

Some people can build up a tolerance to sedatives, muscle relaxers, and pain relievers. Over time, doses or types of medication used for pain relief may need to be increased or changed. Fear of addiction to narcotics is common, although, in most cases it is rarely a problem. It is important to understand that the ultimate goal is comfort, which means taking appropriate measures to control your pain.

Questions to ask your doctor about your pain medication:

Each time a pain medication is prescribed by your doctor: Try getting answers to the following questions:

  • what dose of pain medications is being prescribed and how many times a day will I be taking this medication.
  • what should I do if my pain is not relieved with the recommended dose?
  • what would warrant a dosage increase?
  • should I call you before increasing the dose?
  • what if a dose is missed or not taken on time?
  • should this medication be taken with food or on an empty stomach?
  • should I be taking this medication (if tablet or capsule) with a particular type of liquid?
  • is it safe to drink alcoholic beverages, drive, or operate machinery while taking this pain medicine? Are there any other activity restrictions?
  • are there prescriptions or over the counter medications that are dangerous to take with this medication.
  • are there any side effects associated with this medication? If yes, is there any way to prevent or reduce them?

What if I need to change my pain medicine?

If you are dissatisfied with the medication you have been prescribed, consult your physician or cancer treatment team. There may be other ways to alleviate the pain, including switching to a different pain medication. Changes may also be recommended regarding the way your taking the medication.

Be sure to talk with your doctor when you are uncomfortable, as a different pain medicine, different dose, or different combination of pain medications may be required if:

  • your pain continues.
  • your pain medication does not start working within the time frame specified by your doctor.
  • your pain medication does not work for the length of time specified by your doctor.
  • you are experiencing breakthrough pain (moderate to severe pain that "breaks through" between doses).
  • the dosage schedule or method is inconvenient and you are having trouble adapting to your schedule.
  • pain becomes disruptive to your daily activities, such as eating, sleeping, working, and sexual activity.
  • you experience serious side effects such as difficulty breathing, dizziness, and rashes. If serious side effects occur, call your doctor immediately. Side effects such as sleepiness, nausea, and itching usually resolve after your body adjust to the medication. However, call your doctor if you are experiencing any side effects from your pain medication.

What are non-pharmacological pain management?

non-pharmacological pain management is the management of pain without medications. This method utilizes ways to alter thoughts and focus concentration to better manage and reduce pain. Methods of non-pharmacological pain include:

education and psychological conditioning

Not knowing what to expect with cancer treatment is very stressful. However, if you are prepared and can anticipate what will happen, your stress level will be much lower. To decrease your anxiety about cancer treatment, consider the following:

  • Ask for an explanation of each step of procedure in detail, utilizing simple pictures or diagrams when available.
  • Meet with the person who will be performing the procedure and write down answers to questions.
  • Tour the room where the procedure will take place.
  • Ask what you can expect as an outcome of your treatment.

hypnosis

With hypnosis, a psychologist or doctor guides you into an altered state of consciousness. This helps you to focus or narrow you attention to reduce discomfort. Methods for hypnosis include:

imagery:

Guiding you through imaginary mental images sights, sounds, tastes, smells, and feelings can help shift attention away from the pain.

distraction:

Distraction is usually used to help children, especially babies. Using colorful, moving objects or singing songs, telling stories, or looking at books or videos can distract preschoolers. Older children and adults find watching TV or listening to music helpful. Use distraction appropriately, and not in place of an explanation of what to expect.

relaxation/guided imagery

Guiding you through relaxation exercises such as deep breathing and stretching can often reduce discomfort.

Other non-pharmacological pain management may utilize alternative therapies such as comfort therapy. physical and occupational therapy, psychosocial therapy/counseling, and neuostimulation to better manage and reduce pain. Examples of these non-pharmacological pain management techniques include the following:

comfort therapy:

comfort therapy may involve the following

  • companionship
  • exercise
  • heat/cold application
  • lotions/massage therapy
  • pastoral counseling
  • positioning

physical and occupational therapy:

physical and occupational therapy may involve the following:

  • aquatherapy
  • tone and strengthening
  • desenitization

psychosocial therapy/counseling:

psychosocial therapy/counseling may involve the following:

  • individual couseling
  • family sounseling
  • group counseling

neurostimulation

neurostimulation may involve the following:

  • transcutaneous electrical nerve stimulation (TENS)
  • acupuncture
  • acupressure

 The information you find on our site is for education only it does not take the place of you seeking medical help from a license professional if you have any signs of breast cancer or any other medical issues.

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