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Having cancer doesn't have to mean living in pain. Many effective pain treatments exist, ranging from simple over-the-counter pain relievers to complementary herbal remedies to strong, opium-derived drugs.
Medical experts estimate that about half of all patients with cancer, and 75 percent to 90 percent of patients with advanced cancer, experience pain. Of those patients who say they have pain, about 50 percent describe the pain as moderate to severe. And some cancer patients report having no pain at all.
Cancer can trigger pain in different ways. The tumor may grow into bones, nerves and other organs, which can cause mild to severe pain. Some cancer treatments, such as surgery and radiation, can cause pain as well.
Despite the availability of pain relief, cancer patients often suffer needlessly. A nationwide study of nearly 4,000 elderly cancer patients by Brown University found that 38 percent reported they had daily pain. The 1998 study found that 26 percent of patients received morphine to treat their pain, but another 26 percent received no pain treatment at all, not even aspirin. The study concluded that medical and nursing schools should provide more education on pain management.
The current thinking among patients' advocate groups and informed health-care providers is that a pain patient has every right to expect and receive pain relief based on how much pain he or she can tolerate. Yet, when it comes to cancer pain management, patients and their families often find they must be the ones to broach the subject with their doctors, nurses and other health care providers.
A comprehensive approach to treating cancer pain can improve a person's quality of life. Doctors typically use one or several measuring tools to gauge the severity and impact of cancer pain. By obtaining an in-depth pain history, a health care provider can design the most appropriate pain treatment regime.
Two elements are critical for the successful treatment of cancer pain — you are one and your doctor is the other. Your job is to be sure that you receive skilled and effective treatment of your pain. Don't be afraid to ask for good pain control, and referral if necessary. Be certain that your physician believes that pain can and should be controlled with an active treatment approach that will, by controlling pain, enable you to function at the highest possible level. This means that your doctor must be comfortable with prescribing medications for your pain, including the strongest opioid pain relievers when needed. He or she also must be knowledgeable about how to use the many different types of medication or other treatments that can help control pain.
If your pain treatment is not effective, seek treatment from a Pain Medicine physician, particularly one who has completed board certification in the field of Pain Medicine. You may find Pain Medicine specialists in your area by going to the Web sites of the American Academy of Pain Medicine or the American Board of Pain Medicine.
Physicians who are sub-specialists in Pain Medicine may be found in the fields of psychiatry, neurology, anesthesiology, physical medicine and rehabilitation, or palliative care.
Consider keeping a Personal Pain Journal to learn more about your personal pain patterns and remedies that have worked in the past. This knowledge can help you and your health provider develop the cancer pain management plan that works best for you.
A rehabilitation approach that combines aggressive pain control with physical therapy and behavioral support also may help. Pain and cancer treatment centers may offer these programs for cancer patients. Or, you may find such programs at a rehabilitation center in your area. Physicians in such centers usually are board certified/eligible in physical medicine and rehabilitation (PM&R). The staff typically includes a patient liaison who is a certified rehabilitation registered nurse and a nurse practitioner.
PM&R services may include:
· Assessment of physical and psychosocial function, presence of disability and rehabilitation needs.
· Recommendations regarding appropriate interventions, including medications, physical, occupational, speech and other therapies, nursing care and patient education.
· Recommendations regarding appropriate level of care, including transfer to an inpatient rehabilitation unit or other post-acute-care options.
· Daily medical care for patients transferred to the inpatient rehabilitation unit.
· Recommendations regarding adaptive equipment, orthotics or prosthetics and outpatient support services.
· Treatment of musculoskeletal and soft tissue pain using joint and trigger point injections, medical acupuncture and muscle energy techniques, as well as medications and other therapies.
Regardless of the place you receive treatment, the key to success is the attitude and knowledge of your physician. Be sure your doctor is comfortable focusing on pain control and in using the various medications needed for effective pain management.