Pain treatment for cancer patients

This is an automatically translated article.

The article is expertly consulted by Dr. Nong Ngoc Son - Doctor of Chemotherapy and Palliative Treatment - Oncology Center - Vinmec Central Park International General Hospital.
In cancer, pain manifests itself in many different ways. Have pain that lasts only a short time after certain procedures or after body movement. The other type is pain that is constant and lasts for a long time. Pain can also increase suddenly during treatment called sudden pain. The sudden pain usually occurs in the interval between doses of pain medication.

1. Importance of pain relief in cancer treatment

When you have symptoms of pain, you should notify the medical staff. Some people don't want to talk to their doctor about their pain because they fear pain medication will damage the liver or fear that pain medication is already in the final stages. Others try to bear the pain and take very little medication to avoid becoming addicted. In fact, most patients can still live with cancer with little pain.
If you do not treat pain relief, the pain will be more difficult to treat and cause many consequences that make health decline faster. For example, pain can exacerbate fatigue, depression, anger, anxiety, and stress. Another reason you should treat pain is to help you maintain your daily activities, sleep better, and spend more time with family and friends.

2. Causes of cancer pain

Cancer pain can be caused by the tumor growing or destroying nearby tissue. As the tumor grows, it can press on nerves, bones, or organs. Tumors can also secrete pain-causing chemicals. Or your body's response to chemicals can cause pain.
Treatment can help relieve pain caused by these causes. However, cancer treatments, including surgery, radiation, and chemotherapy, can also cause pain.

3. Pain symptoms in cancer

Cancer pain symptoms are different for each person. The degree of pain depends on the type of cancer, the stage of the disease, and the patient's pain threshold (pain sensitivity). Pain can range from mild to severe; pain nocturnal to continuous all day.

4. Cancer pain relief drugs

There are different ways to treat cancer. One is to remove the source of the pain through surgery, chemotherapy, radiation, or other treatment. While waiting for the effect of cancer treatment, painkillers will provide quick and stable pain relief. These medications include:
Over-the-counter and prescription pain relievers: Aspirin, acetaminophen (Tylenol) and ibuprofen (Advil, Motrin IB) Weak opioids: Codeine Strong opioids: Morphine (oral tablets, injections) ), oxycodone (oral tablet), fentanyl (skin patch, injection), methadone (oral tablet) Drugs that are put into the body in different forms by mouth, injection, skin patch, or suppository anus. Other medications used to treat cancer pain are antidepressants, anti-seizure drugs, and steroids.
In addition, there are specialized treatments such as blocking nerve conduction, which is a local anesthetic that is injected around or into the nerve. This method helps block neurotransmitters to the brain. Other treatments, such as acupuncture, acupressure, massage, physical therapy, relaxation, meditation, and hypnosis may also help.

5. Pain Relief Treatments

After a thorough assessment of the pain, the medical staff will develop a pain relief plan. Some hospitals have pain specialists and palliative care specialists who focus on treating the physical and emotional side effects caused by cancer. Doctors can treat or manage cancer-related pain in several ways:
Treat the source of the pain: The tumor presses on the nerve causing the pain. Removing the tumor with surgery or shrinking it with radiation, chemotherapy, or other drugs can reduce or stop the pain. Change the way you feel pain: Some medications change the way your body feels pain, making it more comfortable for you. Interferes with pain signals sent to the brain: If medication doesn't work, your doctor may refer you to a pain specialist for treatment. There are effective interventions to help inhibit pain transmission nerves such as: nerve destruction, nerve plexus destruction, epidural anesthesia.

6. Side effects of pain relief treatment

Each type of treatment has its own side effects:
Surgery : Surgical removal of cancer causing pain in the surgical area. The majority of postoperative pain is related to nerve injury that occurs during surgery. People who have a limb or breast removed may feel pain as if the limb or breast is still present (phantom pain). Radiation therapy: Radiation therapy can cause redness and a burning sensation in the skin. Depending on the part of the body the radiation therapy affects, it can cause diarrhea, mouth sores, or other problems, such as fatigue. Chemotherapy: Side effects can include nausea, fatigue, infection, hair loss, and numbness in the feet and hands. There are many adjuvant medications that can help alleviate these side effects. Strong pain relievers: The most common side effect of opioids is constipation. This problem can be prevented with stool softeners or laxatives. Preventing constipation is easier than treating it, so before you start taking a pain reliever like morphine ask your doctor about a constipation medicine. Other side effects of strong painkillers include nausea, vomiting, and drowsiness. These symptoms usually occur after the first few doses and go away on their own after a few days of taking the medicine. Pain relievers: Over-the-counter pain relievers have the potential to cause kidney damage, stomach ulcers, or high blood pressure. Aspirin can cause intestinal bleeding and paracetamol can damage the liver if you overdose or drink alcohol while taking it.

7. Causes of ineffective pain relief treatment

Some causes of cancer patients' uncooperative treatment include:
Doctors rarely ask about pain or don't specialize in pain relief: Doctors should ask about a patient's pain at every visit. If your doctor does not specialize in pain management, you should work with a doctor who specializes in pain management or palliative care. Physicians concerned about opioid abuse: Doctors can prescribe opioid medications if needed. It is important that you describe the pain symptoms in detail. Patients hide their pain: Some people don't want to "disturb" the doctor, or fear pain is a sign of a worsening cancer. Others worry doctors think of them as complainers or can't afford painkillers. Patients are afraid of addiction: But the risk of addiction for cancer patients who take pain relievers exactly as directed by the doctor is very low. Of the 1,000 cancer patients who take morphine for pain relief, about 998 will not become addicted to the drug. Resistant to pain medication: This means that the doctor needs to increase the dose of the medicine to control the pain. This happens after 1.2 months of taking the drug as the nerves begin to get used to the pain reliever. Increasing the dose is not an addiction. If your medicine is not working as well as it used to, talk to your doctor about a higher dose or a change to another medicine. Do not increase the dose on your own. Fear of side effects: Patients are afraid to take pain relievers due to side effects such as drowsiness, heat, liver damage, kidney damage. However, these symptoms are relieved when your doctor prescribes a pain reliever that is appropriate for your pain level. For terminal cancer patients who respond poorly to pain relievers, modern surgical intervention is the solution being applied by Vinmec International General Hospital. Example:
Alcohol denervation to treat pain caused by tumor invasion of peripheral nerves. Canceling the solar plexus in visceral pain in pancreatic cancer, stomach cancer... Canceling the hypogastric plexus in cancers that invade the pelvic region such as prostate cancer, cervical cancer. Continuous epidural anesthesia, spinal anesthesia with intramedullary injection chamber to control symptoms of late stage cancer.... Dr. Nong Ngoc Son has many years of experience in directly treating cancer patients, especially in the field of chemotherapy, metastatic late-stage cancers, and end-of-life patients.

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Articles refer to the source: webmd.com, mayoclinic.org, cancer.net

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