Pain Management For Cancer Patients

  • Mrunal DaveExperienced Medical Writer wants to learn Medical Communication in UK perspective
  • Zayan SiddiquiBSc in Chemistry with Biomedicine, KCL, MSc in Drug Discovery and Pharma Management, UCL

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Introduction

Cancer is an imposing enemy, frequently accompanied by extreme agony – physical as well as emotional. This is a journey nobody chooses. For people who are embarking on this journey, they can have hope. This thorough article encompasses various effective pain relief techniques, especially aimed at cancer victims. We know how hard it is and we have some answers which will make living by you easier in your difficult path.

The impact of cancer-related pain

Cancer-related pain is a complex problem which has adverse effects on patients’ quality of life. Cancer pain is highly unpredictable because it depends on the cancer type/stage, as well as the general overall fitness of a patient. It could either be acute or chronic (short or long term), mild or severe and may result from the cancer or its treatments.

To make matters worse, the physical pain is always associated with the emotional burden of the disease. In this case, cancer affects one’s body and soul. Increased perception of pain may also occur as a result of the accompanying stress, anxiety, and depression in association with cancer diagnosis. Therefore, total care is necessary when dealing with pain enquiring into not only the physical but also psychological distress endured.¹

Medication: the first line of defence

Cancer pain management usually starts with medications. Your healthcare team will assist you in selecting the best medication and dose for your unique case among the many options provided. It’s important to note each one’s understanding of pain will vary, and thus call for an individualistic approach in management.

A. Opioids: In this case, they mostly include opioid-based medications, which offer a good option for serious cancer pain relief. They act by targeting specific receptors in the brain and the spinal cord that cause pain sensation. Examples of opioids include morphine, oxycodone, and fentanyl. These medications are useful, but should only be administered by a medical doctor with caution, because they may cause addictions as well as other side effects.

B. Non-opioid pain relievers: Other analgesics such as acetaminophen (Tylenol), paracetamol, and NSAIDs can be administered for lesser pains. They have lesser strength compared with opioids, yet they offer relief to certain cancer victims.

C. Combination therapy: Some pain management strategies that involve different medicines could be optimal for patients. The nature of your pain should be evaluated by your healthcare provider based on your medical history.¹º

Non-pharmacological interventions: enhancing pain relief

Non-pharmacological therapies could be used as an adjunct therapy to medication, to improve global pain treatment. They help to relieve stress, relax and tackle the emotional part of pain.

Here are some examples of non-pharmacological interventions:

A. Acupuncture: The ancient Chinese medical art of acupuncture consists of putting fine needles in certain places on the body’s surface to activate flow and alleviate pain. Acupuncture can help cancer patients manage pain and reduce anxiety.⁵

B. Massage therapy: Massage is effective in relieving tension in muscles, decreasing pain, and inducing calmness. Cancer patients may find it comforting and relaxing.⁴

C. Meditation and mindfulness: The mindfulness medication can be beneficial for patients as focusing on present moments and reducing stress and anxiety that can be caused by chronic pain. Therefore, these approaches could serve as useful pain relief mechanisms in cancer patients.²

D. Yoga: Yoga incorporates a sequence of poses, breathing methods, and relaxation procedures that promote a better range-of-motion, alleviate discomfort, and foster healthfulness. It is adjustable to the personal capabilities and health issues of people with different kinds of cancer.³

Physical therapy: regaining mobility and alleviating pain

Physical limitations and discomfort usually follow cancer conditions as well as treatments. Physical therapy could constitute an important element in cancer patients’ pain control regimen. Physiotherapists focus on helping people get back to normal movements, reducing pains and improving their lives. These include designing specific exercise programs for a patient based on various facts including type and stage of cancer or side effects of treatment. Some key benefits of physical therapy for cancer patients include:

A. Improved mobility: Physiotherapy enables cancer victims to recover strength and ease movement for performing routine duties.

B. Pain reduction: Through this process, therapists can suggest appropriate exercises to improve areas of pain.

C. Lymphedema management: Lymphedema, characterised by swollen legs and arms as a result of cancer surgery or radiation treatment, can be managed by physiotherapy.

Nerve blocks: interrupting pain signals

For instance, some types of cancer can result in focal pain, which may become difficult to control using just oral medicines. Medical nerve block is a process that interrupts pain signals, hence offering substantial relief. This procedure consists of administering local anaesthetics, and blocking pain through nerves. Nerve blocks can be particularly effective for:

A. Surgical pain: Nerve blocks are also useful for managing post-surgery pain (after operations) related to cancers like for example mastectomies and prostatectomies.

B. Painful lesions: Nerve blocks can also be used in situations where pain has been brought about by painful lesions due to cancer.

C. Neuropathic pain: Neuropathic pain typically presents with symptoms of burning, shooting, or electrical-type sensations; thus nerve blocks can be helpful in these cases.⁶

Healthcare providers should also talk to you about the pros and cons of nerve block in order to establish whether it’s appropriate or not.

Counselling and psychological support

Cancer affects emotionally as much as physically. A cancer diagnosis, treatment, and associated uncertainties cause emotional and psychological distress including stress, anxiety, and depression which in turn worsen the perception of pain. Therefore, counselling and psychological support are indispensable elements included in the total treatment paradigm of cancer patient’s pain.

A. Individual counselling: Cancer patients can deal with the emotional difficulties associated with this journey through one-on-one counselling by a qualified therapist or psychologist. It serves as an environment, where it is safe to share feelings, and fears, and generate coping skills.

B. Support groups: Cancer support groups connect people who are undergoing the same struggle. It is reassuring and authenticating to share your experience and insights with others who may have gone through a similar situation.

C. Cognitive-behavioral therapy (CBT): Cognitive behavioural therapy is a form of psychotherapy which assists patients in analysing their adverse thinking and destructive behaviours, to alter them. This is very significant in the management of anxiety and depression that usually occurs among cancer patients.

D. Stress-reduction techniques: Cancer patients may learn some stress reduction skills like deep breathing, progressive muscle relaxation and guided imagery that help them manage anxieties and perceive less pain.

The role of counselling and psychological support is not simply a function of palliation of emotional distress, but also indirectly enhances pain control by addressing factors that increase perceptions of pain.⁸

Diet and nutrition: nourishing the body

Cancer care involves proper nutrition. Nutrition has a great impact on pain management. A balanced diet helps the body get better, fights against inflammation, and is good for one’s health in general.

Dietary considerations for cancer patients:

A. Maintaining a healthy weight: Since obesity will make it worse, maintaining a healthy weight can help people in pain.

To receive guidance on crafting a nutrition regimen conducive to managing your weight, seek the expertise of a registered dietitian.

B. Anti-inflammatory diet: One group of patients with cancer can benefit from an anti-inflammatory diet, containing vegetables, fruits, nuts, seeds, olive oil, spices, herbs, tea, fish, beans, eggs, chicken, and dairy products low in saturated fat. They may also serve as anti-inflammatory agents that work against pain.

C. Hydration: Cancer patients who are going through dehydrating drugs must stay adequately hydrated. Drinking enough water is important for good health and may help cure certain kinds of pains like headaches.

D. Dietary supplements: Sometimes, supplements are prescribed to provide a specific diet lacking substances that influence pain sensation. This will help your healthcare team ascertain if further supplementations are required.

E. Dietary restrictions: Patients might also observe certain restrictions on their diets upon undergoing some cancer treatment processes. These guidelines should be adhered to as they promote the best-case results and prevent more pain from arising.⁷

Palliative care is a specialised medical approach that focuses on improving the quality of life for patients with serious illnesses, including cancer. It is not limited to end-of-life care and can be beneficial at any stage of the disease. A palliative care team consists of healthcare professionals, including doctors, nurses, social workers, and chaplains, who work together to address the physical, emotional, and spiritual needs of patients.

The importance of personalised care

Every individual's experience with cancer is unique, and the same holds true for their experience of pain. Therefore, the approach to pain management should be highly personalised. It's crucial to work closely with your healthcare provider to create a tailored pain management plan that fits your specific needs. Here are some key points to keep in mind:

A. Open communication: Be open and honest with your healthcare team about your pain and its impact on your life. The more they know about your experience, the better they can tailor your treatment.

B. Regular assessments: Pain is dynamic and can change over time. Regular assessments and discussions with your healthcare provider help ensure that your pain management plan remains effective and up-to-date.

C. Adjustments as needed: Be prepared for adjustments to your pain management plan. What works best for you may evolve as your cancer journey progresses.

D. Multidisciplinary approach: Pain management often requires a multidisciplinary approach, with various healthcare professionals collaborating to provide the best care. Don't hesitate to seek second opinions or consult specialists when necessary.

E. Self-advocacy: As a patient, it's essential to advocate for yourself and your pain management needs. You have the right to be an active participant in your care.⁸

FAQs

Are opioids the only option for cancer-related pain?

No, opioids are not the only option. While they can be effective for severe pain, there are various non-opioid medications, complementary therapies, and interventions that can be explored. Your healthcare provider will work with you to determine the most appropriate approach.

How can complementary therapies like acupuncture and meditation help with pain management?

Complementary therapies can help by reducing stress, promoting relaxation, and even addressing the emotional component of pain. These therapies work in conjunction with traditional treatments to enhance overall pain relief.

What is the role of palliative care in pain management for cancer patients?

Palliative care focuses on improving the quality of life for cancer patients. It includes pain management, symptom control, and addressing emotional and spiritual needs. It is not limited to end-of-life care and can be beneficial at any stage of the disease.

How can a well-balanced diet and nutrition aid in pain management for cancer patients?

Proper nutrition can help reduce inflammation, improve overall well-being, and support the body's healing process. It plays a crucial role in managing pain and enhancing the patient's overall quality of life.

Summary

Although cancer pain may be extremely difficult both physically and emotionally – it’s not the end of the world! The management of the pain can be done using a combination of medications, such as non-pharmacological interventions, physical therapy, nerve blocks, counselling, nutrition, and palliative care. Recollect, though; all experiences are different and therefore require you to engage in an open conversation with your health care team for a customised pain management plan specific to your needs.

Simply, at the core of all this is an awareness that you are not alone on this path/journey. As we fight against cancer and its accompanying pain, there are many healthcare professionals, support groups, and resources within our community that can help us. However, with good pain-management strategies, you should be able to improve your quality of life and enjoy some periods of relief now and then.

References

  1. Cancer Pain (PDQ®) - NCI. 15 Oct. 2023, https://www.cancer.gov/about-cancer/treatment/side-effects/pain/pain-hp-pdq
  2. Carlson, Linda E., et al. ‘One Year Pre-Post Intervention Follow-up of Psychological, Immune, Endocrine and Blood Pressure Outcomes of Mindfulness-Based Stress Reduction (MBSR) in Breast and Prostate Cancer Outpatients’. Brain, Behavior, and Immunity, vol. 21, no. 8, Nov. 2007, pp. 1038–49. PubMed, https://doi.org/10.1016/j.bbi.2007.04.002.
  3. Agarwal, Ram P., and Adi Maroko-Afek. ‘Yoga into Cancer Care: A Review of the Evidence-Based Research’. International Journal of Yoga, vol. 11, no. 1, 2018, pp. 3–29. PubMed Central, https://doi.org/10.4103/ijoy.IJOY_42_17.
  4. Zhang, Yueyue, et al. ‘Massage Therapy Can Effectively Relieve Cancer Pain: A Meta-Analysis’. Medicine, vol. 102, no. 27, July 2023, p. e33939. PubMed, https://doi.org/10.1097/MD.0000000000033939.
  5. Hu, Caiqiong, et al. ‘Acupuncture for Pain Management in Cancer: A Systematic Review and Meta-Analysis’. Evidence-Based Complementary and Alternative Medicine : eCAM, vol. 2016, 2016, p. 1720239. PubMed Central, https://doi.org/10.1155/2016/1720239.
  6. Nagaro, Takumi, and Shinzo Tsubota. ‘[Cancer pain treatment with nerve blocks and neuroablative procedures]’. Nihon Rinsho. Japanese Journal of Clinical Medicine, vol. 65, no. 1, Jan. 2007, pp. 103–08.
  7. Nutrition in Cancer Care - NCI. 24 Mar. 2003, https://www.cancer.gov/about-cancer/treatment/side-effects/appetite-loss/nutrition-pdq.
  8. Riba, Michelle B., et al. ‘NCCN Guidelines® Insights: Distress Management, Version 2.2023: Featured Updates to the NCCN Guidelines’. Journal of the National Comprehensive Cancer Network, vol. 21, no. 5, May 2023, pp. 450–57. jnccn.org, https://doi.org/10.6004/jnccn.2023.0026.
  9. Clark, David, et al. ‘Implementation Science Methodologies for Complementary and Integrative Health Research’. The Journal of Alternative and Complementary Medicine, vol. 27, no. S1, Mar. 2021, p. S-7-S-13. DOI.org (Crossref), https://doi.org/10.1089/acm.2020.0446.
  10. Swarm, Robert A., et al. ‘Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology’. Journal of the National Comprehensive Cancer Network, vol. 17, no. 8, Aug. 2019, pp. 977–1007. jnccn.org, https://doi.org/10.6004/jnccn.2019.0038.

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Masters in Biotechnology, Guru Ghasidas University

I'm a highly motivated and skilled biotechnology professional, known for my strong background in research and laboratory work. My proficiency extends to cryosectioning, immunohistochemistry, confocal imaging, and various molecular biology techniques. I am detail-oriented and dedicated to consistently producing high-quality results.

My educational journey led me to a Master's degree in Biotechnology from Guru Ghasidas Vishwavidyalaya, India. This academic foundation, combined with my practical experience, fuels my commitment to advancing scientific research and improving human health.

My practical experience includes roles as a Research Assistant at Saarland University in Germany and as an Internship Research Trainee at the All India Institute of Medical Sciences. In these positions, I mastered the use of cryosectioning, immunohistochemistry, and various laboratory techniques, consistently delivering high-quality data for scientific research.

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