Cancer Pain

Cancer is a major healthcare related concern in modern times and is a modern pandemic. Millions are affected by cancer at various sites in their body. As cancer advances, it spreads to other organs and causes pain. One of the most challenging aspects of living with cancer is managing the pain that often comes with it. It ranges from Mild, Moderate to Severe in intensity. With time it becomes severe, chronic and often difficult to control.

Pain may be related to the cancer itself, location, duration, spread to other tissues, compression of adjacent nerves, or sometimes treatment related side effects. Various neurotransmitters and inflammatory mediators are released which cause pain. WHO has advocated Pain as the FIFTH VITAL SIGN and RIGHT TO PAIN RELIEF as BASIC HUMAN RIGHT!

Symptoms-

pain is typically described as dull, diffuse or sharp and localised. It may be radiating if adjacent nerves are compressed by the tumor.

When understanding cancer pain and its underlying etiology, there are certain factors that are given consideration. These include-

Severity of pain
Type and Character – whether stabbing, burning, sharp or dull
The location of pain in the body – close to tumor or distant site.
Aggravating and relieving factors.
The pain relief measures that the patient is already using such as certain medications, hot or cold packs etc.
Any other visual symptoms like redness or swelling associated with the cancer pain.

Pharmacological Treatment

Pain Killers like Diclofenac, Paracetamol or Ibuprofen to treat mild pain.
Opioids – weaker opioids like tramadol are used to treat mild to moderate pain not responding to simple analgesics, while moderate to severe pain is treated with stronger opioids like Morphine or Fentanyl.
Adjuvant Analgesics – these drugs modify the pain pathway and give best results when started early in treatment. Besides pain relief, they uplift the mood of the patients and improve quality of life. These include drugs like Amitriptyline, Nortriptyline, Gabapentin, Pregabalin and Duloxetine. These drugs don’t cause any side effects usually associated with long use of opioids.
Interventions and Nerve blocks- pain refractory to all these measures responds to nerve blocks, radiofrequency procedures or some implantable pumps which constantly deliver medicines to relieve pain into the body of the patient. Appropriate patient and procedure selection is of utmost importance. The best part of this treatment is that patients practically are without any medication for pain relief and live a life as close to normal as possible.

Non Pharmacological Treatment

In addition to medications, there are several non-pharmacological therapies that can help manage cancer pain. These include:
Acupuncture: Acupuncture is an ancient Chinese therapy that involves inserting thin needles into specific points on the body to stimulate healing and relieve pain.
Massage therapy: Massage therapy can help reduce muscle tension and improve circulation, which can help manage cancer pain.
Meditation: Meditation can help reduce stress and anxiety, which can worsen cancer pain. By promoting relaxation, meditation can help reduce pain levels.
Hypnosis: Hypnosis is a therapeutic technique that uses suggestion and relaxation to help manage pain and other symptoms.
Physical therapy: Physical therapy can help manage pain by improving mobility and function, reducing muscle tension, and promoting healing.

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Cancer Pain

Symptoms-

Pharmacological Treatment

Non Pharmacological Treatment

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