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Treatment for pain:
Specific treatment for pain will be determined by your physician based on the following:
- your age, overall health, and medical history
- type of cancer
- extent of disease
- your tolerance for specific medications, 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.
1.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 any procedure that may be 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
- with an injection into a muscle (IM) or under the skin (subcutaneous injection)
- 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 alleviate your pain.
Questions to ask about your pain medication:
Each time a pain medication is prescribed by your physician, consider seeking answers to the following questions:
- What dose of pain medication is being prescribed and how many times a day will I be taking 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?
- How long does it take the medication to start working?
- Is it safe to drink alcoholic beverages, drive, or operate machinery while taking this pain medicine? Are there any other activity restrictions?
- Are there prescription or take 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 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 you are taking the medication.
Be sure to talk with your physician 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 physician.
- your pain medication does not work for the length of time specified by your physician.
- 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 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 physician immediately. Side effects such as sleepiness, nausea, and itching usually resolve after your body adjusts to the medication. However, call your physician if you are experiencing any side effects from your pain medication.
2.What is 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 a 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 the treatment.
- Ask what you can expect as an outcome of the treatment.Imagery
Guiding you through imaginary mental images of sights, sounds, tastes, smells, and feelings can help shift attention away from the pain.
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 neurostimulation 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
- meditation
- music, art, or drama therapy
- pastoral counseling
- positioning
Physical and Occupational Therapy
Physical and occupational therapy may involve the following:
- aquatherapy
- tone and strengthening
- desensitization
Psychosocial Therapy/Counseling
Psychosocial therapy/counseling may involve the following:
- individual counseling
- family counseling
- group counselingp
Neurostimulation
Neurostimulation may involve the following:
- transcutaneous electrical nerve stimulation (TENS)
- acupuncture
- acupressure
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