Cancer and pain, unfortunately, are close companions. One out of three patients undergoing treatment reports moderate to severe pain; so do most people with advanced stages of the disease.
Yet, doctors stress, very few patients have pain so severe that it won’t respond to modern-day therapy. Physicians have many ways to control pain effectively—and provide at least some relief—to almost everyone.
Since no two people feel pain the same way, caregivers have no way to measure the severity of someone’s pain. That’s why doctors ask patients to rate their pain on a scale of zero to 10—it helps determine which pain relievers to prescribe and how well they’re working.Clear signals
If you’re facing pain from cancer treatment, your doctor needs as much specific information as you can provide about:
- basics, such as where you hurt, when it starts or how it feels—throbbing or burning, for example
- factors that increase or decrease pain, such as body position or time of day
- statements that define how much pain you’re willing to tolerate
This way, your caregivers can decide whether a tumor pressing on nerve endings is causing pain or if tissue damage from chemotherapy or radiation is the culprit.
They’ll also classify your pain as acute, or short-term; chronic, or continuing; breakthrough, meaning a flare-up; neuropathic, or caused by nerve injury; visceral, from injury to an internal organ; or somatic, meaning bone pain. This helps doctors know which pain relief techniques are most likely to work in your case.Climbing the ladder
Surgery, chemotherapy and radiation that remove or shrink tumors can bring dramatic relief—but it’s seldom that straightforward. Doctors usually prescribe medications as well, according to the “pain ladder”:
- First rung: Aspirin, ibuprofen and acetaminophen to relieve mild to moderate pain from incisions or achy muscles and bones.
- Second rung: For moderate pain, opioids like morphine or codeine; for severe pain, opioids combined with first-rung medications.
- Third rung. If pain breaks through, dosage is increased as needed. The patient receives enough medicine to “keep ahead” so pain can’t break through.
- Other steps. Various antidepressants, anticonvulsants, steroids and anesthetics can be helpful in taming cancer pain.
While highly effective, medications aren’t the only way to battle pain. Your doctor may also recommend:
- nerve blocks, injections that numb nerve endings and interrupt pain messages to the brain for extended periods
- neurosurgery to sever the nerve in the painful area
- TENS, short for transcutaneous electrical nerve stimulator, a procedure that uses nonpainful doses of electricity against the skin to relieve pain
- alternative medicine like acupuncture, meditation, movement therapy and massage