Cancer Pain
Cancer pain can occur for many reasons and is often a symptom of cancer. This is possible
- Related to cancer itself or its spread to other body parts
- A late presentation due to side effect of treatments such as chemotherapy, radiotherapy and surgery
- A result of extra stress placed on other body parts for example shoulder pain due to using of a stick for walking
- A totally unrelated coincidental problem such as arthritis
Pain can be divided into back pain (which is always in the back and can be controlled with regular medication) and chronic pain (pain that is outside of your normal pain). Chronic pain may occur unintentionally or may be caused by external or internal factors. Cancer patients may experience different types of pain. It is not limited to pain due to inflammation and tissue damage, for example, pancreatic cancer can spread to nearby tissues and nerves, causing visceral and neuropathic pain and distant bone metastases, causing bone pain. For example, different types of pain present differently.
- Neuropathic/ Nerve pain is generally described as burning, shooting, electric shock like or stabbing pain with associated tingling or numbness. It may be a consequence of cancer itself or a result of treatments such as chemotherapy (chemotherapy-induced peripheral neuropathy- CIPN).
- Visceral Pain originates from viscera (organs in body cavity) and is generally described as deep aching, squeezing and cramping sensation
- Bone pain presents as an aching, throbbing sensation. Some cancers have a preference to spread to bones
Pain Management
Pain relief should be tailored to the cause, intensity and duration of the pain. In most cases, reasonable control can be achieved using methodical methods. A multimodal, multidisciplinary approach offers the opportunity to reduce pain and provide support not only for physical needs but also for emotional, spiritual and social needs.
Pain Medications management
This involves using different classes of medications to reduce pain. The use of medication helps reduce side effects and increase benefits. When evaluating drug therapy, several factors should be considered, including the type of pain, cause and severity of pain, other medical problems and medications used, previous medications, nausea/vomiting, bowel movements, ability to take and absorb medications, liver function. kidney function etc.’ More.
Nerve blocks, Radiofrequency & Neurolytic procedures
Muscles commonly affected by analgesics are, for example, pudendal muscles for perineal or rectal pain, suprascapular muscles for shoulder pain, intercostal muscles for chest pain, etc. Transmission can be reduced in the long term by using neurolytic methods such as injection or phenol instead of local anesthesia. Including
neurolytic samples
- Coeliac plexus, splanchnic nerves neurolysis
- Hypogastric plexus neurolysis
- Lumbar sympathetic neurolysis
Radiofrequency procedures
- Splanchnic nerve radiofrequency ablation for abdominal pain
- Suprascapular nerve radiofrequency for shoulder pain
- Pudendal nerve radiofrequency for pelvic pain
Psychology
Cancer is often accompanied by anxiety, depression and fear of the worst. Psychologists can help analyze these thoughts rationally and develop positive strategies. They can help by teaching relaxation techniques and coping strategies and reducing the emotional impact of pain.
Dr. Akanksha Bansal
MD, FIAPM (GOLD MEDALLIST), EDPM (EUROPE), PAIN & PALLIATIVE CARE PHYSICIAN