Pharmacological Management of Cancer Pain
What do I need to know about cancer pain? Cancer pain may be short-term or long-term. It may come and go. You may have pain if the tumor damages or blocks tissues, nerves, and blood vessels as it becomes larger. Some cancer cells may produce chemicals that cause pain. Chemotherapy, radiation therapy, or surgery may cause pain. Pain management is an important part of cancer care.
How is the cause of cancer pain diagnosed?
A pain diary can help your healthcare provider find the cause of your pain. Include anything that makes your pain better or worse. Also include when your pain begins and ends. Bring the pain diary to follow-up visits with your healthcare provider.
Pain scales help measure the amount of pain you feel. Pain scales may include numbers or faces. Your healthcare provider may ask you to rate the pain on a scale of 0 to 10.
An x-ray, CT, or MRI may be used to find the cause of your cancer pain. You may be given contrast liquid to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
Stimulation tests may help find nerves or muscles affected by pain. These tests may include electromyography (EMG), nerve conduction studies, and evoked potential (EP) studies.
Which pain medicines do I need?
Acetaminophen decreases pain. This medicine is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
Narcotic analgesic medicines are used for moderate to severe pain. They may be used to control cancer pain or after surgery and other procedures.
Anesthetic medicines may be injected in or around a nerve to block pain signals from the nerves.
Which other medicines are used to treat cancer pain?
Antidepressants may be used to help decrease or prevent the symptoms of depression or anxiety. They are also used to treat nerve pain.
Antianxiety medicine may help you feel calm and relaxed. It may also decrease pain and help you sleep.
Muscle relaxers help decrease pain and muscle spasms.
Steroid medicine may be given to decrease inflammation that causes pain.
Radiopharmaceuticals and biphosphonates help decrease cancer growth, pain, and inflammation that happens when cancer gets inside bones.
Anticonvulsant medicine may given to control seizures. It may also be used to decrease chronic pain.
What else can I do to help manage my pain?
Rest as often as you need to. Rest is important for your recovery. Do not return to your regular activities too quickly. Start slowly and do more as you feel stronger. Rest during the day. Plan for 6 to 8 hours of sleep each night. Contact your healthcare provider if you are not able to sleep.
Go to physical and occupational therapy as directed. A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain. An occupational therapist teaches you skills to help with your daily activities.
Exercise as directed. Activity may help increase your strength and control cancer pain. Ask your healthcare provider or pain specialist about the best exercise plan for you.
Prevent bed sores. You may need an egg crate or air mattress on your bed to help prevent bed sores. If you cannot move by yourself, someone will need to turn you from side to side often.
Call 911 for any of the following:
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
- You suddenly feel lightheaded and short of breath.
- You have chest pain when you take a deep breath or cough.
- You cough up blood.
When should I seek immediate care?
- You feel more pain even after you take your pain medicine.
- You feel so depressed that you cannot cope.
- You feel very anxious or irritable after you take your medicines.
- You have problems thinking clearly.
- You cannot control when you urinate or have a bowel movement.
When should I contact my healthcare provider?
- You have a fever.
- You have chills, a cough, or feel weak and achy.
- You have nausea or vomiting.
- Your skin is itchy, swollen, or has a rash.
- You have questions or concerns about your condition or care.
You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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