Encyclopedia of Health and Medicine

P
pain management in cancer The ability to
improve comfort and provide relief from PAIN and
related symptoms that cancer and cancer treatment
may cause. Many people worry about the
potential for their cancer to cause pain. However,
the broad spectrum of available ANALGESIC MEDICA-
TIONS and other methods provide numerous
options to manage, and often entirely relieve, pain
due to cancer.
Causes of Pain in Cancer
Pain in cancer arises from either the cancer or
from treatments for the cancer. Cancerous tumors
can cause pain when they invade tissues and disrupt
the nerves. Sometimes cancer can also invade
NERVE tissue, also causing pain. Damage to structures,
such as may occur when cancer invades and
destroys tissues and organs, causes the cells of
those structures to release numerous CYTOKINES
(biochemicals that activate various components of
the IMMUNE RESPONSE). Among these cytokines are
substances that stimulate nociceptors, specialized
molecules in peripheral neurons that send pain
signals to the CENTRAL NERVOUS SYSTEM. RADIATION
THERAPY is often effective for pain relief in such situations,
as it can shrink the tumor so it no longer
pressures nerves and other structures. Sometimes
surgery to remove part of the tumor also provides
relief.
SURGERY FOR CANCER is most often the cause of
treatment-related pain. Sometimes surgery for
cancer is extensive, and the recovery period can
be lengthy and challenging. Most people are eager
to recuperate and return to their normal activities
as quickly as possible. They may feel taking analgesic
medications prolongs their recovery or may
fear that taking narcotic medications, the strongest
pain relievers, will result in ADDICTION. Neither is
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true. It may be necessary to take analgesic medications
regularly and for an extended time after
major cancer surgery to effectively manage the
pain. This is important because adequate pain
relief not only provides comfort but also allows
the body to heal. Protracted pain is emotionally
and physically stressful in ways that interfere with
HEALING and QUALITY OF LIFE.
Analgesic Medications for Pain Relief
Over-the-counter analgesic medications such as
NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS)
and acetaminophen often provide relief from mild
to moderate discomfort and pain. Prescription
NSAIDs and narcotic medications may be necessary
for moderate to significant pain. Dependence
and addiction are very seldom concerns in people
who are taking narcotic pain relievers for such
levels of pain. As well, there is little risk for overdose,
another major concern.
Though there is a ceiling effect with NSAIDs (a
point beyond which increasing the dose does not
provide any greater pain relief), this is not the case
with opioid analgesics. The body seems able to
accommodate the effects narcotics have on the
respiratory cycle when the narcotics are necessary
to relieve high levels of pain. However, opioid
pain relievers do impair judgment and thought
processes enough to make activities such as driving
hazardous and ill-advised.
Palliative Treatments for Pain Relief
Radiation therapy and surgery are often options
for palliative treatment for pain resulting from
cancer. These treatments reduce the size of
tumors, relieving their pressure on surrounding
tissues. The relief may extend months to years,
depending on the cancer. There is no discomfort