Cancer Pain Facts

Cancer Pain Factoids — Dr. Prakash Deshmukh, MD

Cancer is very traumatic to the patient and its relatives. If patient develops pain symptoms, it further adds to misery. If this is not sufficient, it is further worsened by some misconceptions. The whole idea for this post is to clear some of the myths we have about cancer pain.

Pain is the protective phenomenon which helps in recognizing that something is wrong. It's a system just as our digestive system to digest food. Pain is of paramount importance if we want to survive and protect ourselves. Feel warm and pain once you are in contact with heated objects or fire — this phenomenon protects us to be safe.

How Do We Control Pain?

Our body has a unique system that can generate endogenous opioids or pain relieving factors which help us in controlling pain. For example, Sunil Gavaskar was having severe tooth ache on the day of test match between India and West Indies. Without taking pain killers he went on to score a century in that innings. Our brain can ignore pain when we have some other important thing at hand.

The commonest example is our soldiers during war — irrespective of their injury they continue to battle. Common household scenario: when our mom cooks roti she invariably gets burnt on hand but comes to know about it only after cooking is done. In the cases given above our body produces pain relieving factors which takes care of the pain till the time important work is done.

The reverse process can also occur in our body where the incoming pain signal is facilitated or enhanced where even a small cut might lead to insurmountable pain. Usually happens when you are afraid and get hurt.

There is another mechanism that occurs when this system fails to function normally. It leads to pain even on light touch or by things which are not supposed to cause pain — for example a gentle tap. Here the pain mechanism goes haywire and causes a lot of pain.

There are specialists available who are trained in dealing with such types of pain who are called as pain specialists. They help you to relieve your pain in a variety of ways.

How Cancer Causes Pain

Cancer patients can have pain just like any other person not necessarily due to cancer itself. If cancer caused pain as a first symptom then it would be detected early but alas that is not the scenario in most of the cases.

They can have pain due to cancer if any one of the following occurs:

• Cancer cells invading the nerve tissue causing intense pain
• Cancer growth compressing the nerve in our spinal cord
• Cancer causing destruction of bone eventually leading to fracture which causes pain
• Cancer treatment like radiotherapy and chemotherapy occasionally can lead to severe burning pain
• Cancer causes generalised weakness which can lead to muscle pain

Not all patients with cancer have pain. It's one in 3 patients with cancer that have pain. Of these patients having pain, majority (50 to 80%) can be managed by means of opioid medication and other medication. Only a few people need more than one modality to get rid of their pain.

Opioid Medication and Addiction

Taking opioid medication will lead to addiction — Myth:

It's true drug addiction is a real menace and a difficult problem. But in cancer patients we rarely see opioid addiction. The reason is drug addicts take this drug for their psychological effects not for pain control so they become addicted, whereas cancer patients take it for cancer pain relief.

The amount of drug taken in cancer patients might increase in some patients but this is because the demand for pain relief is more.

The Team Approach

Finally to get adequate pain relief and optimisation of quality of life of patient we need to work as a team. A team of doctor, the patient and relatives. We always in our first visit assign task to a relative who will communicate with us the patient's situation so that we arrive at an optimal pain control with improvement of quality of life.