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Pain is a common and often disabling problem in many cancer patients. Although less than 25% of patient with early stage of disease experiences pain, more than 80 to 90% of patients with advance cancer reported pain. It is also common for patient to complain of pain arising from 2 or more different sites within the body, making pain control more complicated.
Causes of pain may be disease-related (caused by the tumor itself) or treatment-related (caused by the surgery, chemotherapy or radiotherapy). In addition, patient’s chronic pain condition, such as chronic neck pain, can contribute to patient’s pain problem. Psychological and social issues at this critical stage of life will compound and influence the perception of pain in many patients. It is well-recognized that despite effective cancer therapy, many patients can still continue to experience pain.
Pain Management in Cancer Patients
Cancer pain treatment should begin with a careful and comprehensive clinical assessment of patient, evaluating the causes of pain using an accurate history, a full physical examination and a review of laboratory, radiological, and other investigations. Psychological assessment during consultation is also critical as anxiety, fear and depression can all compound the pre-existing pain problem. Other assessments include social and spiritual assessment.
Cancer pain is very treatable and integration of pain care is critical to the overall well-bring of patient. Explanation of the causes of pain and the multi-modal treatment option is important in helping allay any fear and anxiety in patient.
The main stay of therapy is drug treatment, controlling between 70 – 90 % of patients with cancer pain. Pain can also be minimized with the use of chemotherapy and radiotherapy as appropriate.
In approximately 5 – 10 % with severe cancer pain not well controlled with medication, interventional techniques such as nerve block and lysis can be used to control pain. Some of these patients with severe pain may benefit from having their pain-killers (opioid and local anaesthetics) delivered directly via a spinal or epidural route to better control pain and minimize side effects.
Expert Author:
Dr Tan Tee Yong, Integrative Pain Centre
The article above is meant to provide general information and does not replace a doctor's consultation.
Please see your doctor for professional advice.
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