Cancer Pain

[bpel]

I have metastatic cancer and I am in so much pain. I have difficulty sitting and even laying down. It is also painful for me to eat. Has anyone else had these conditions? If so, what did you do to get relief?

[wobblybee Administrator Pioneer]

😕 I’m so sorry you’re coping with this challenge. My first thoughts are to contact the Oncologist who is looking after your care.

I’ve had my own brush with Grade 3 breast cancer, which I know can spread through the body via lymph nodes and the blood stream. In my case it hadn’t spread to the lymph nodes, but it’s always at the back of my mind that it could be circulating through blood.

You could type ‘metastatic cancer’ in the searchbox (above right), there are links, it’s possible some of the posts will refer to pain relief.

[bpel in reply to wobblybee]

Yes, my oncologist is aware of these symptoms. She has prescribed a drug for pain, but it is not working.

[wobblybee Administrator Pioneer in reply to bpel]

🤔What causes cancer pain?

If the pain is from the cancer itself, it can be from the cancer growing into or destroying nearby tissue. As a tumor grows, it can press on nerves, bones or organs. The tumor can also release chemicals that can cause pain. Or your body's reaction to the chemicals can cause pain.

Treatment of the cancer can help the pain in these situations. However, cancer treatments, including surgery, radiation and chemotherapy, also can cause pain.

How do you treat cancer pain?

There are a variety of ways. One is to remove the source of the pain through surgery, chemotherapy, radiation or other treatment.

If that can't be done, pain medications can usually control the pain. These medications include:

Over-the-counter and prescription pain relievers, such as aspirin, acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others)

Weak opioid (derived from opium) medications, such as codeine

Strong opioid medications, such as morphine (Kadian, Ms Contin, others), oxycodone (Oxycontin, Roxicodone, others), hydromorphone (Dilaudid, Exalgo), fentanyl (Actiq, Fentora, others), methadone (Dolophine, Methadose) or oxymorphone (Opana)

Some medications come in tablets or liquids you swallow; others dissolve quickly in your mouth. You can receive some medications by shots, either under the skin or in a vein; through rectal suppositories; or by wearing a skin patch.

Other medications used to treat cancer pain are antidepressants, anti-seizure drugs and steroids.

Also, there are specialized treatments, such as a nerve block, which is a local anesthetic that's injected around or into a nerve. The block prevents pain messages along that nerve pathway from reaching the brain.

Other therapies, such as acupuncture, acupressure, massage, physical therapy, relaxation, meditation and hypnosis, might help.

What are some reasons for not receiving adequate treatment for cancer pain?

Unfortunately cancer pain is often undertreated. Many factors can contribute to that, some of which include:

Reluctance of doctors to ask about pain or offer treatments. Health care professionals should ask people with cancer about pain at every visit. Some doctors don't know enough about pain treatment. In that case, request a referral to a pain specialist.

Given current concerns about opioid use and abuse, many doctors might be reluctant to prescribe these medications. Maintaining a close working relationship with your cancer specialists is essential to proper use of these medications.

Reluctance of people to mention their pain. Some people don't want to "bother" their doctors, or they fear that the pain means the cancer is worsening. Others are worried their doctors will think of them as complainers or that they can't afford pain medications.

Fear of addiction. If you take medications when you're not in pain or to get high, then the chance of developing addiction is high. But the risk of addiction for people who take pain medications as directed for cancer pain is low.

You might develop a tolerance for your pain medication, which means you might need a higher dose to control your pain. Tolerance isn't addiction. If your medication isn't working as well as it once did, talk to your doctor about a higher dose or a different drug. Don't increase the dose on your own.

Fear of side effects. Some people fear being sleepy, unable to communicate, acting strangely, or being seen as dependent on medications. You might have these side effects when you start taking strong pain medications, but they often resolve once your doctors find the correct level of pain medications for you and once you achieve a steady level of pain medications in your body.

[bpel in reply to wobblybee]

Thank you soooo much for this detailed response. It was just what I was looking for.

[Lm92]

I'm sorry you're dealing with so much pain. My Dad had metastatic Colin cancer and I remember the only thing that would dull his pain for any length of time was a Fentanyl patch. I hope you can find a solution that works for you.