WHAT IS IT? (DEFINITION)
People with cancer do experience pain and this pain can takes many forms. Pain can occur from the cancer or growth itself and this is the commonest cause of cancer pain. Other causes of cancer pain include pain resulting from the treatment of the cancer. Examples of this include pain following surgery to remove the cancer or other minor procedures like a bone marrow biopsy or pain caused by the radiotherapy or chemotherapy.
IS IT COMMON? (INCIDENCE)
According to the Cancer Council Australia, pain can still occur in 30-75% of people with cancer and in about 50% of these cases of cancer pain, the pain itself is undertreated. We need to do better at managing cancer pain.
WHAT DOES IT FEEL LIKE? (SYMPTOMS AND SIGNS)
The symptoms of pain are very variable from person to person and depend on the type cancer or where it is located on the body and/or the treatment that is causing the pain.
These pains can feel like a deep ache or can be sharp and stabbing. If a nerve or group of nerves has been damaged then the pain can have neuropathic (nerve-like) features like burning, pins and needles, numbness, sensitive skin or even electric shocks.
WHAT HAPPENS BECAUSE OF IT? (CONSEQUENCES)
Uncontrolled or poorly managed pain can have many consequences. Some consequences can be easily managed but others require specialist management.
Pain leads to fear of moving so people reduce or stop moving. This leads to deconditioning. Deconditioning is a complex problem that follows a period of inactivity, bed rest or even just a sedentary lifestyle. Deconditioning causes a decline in physical, functional, psychological, and even social aspects of life. Deconditioning leads to weak muscles, stiff joints, reduced coordination, weak bones, poor sleep, high blood pressure. This can go on to cause depression, anxiety, low self-confidence and inability to enjoy life.
In short, uncontrolled pain is exhausting, physically and mentally and emotionally.
HOW DO YOU DIAGNOSE IT? (DIAGNOSTIC TESTS)
Diagnosing the source of pain can sometimes be tricky because there can be many causes of pain in a single person. Pain specialists are trained in diagnosing the source of pain. Sometimes tests, scans and investigations are required. Sometimes tests are used to guide further treatment.
HOW DO YOU TREAT IT? (TREATMENTS)
If you can, the first step is to treat the cause of the pain e.g. if a cancer is pushing on a nerve then the cancer should be removed. Sometimes this is not always possible e.g. pain caused by chemotherapy medications. Your pain specialists will consider different pain medication combinations to find the best ones that work for you with the least side effects. Everyone is different and there is no one size fits all approach because people are so different.
The analgesic medications may be combined with other forms of treatment like:
- Nerve blocks and injections like coeliac plexus blocks for pancreatic cancer pain. Phenol injections.
- Physical therapy and functional improvements
- Psychological support. When we manage pain we also managing the people in pain and this includes their concerns and worries so we sometimes look to the help of other members of the pain management team when needed.
HOW DO YOU PREVENT THIS CONDITION? (PREVENTION)
Cancer pain should be managed early and should be treated by a proactive team of specialists. If people experience pain from cancer or the cancer treatments make sure your treating teams are ware of this and giving you medications and even doing nerve blocks to catch the pain as early as possible. The earlier the pain is well managed the better. It is not always possible to prevent cancer pain from happening in the first place. But, that doesn’t mean people with cancer should experience severe pain. With the right team in place, things can be done to reduce the pain and get on top of things early.
When in doubt about what can be done, just ask.