Pain affects every aspect of your life. If you have pain; you start to have difficulty doing your daily activities. You may begin to experience sleep deprivation, decreased appetite, despair and fatigue. Unfortunately, pain can lead to nervousness, hopelessness, grieve, or even anger. Family and friends may not always understand how you feel, and in this case you may feel lonely.

Having cancer does not always mean having pain
Approximately 30% of all cancer patients complain of pain and 90% of patients with advanced-stage cancer experience pain. The main cause of cancer pain (75%) depends on the spread of the tumor (metastasis). The most common cause of cancer-related pain is bone metastasis pain. Bone pain complaint is present 20-30% in lung cancer and 50-70% in breast and prostate cancer. Pain may occur in different locations and in different characteristics due to circulatory disorder caused by blockage in blood vessels, tumor mass compressing nerves, infection, blockage in organs or canals. During cancer treatment (surgery, chemotherapy, radiotherapy) pain complaint is seen in 20% and 5% of pain complaint occurs independently from cancer due to other reasons.

Pain treatment is part of the treatment and follow-up therapy of the cancer. A multidisciplinary approach, i.e. a collaboration with physicians from various branches of medicine (such as oncology, anesthesia, surgery, psychiatry) plays a very important role in controlling pain in cancer patients.

There are many different medications, many ways of drug administration and different ways of pain control other than drug use available for cancer patients with pain.

Drug therapy is the first option in the most cancer pains. According to the World Health Organization Analgesic Ladder, weak opioid medications are firstly used. The intensity of pain is assessed and the pain medications are switched from weak to strong opioids. Depending on the general condition of the cancer patient, drugs can be administered in different ways. In patients who are unable to take oral medications, drugs can be administered as transdermal patches (through the skin).

One of the advanced methods in cancer pain is intrathecal pain pumps. With this method, morphine or similar drugs can be applied by placing catheter in the cavity where the nerves transmit the sense of pain in the spinal cord.

In cases where drugs are insufficient to control pain, nerve blocks can be applied from non-drug methods. This is the desensitization of the nerve, which transmits the pain sensation depending on the location of the cancer and the organ, with various chemicals or radio frequency method.

Increase in pain is not every time a sign that disease is progressing 
Every pain can be managed. When the pain is brought under control, you can sleep, eat better, spend time enjoying family and friends, continue your work and hobbies.

If you mention of your pain complaints in a timely manner to the team that treats and follows your disease (your doctors, nurses), the pain control treatment will be easier. Sometimes pain can be an indicator of other health problems and be important in cancer treatment. It is your absolute right to ask for the cancer pain treatment.

Spec. Ece Dumanlar Tan, M.D.
Anesthesiology and Reanimation Specialist, Bayındır Söğütözü Hospital

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