Pain Control

Important Facts About Cancer Pain Management
Having cancer does not always mean having pain. For those with pain, there are many different kinds of medicines, ways to receive the medicine, and non-medicinal methods that can relieve the pain you may have. You should not accept pain as a normal part of having cancer. When you are free of pain, you can sleep and eat better, enjoy the company of family and friends and continue with your work and hobbies.

Only you know how much pain you have. Telling your doctor and nurse when you have pain is important. Not only is pain easier to treat when you first have it, but pain can be an early warning sign of the side effects of cancer or cancer treatment.

Cancer pain can almost always be relieved.There are many different medicines and methods available to control cancer pain. You should expect your doctor to seek all the information and resources necessary to make you as comfortable as possible. However, no one doctor can know everything about all medical problems. If you are in pain and your doctor suggests no other options, ask to see a specialist or have your doctor consult with a specialist. Pain specialists may be oncologists, anesthesiologists, neurologists, or neurosurgeons, other doctors, nurses, or pharmacists. A pain control team may also include psychologists and social workers.

Controlling and managing pain is part of the over-all treatment of cancer.
Your doctor wants and needs to hear about what works and what doesn’t work for you. Knowing about the pain will help your doctor better understand how the cancer and the treatment are affecting your body. Discussions about pain will not distract your doctor from treating the cancer.

Preventing pain from starting or getting worse is the best way to control it.
Pain is best relieved when treated early. You may hear some people refer to this as “staying on top” of the pain. Do not try to hold off as long as possible between doses. Pain may get worse if you wait and it may take longer, or require larger doses, for the medicine to give you relief.

You have a right to ask for pain relief.
Not everyone feels pain in the same way. There is no need to be “stoic” or “brave” if you have more pain than others with the same kind of cancer. In fact, as soon as you have any pain you should speak up. Telling the doctor or nurse about pain is not a sign of weakness. Remember, it is easier to control pain when it starts rather than waiting until it becomes severe.

People who take cancer pain medicines rarely become addicted to them.
Addiction is a common fear of people taking pain medicine. Such fear may prevent people from taking the medicine. Or it may cause family members to encourage you to “hold off” as long as possible between doses. Addiction is defined by many medical societies as uncontrollable drug craving, seeking, and use. When opioids (also known as narcotics) — the strongest pain relievers available — are taken for pain, they rarely cause addiction as defined here. When you are ready to stop taking opioids, the doctor gradually lowers the dose. By the time you stop using them completely, the body has had time to adjust. Talk to your doctor, nurse, or pharmacist about how to use pain medicine safely and about any concerns you may have.

Most people do not get “high” or lose control when they take cancer pain medicines as prescribed by the doctor.
Some medicine can cause you to feel sleepy when you first take them. This feeling usually goes away within a few days. Sometimes you become drowsy because, with the relief of the pain, you are now able to catch up on the much needed sleep you missed when you were in pain. On occasion, people get dizzy or feel confused when taking pain medicine. Tell your doctor or nurse if this happens to you. Changing your dose or type of medicine can usually solve the problem.

Side effects from medicine can be managed and often prevented.
Some medicine can cause constipation, nausea, vomiting, or drowsiness. Your doctor or nurse can help you to manage these side effects. Many side effects can be managed by changing the medicine or the dose or times when the medicine is taken.

Your body does not become immune to pain medicine.
Pain should be treated early. It is important to take whatever medicine is needed at the time. You do not need to save the stronger medicines for later. If your body gets used to the medicine you are taking, your medicine may not relieve the pain as well as it once did. This is called tolerance. Tolerance is not usually a problem with cancer pain treatment because the amount of medicine can be changed or other medicines can be added.

The following links provide good information about pain issues related to hospice palliative care.

This Hospice Net article addresses some common myths about pain control:

Pain Control: A Guide for People with Cancer and Their Families

BC Cancer Agency patient information including items on pain.

Canadian Cancer Society patient information about pain

Cancer Supportive Care has good information about pain

Cancer Links provides descriptions to several good links on pain issues

The “Handbook for Mortals” includes a good section about pain.
Controlling Pain