The introduction of targeted treatments and immunotherapy has transformed cancer treatment. Many conditions that used to end in death after only a few months have become chronic conditions that the patient lives with and manages for years to decades.
Pain caused by cancer
Cancer patients often experience pain. The pain can be due to the cancer itself, but more often, it is related to various treatments, such as muscle pain as a common side effect of TKIs. Unfortunately, in some cases, the pain continues long after cessation of the treatment. Nerves damaged by surgery, chemotherapy, and radiation can take a long time to heal. Pain caused by cancer invading the bones can be particularly severe.
Doctors will ask cancer patients to rate their pain on a scale of 0 to 10, where 0 is completely pain-free, and 10 is the worst pain imaginable. Usually, 7 to 10 is considered severe pain, and 4 to 6 is moderate pain.
Pain needs to be treated
While pain is common with cancer, patients need to avoid the trap of just trying to live with it. Some people think it is just part of their disease, and they have to accept it. Other people “don’t want to be a bother” and don’t complain about or report their pain. They end up being undertreated for pain, which seriously impairs their quality of life and may even shorten their life. Cancer pain can and should be treated.
Treating chronic pain caused by cancer
Patients living with cancer should consult with a pain specialist to develop a plan to prevent, treat, and manage their cancer. Sometimes the pain can be relieved through surgical reconstruction or changing to a different treatment. Most patients living with cancer will need medications to control their symptoms, including opioids. Patients should not be afraid of opioids; if taken as directed for pain relief, they are not dangerous and rarely lead to addiction. Opioids do cause physical dependence and tolerance, where increasing doses are needed to achieve the same level of pain relief, and abruptly stopping the medication will cause unpleasant withdrawal symptoms. These effects are not the same thing as addiction.
Some patients may find relief from:
• Nerve blocks
• TENS
• Implanted electrical stimulation device
• Physical therapy
• Acupuncture
• Medical cannabis
• Palliative radiation
• Ablation or surgical cutting of a specific nerve to block pain signals
Depression is not something that needs to be lived with
Patients living with cancer should also be aware that depression and anxiety are common side effects of their condition and need to be treated, not accepted as inevitable. Depression and pain can form a vicious feedback loop where the depression makes the pain worse, and the pain makes the depression worse. Let your care team know if you’re feeling depressed.
Active self-care is important
Engaging in active self-care is very important when living with a chronic condition. Getting sufficient sleep and rest, regular exercise, and a nutritious diet will help the body heal. Actively participating in a support group with other patients living with cancer and pain can be extremely helpful.
Conclusion
With advances in cancer treatments, many people are now living with cancer as a chronic condition. Many cancer patients are also experiencing chronic pain as part of their condition. Cancer-associated pain can and should be treated. Depression and anxiety are also common among cancer patients, and they can and should be treated. If you or a loved one is experiencing pain as part of living with cancer, it is vital to consult a pain specialist to discuss treatment. to end it in a friendly and positive way.
