Around one-third of people with cancer report some type of pain. The pain may come and go, be long-lasting, be mild or severe, and it can originate from organ systems, bones, or structural problems. Many people with cancer pain benefit from pain management strategies.
Cancer pain can come from treatments, such as chemotherapy, radiation, or surgery. Some painful conditions develop as a result of a suppressed immune system, which occurs with these therapies. Tumors are often a cause of cancer pain. When the tumor presses on nerves, organs, and/or bones, pain can occur. This is particularly true of a tumor near the spinal cord or nerves. Another cause of cancer pain is surgery. Post-operative pain relief helps patients recover more effectively.
Many treatment options are available for cancer pain. These include:
Medications – There are many methods of medication delivery, including rectal suppositories, skin patches, injections, and oral agents. The doctor can prescribe analgesic agents to control the pain, such as hydrocodone, oxycodone, fentanyl, and codeine.
Antidepressants are often prescribed along with other drugs, such as imipramine, amitriptyline, and trazadone. Antiepileptics are used for nerve pain, such as gabapentin. Other drugs used to treat cancer pain include corticosteroids, local anesthetics, stimulants, and bisphosphonates.
Transcutaneous electrical nerve stimulation (TENS) – This involves a mild current applied to the skin to block pain signals to the brain.
Nerve blocks – This involves injection of a long-acting anesthetic near a nerve bundle. This prevents the pain messages from reaching the brain.
Patient-controlled analgesia (PCA) – With this measure, the patient has an implanted intravenous device (IV) that attaches to a pump. The pump allows the patient to give him- or herself pain medication as needed.
Epidural analgesics – Studies show that this can provide successful pain relief in 100% of patients. With this procedure, the doctor injects an opiate agent into the epidural space, which is near the spinal cord.
Relaxation and biofeedback – These techniques are both useful as distraction measures to allow the patient to focus on something other than the cancer pain.
Superior hypogastric plexus block – This block is useful to treat pelvic and pancreatic cancers. A needle is inserted near the nerves of the abdominal region, and the doctor injects a long-acting anesthetic or neurolytic agent onto the nerves. One clinical study found this technique to have a 79% efficacy rate.
Celiac plexus block – This is also a technique used to block pain associated with the abdominal region. A long-acting anesthetic or neurolytic agent is injected near the nerves. Based on research, this block has a 90% success rate.
Radiation therapy – This is often used to relieve bone pain. It is give as a palliative treatment, which is often aimed directly at a tumor or large body area. Radiation therapy also helps other treatments work better by shrinking pain-producing tumors.
Radiofrequency ablation – This procedure uses a special problem with tiny electrodes on the end. The probe is inserted through a tiny incision and under general anesthesia. It destroys cancer cells using radiofrequency energy.
Massage therapy – As a means of supportive care, massage therapy is used to relax the patient and improve mood. Studies show that massage therapy increases the flow of blood, decreases swelling/inflammation, causes the release of endorphins from the brain, decreases pain related to muscle tension and spasms, and increases the effectiveness of drugs.
Acupuncture – This is an integrative therapy involving needles, pressure, heat, and other modalities. The needles are placed into acupoints on the skin.