Guest Author - Adelle Ottavini
There are various reasons why pain occurs during your illness with cancer. It could be a tumour blocking nerves, or putting pressure on other organs. Post operative measures, type of cancer, stage of cancer, metastasising of cancer, and a patients’ pain threshold - all influence pain severity and discomfort. No matter what the reason – pain is a clinical condition, and should be treated as such. Unfortunately, pain (often) gets associated with cancer – therefore being a ‘normal’ symptom of cancer. If you experience pain: Speak up!
First, a few facts you should be aware of:
* You can not get addicted to cancer pain medication!
* Tolerance and addiction is not the same thing.
* Tolerance to a drug is ‘normal’ and your physician will adjust dosages or type of drug administered.
* There is no shame in pain!! You are not ‘weak’!!
* You are not distracting your physician with your pain.
* Painkillers do not mask changes in your cancer progress.
* Cancer pain does not equal cancer getting ‘worse’.
* Side-effects are minimal and are easier to deal with than a patient in pain.
* Respiratory depression in opioids (pain killer) occurs in only 1% of cases.
After surgery – when pain management is not controlled effectively, your body releases a stress hormone. This stress hormone damages body tissue, increases blood pressure, causes protein loss and your body looses control over blood sugar balance. This all delays healing! The same can happen when any other form of pain is experienced and not managed. Various psychological changes will also occur. You tend to get depressed, have mood swings, and become irritable, anxious, tearful and even aggressive. These feelings are unnecessary, and not helpful in your fight against cancer. When managing pain effectively, you don’t only sleep better, but also have a better attitude in dealing with your illness. Doctors have also found that patients ‘free’ of pain are more cooperative when being questioned about- or examined for their condition. Another fact to remember is: morphine has no ceiling dose! That is also why you don’t have to worry about: ‘What if the pain gets worse than now?’ Seek the advice of Pain Specialists like: oncologists, neurosurgeons, pharmacists, anaesthesiologists or psychologists.
When seeking help from your caregiver – be as descriptive as possible. Be vivid about the pain location and severity. Is your pain: Pinching, aching, throbbing, steady, stabbing, dull or sharp? How long have you experienced this pain, and for how long does it normally last? Have you found anything making it better or worse? Describe your pain according to a numeric rating scale – say 0 – 10 (nothing to severe). Pain 1 - 3 can normally be dealt with in a non-clinical way, e.g. Massage, visualisation, music, hot/cold packs, EMLA cream or with non-opioid analgesics. Moderate pain 4 - 6 will be dealt with by administering low doses of opioid analgesics, combined with non-opioids. For moderate-to severe pain 6 - 10, higher doses of opioids plus adjuvant analgesics will be used. When chronic or severe pain is experienced, ask/demand for ‘around the clock’ pain relief and NOT ‘as needed’ (PRN) – especially after surgery. Often in patients experiencing chronic pain – care givers are uncertain of the severity of pain, as these patients don’t ‘act up’ when experiencing pain. Be adamant in your pain control request!
Unnecessary suffering hampers healing, influences your activities and even your relationship with loved-ones. And remember: pain threshold is like eye colour – some are blue, others are brown. It is NOT a sign of weakness!
