Non-pharmacological Management Of Cancer Pain
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GENERAL INFORMATION:
What is cancer pain?
- Cancer pain is an unpleasant feeling and emotional experience related to cancer. Pain is one of the many symptoms that may tell you something bad is happening to your body. Cancer occurs when cells grow and split without control or order, often making too much tissue (tumor). Cancer cells can pass through the blood or lymph vessels, and spread to other areas of the body. The body has special cells that receive signals when there is damage or an injury. These cells send a message to the brain. When the brain receives the message, you will feel pain.
- Cancer pain may be acute or chronic. Acute cancer pain comes on suddenly and does not last for a long period of time. Chronic pain persists or grows worse during the whole time that you have cancer. It may not always be present and may sometimes come with breakthrough pain. Breakthrough pain is the on and off episodes of pain that may occur even if you are taking pain medicines. This pain usually comes very fast and lasts for 30 minutes. With cancer pain, you may feel depressed or hopeless, or have problems eating or sleeping. Diagnosing and treating cancer pain as soon as possible may help you to enjoy your life more.
What causes cancer pain? Cancer pain may come from where the cancer started. It may also come from other areas in the body where the cancer has spread. Any of the following may cause or trigger cancer pain:
- Cancer growth: As the cancer grows and becomes bigger, it may damage, block, or put pressure on tissues, nerves, and blood vessels.
- Harmful chemicals: Cancer cells may produce chemicals that harm and cause pain to the body.
- Treatments: These include chemotherapy, radiation therapy, or surgery.
- Others: Cancer affects your body in many different ways. It causes your body to become weak that may lead to other serious problems, such as bed sores or constipation (dry, hard stools). You may also suffer from having troubled breathing, seizures (convulsions), nausea (upset stomach), or vomiting (throwing up).
How is cancer pain diagnosed? It may be easier to diagnose your cancer pain if you have a pain diary. A pain diary helps track pain cycles, and lets you know when and how the pain may start and end. You may also need any of the following to check how much pain you have or find its cause:
- Physical examination: Your caregiver will look for painful areas during a physical exam. He may touch, press, or stroke different sites or points on your body.
- Imaging tests: You may need imaging tests to look for the cause of your cancer pain. These may include x-rays, a computed tomography (CT) scan, and a magnetic resonance imaging (MRI) test.
- Pain scales: These are special tools that can help caregivers measure how much pain you feel. There are many pain scales that include numbers or cartoon faces. Your caregiver may ask you to rate the pain on a scale of 0 to 10.
- Stimulation tests: Stimulation tests tell exactly which nerves or muscles are affected by pain.
What is non-pharmacologic treatment for cancer pain? These are treatments that do not use medicines to decrease or control cancer pain. You and your caregiver will work together to choose which therapy is right for you. Each treatment has its advantages and may work more effectively depending on your pain and health status. You may have one or more of the following:
- Complementary and alternative therapies:
- Acupuncture: Acupuncture is a treatment based on a belief that our bodies have channels through which fluids flow. Caregivers will insert very thin needles just under your skin. This is believed to open the channels allowing fluids to flow better. This treatment may decrease pain and improve healing. Always see a caregiver for this treatment. Do not try to give this treatment to yourself.
- Aromatherapy: Oils, extracts, or fragrances from flowers, herbs, and trees are used. These may be smelled or applied for massage, facials, body wraps and baths. Aromatherapy helps you relax and relieves stress.
- Dietary supplements: Vitamins, minerals, herbs, or other plants may be given to ease cancer pain.
- Mind-body therapies:
- Biofeedback training: Biofeedback is a special way to control how your body reacts to things like stress or pain. The first step in this training is to use electrodes (wires) to monitor your body responses. These electrodes are placed on different parts of your body, such as your chest. The electrodes are attached to a TV-type monitor which gives a paper tracing of your heart beating. You will learn how to control body changes, such as slowing your heart rate, when you become upset.
- Hypnosis: This is done by putting you in a trance-like (sleep-like) state. Your caregiver then suggests ways that may help you heal yourself.
- Meditation: This therapy teaches you how to focus inside yourself. The goal of meditation is to help you feel more calm and peaceful.
- Relaxation therapy: Relaxation therapy teaches you how to calm your body and mind. The goal is to feel less physical (body) stress and have less emotional (mind) stress.
- Biofeedback training: Biofeedback is a special way to control how your body reacts to things like stress or pain. The first step in this training is to use electrodes (wires) to monitor your body responses. These electrodes are placed on different parts of your body, such as your chest. The electrodes are attached to a TV-type monitor which gives a paper tracing of your heart beating. You will learn how to control body changes, such as slowing your heart rate, when you become upset.
- Acupuncture: Acupuncture is a treatment based on a belief that our bodies have channels through which fluids flow. Caregivers will insert very thin needles just under your skin. This is believed to open the channels allowing fluids to flow better. This treatment may decrease pain and improve healing. Always see a caregiver for this treatment. Do not try to give this treatment to yourself.
- Education: It is important that you know and understand your condition, treatment, and care. This will help you tell your caregivers how you really feel about your cancer and its pain. You may also talk about your concerns, such as becoming dependent on pain medicines. Your questions about the side effects and costs of medicines and other treatments may also be explained. Cancer pain may be decreased by believing that you can control and handle pain.
- Electrical stimulation: A special device is used that sends mild and safe electrical signals. These signals decrease your pain when used over a painful body part.
- Heat and cold application: Some types of pain are decreased by using warm packs while others improve with cold. Your caregiver will tell you if warm or cold packs, or both used alternately, will help your pain. Taking a warm bath may also calm you and let your muscles relax. A cool shower on a very hot summer day may also do the same thing.
- Rehabilitation: This program may include physical and occupational therapy. In physical therapy (PT), you do special exercises to help your body get stronger and heal faster. Caregivers may suggest that you use special devices, such as a wheelchair, brace, crutch, or a cane. Using these devices may decrease the strain on your back and muscles. Massage and physical therapy can work better if you also use guided imagery, breathing exercises, or music. Occupational therapy (OT) uses work, self-care, and play activities to help you in your daily life. These include special skills for bathing, dressing, cooking, eating, and driving.
- Surgery and other procedures: Your caregiver may do surgery to help relieve your pain. He may need to remove the whole or a part of the tumor. He may also cut nerves or remove joints that may be causing your pain. He may use ultrasound, radio waves, thermal (heat), or laser therapy to relieve your pain. Ask your caregiver about these different treatment options for cancer pain.
What might happen if cancer pain is not treated? Cancer pain may affect many areas of your life. It can affect your appetite (ability or desire to eat), how well you sleep, your energy and your ability to do things. It can also affect your mood (how you feel about things) and your relationships with others. It is sometimes hard to find the cause of cancer pain. You may feel that it is impossible to get rid of your cancer and pain. This can cause a cycle of suffering, sleeplessness and sadness. If caregivers can help control your cancer pain, you will suffer less and enjoy your life more.
Where can I find support and more information? Having cancer pain is a life-changing condition for you and your family. Accepting that you have cancer pain may be hard. You and those around you may feel sad, frightened, and anxious. These feelings are normal. Talk to your caregiver, family, or friends about your feelings. Contact the following for more information about cancer pain:
- American Academy of Family Physicians
PO Box 11210
Shawnee Mission, KS 66207-1210
Phone: 1-913-906-6000
Web Address: http://www.aafp.org
- American Cancer Society
Phone: 1-800-227-2345
Web Address: http://www.cancer.org
- National Cancer Institute
Phone: 1-800-422-6237
Web Address: http://www.cancer.gov
CARE AGREEMENT:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
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