PAIN MANAGEMENT FAQ's
The Challenge
Being diagnosed with cancer brings a host of concerns and fears to mind. Among the most common fear is that of pain. In fact, many patients are concerned that pain may not only affect their quality of life, but the medicines to treat it will get them addicted, or even worse, stop working. Your physicians are skilled in pain management and through a combination of techniques, your cancer pain can be controlled.
Who treats the pain?
Your nurses, PA and doctor will be primarily responsible for helping you manage any pain. Often, a team approach is needed with additional participation from consultant physicians specializing in pain management, and radiation oncologists.
What causes cancer pain?
There are many causes of cancer pain. Most pain is due to the tumor pressing against nerves, bones, or tissue. However, some treatments for the cancer can also cause pain, infection and immobility (being inactive). It's important to remember that cancer patients can have pain that has nothing to do with the cancer or its treatment. Headaches, muscle strains, chest pain, and arthritis are common ailments which may need to be treated along with cancer pains.
How do I choose the right treatment?
Pain is most often treated with analgesics or "pain killers," many of which are opioids (narcotics). However, there are many different kinds of medicines which help to ease pain, therefore a combination of two or three medicines may be used. Your doctor will first recommend medicine taken by mouth, by rectal suppository or placed on the skin, using intravenous or subcutaneous medicines only if the pain cannot otherwise be controlled. In addition, some cancer pains need radiation therapy, chemotherapy, surgery or nerve blocks to successfully be relieved.
Why should cancer pain be treated?
Obviously pain keeps people from feeling good. It keeps people awake, can make them grouchy and irritable, and prevents them from enjoying activities such as exercise and eating. Also friends and family worry about people that are in pain, and often feel quite helpless. With treatment, most cancer pain can be eased with very simple interventions so patients can enjoy life.
What is a pain partnership?
Never is the relationship between physician and patient more important than when a patient has pain. The patient relies on the doctor to select the right types of medicines for the kind of pain experienced. The physician relies on the patient to accurately report their pain, take their pain medicine correctly and not abuse narcotics. If you have questions about pain or its treatment, ask your nurse or doctor for more information.
What are mouth sores (STOMATITIS)?
Mucositis is a medical term that refers to the inflammation and ulceration of mucous membranes caused by some chemotherapy drugs. Stomatitis is mucositis that occurs in the mouth. Some drugs, especially 5-FU and methotrexate, frequently cause this. Others, such as Taxol, Taxotere, Adriamycin, and Doxil, may cause mucositis in some patients. The severity of mucositis varies considerably. Some patients with mild sores simply have discomfort when eating, More severe mucositis can prevent any oral intake and lead to dehydration. Since the same chemo drugs that cause mucositis may cause diarrhea, patients with both of these problems may become dehydrated quickly. The following treatments may help to ease the discomfort of mucositis. However, once mucositis has started it usually takes time (a few days) to resolve.
Step 1 . Keeping ice in your mouth during an infusion of 5-FU can reduce the severity of mucositis.
Step 2 . Rinse your mouth frequently with a solution of two teaspoons baking soda in a cup of water. This should be repeated every 2-4 hours. Be sure to spit it out; do not swallow it.
Step 3 . Avoid citrus juices, over-the-counter mouthwashes, hot or very cold foods, and spicy or salty foods,
Step 4 . Prescription anesthetic mouthwash can ease pain and allow you to eat or drink ate using it. Ask your oncologist or your nurse for a prescription.
Step 5 . If you see white patches in your mouth you may need a special antibiotic for yeast (thrush) infection. Call your primary office and talk to the nurse.
Step 6 . If you cannot eat or drink, call the nurse at your primary office for instruction or to be seen by a doctor. You may need to get IV fluids or more potent pain medications.
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