WHAT PAIN IS AND WHAT CAUSES IT

Pain is an unpleasant or uncomfortable physical sensation that occurs when some part of our body is damaged. About 5 out of 10 people undergoing cancer treatment have some kind of pain.

How each person feels and expresses their pain varies from person to person. Your pain may differ from someone else's who has had the same treatment or type of cancer as you. Remember that higher or lower levels of pain do not necessarily mean that your cancer is worse or more advanced.

Your pain may be due to a number of factors. Certain cancer treatments such as surgery, chemotherapy, or radiotherapy may damage the body's tissues or nerves, causing pain. These are physical causes. Your emotional state may also affect the degree of pain you feel. For example, feelings of anxiety or depression may worsen pain.

Pain can almost always be reduced. It is important that you tell you doctor as soon as possible if you are experiencing pain. The earlier pain treatment can begin, the more effective it will be.


DIFFERENT TYPES OF PAIN

There are different types of pain:

  • Acute pain begins suddenly and is short-term.
  • Chronic pain affects people over a longer period of time.
  • Neuropathic (nerve) pain: pain may come and go.
  • Visceral pain is felt when organs or tissues are damaged.
  • Total pain includes the emotional, social, or spiritual factors that also affect a person's experience of pain.

Pain does not feel the same for everyone. Clearly describing what pain is like will help your doctor treat it. Try to describe where it hurts, what kind of pain it is, how much and when it hurts can help your pain management. Also, try to explain how the pain changes over time and what makes it get better or worse.

Keep a pain journal can aid in explaining pain and planning the best treatment.


PAIN LEVELS AND DIFFERENT STRENGTHS OF PAINKILLERS

Pain can be mild, moderate, or severe and can be treated with different types of painkillers depending on pain level. In order to decide which type of painkiller is best, your doctor may use a tool called the analgesic ladder, which shows each level of pain and the type of painkillers that are best to control it.

  • Mild pain, step 1: includes non-opioid drug such as paracetamol and anti-inflammatory drugs such as ibuprofen.
  • Moderate pain, step 2: includes weak opioid drugs such as dihydrocodeine, codeine phosphate, or tramadol.
  • Moderate to severe pain, step 3: includes opioid drugs like mophine, fentanyl, and oxycodone.

Different painkillers work in different ways and are sometimes used in combination; for example, non-opioid painkills are often used together with weak or strong opioids. Other medicines known as adjuvant drugs can be used to control pain; an example of these are steroids.


STORING AND REMEMBERING YOUR MEDICATION

It is important to store your medicines correctly and take them at the right time in order to ensure that they work as well as possible. Here are some practical tips.

  • Painkiller storage - keep these in their labeled packet and in a cool, dry place out of reach of children.
  • Checking dates - review the label to ensure that your medicines are not past their expiration date.
  • Remember to take your medication - write a note, set an alarm, or get someone to remind you to take your scheduled dose.
  • Take your medication with you when traveling - remember to bring them with you and make sure you have enough medicine to last you the entire time you will be away. Carry a list of medications, copies of prescriptions, and your doctor's phone number if necessary.
  • A pain journal: taking notes that can help you track your pain and thereby improve treatment.

PAINKILLERS AND WAYS OF TAKING THEM

Painkillers help control pain and come in many types and methods of taking them.

They are normally taken orally as pills or capsules. If you have difficulty swallowing, painkillers can often be taken in liquid form or as pills that dissolve in water.

You can also take painkillers in other ways, such as skin patches, gels, nasal sprays or suppositories. There are also buccal and sublingual medicines that dissolve in the mouth and are fast-acting. If you require strong painkillers for a period of time, there are small pumps that are equipped with a needle and release doses of painkillers at a constant rate.

Always let your doctor or nurse know if you are in pain or if your pain worsens.


CANCER TREATMENTS USE FOR PAIN CONTROL

Some cancer treatments may help alleviate the pain caused by cancer.

  • Surgery can be used to eliminate some or all of the tumor, thus reducing pain by relieving pressure on organs or nerves. Surgery may involve the insertion of a stent (a hollow tube) if you have a blockage in a tube-shaped organ such as the throat. This relieves the blockages and reduces pressure.
  • Radiotherapy can be used to reduce the size of the tumor. A special type of radiotherapy known as radioisotope therapy can also be used to control bone pain.
  • Chemotherapy and targeted therapies reduce pain by shrinking the tumor.
  • Hormonal therapy may be used to treat certain types of cancer and help relieve pain.
  • Nerve blocks relieve pain by preventing pain messages from reaching the brain.
  • Radiofrequency ablation (RFA) uses heat to destroy cancer cells. It is sometimes used to relieve bone pain caused by small secondary bone tumors.

Your doctor or specialist nurse will be able to advise you on what pain-control method is most appropriate for you.


CONTROLLING PAIN WITHOUT DRUGS

There are several non-drug treatments or complementary therapies that can help with pain. Some people find them very useful, although they do not work for everybody.

These non-drug treatments or complementary therapies can be used alone or together with painkillers. If you decide to use a complementary therapy, you should always talk to your doctor first. Complementary therapies should not replace the treatments prescribed by your doctor.

Some treatments or therapies aim to help you cope better with pain, for example by teaching you relaxation techniques. Others use physical therapies to relieve pain. There are many different treatments and therapies available:

  • TENS machine
  • Acupuncture
  • Cognitive behavioral therapy (CBT)
  • Physical therapy and exercise
  • Relaxation
  • Hypnotherapy
  • Meditation
  • Massage therapy
  • Visualization (imagery)

WHAT ELSE CAN HELP YOU DEAL WITH PAIN?

There are many things you can do to make your pain easier to manage. Even small changes in your routine can make a difference.

Try to ensure that you are as comfortable as possible. Sit or lie down in position that does not cause you to feel pain. Change positions regularly, using special cushions or pillows.

You may want to try applying heat or cold to relieve pain. Heat-therapy pads and warm baths can relieve pain and stiffness, while an ice bag can relieve inflammation and swelling.

Other thing can help keep your mind off your pain, such as watching television, reading, or listening to music. Some people also find that art or music reduce the feelings of anxiety and help them relax.

Talking to family and friends can often help alleviate worry or anxiety.