Dealing with Constipation Diarrhea Nausea and Vomiting

Pain is not the only factor that can take its toll on a patient's quality of life. Side effects from radiation, surgery, chemotherapy, and other medications, as well as other ailments resulting from cancer, can cause significant discomfort. Just as the pain of cancer can be well controlled when treated aggressively, most of these symptoms, such as nausea, vomiting, diarrhea, and constipation, can also be effectively managed. As with pain, families shouldn't ever assume that these unpleasant...

Other Sources of Pain Associated with Cancer Other Conditions

Pain may also result from other conditions that occur at the same time as the cancer (comorbid conditions) and which may or may not be directly related, such as arthritis, gastrointestinal disorders, and long-standing back pain these account for pain in about 3 percent of hospitalized cancer patients and 10 percent of those cared for at home. Some physicians also consider problems related to the side effects of cancer therapies as another category of pain, such as discomfort due to muscle...

Using NSAIDs with Opioids

While doses of opioids can be increased to very high (theoretically unlimited) levels if needed, NSAIDs have a ceiling dose beyond which there is no additional pain relief, only increased side effects. Although each NSAID is associated with a usual ceiling dose, there is still some variation among individuals, even for the same drug. As a result, the doctor may recommend a moderate increase in the initial dose of an NSAID, hoping for a corresponding improvement in comfort. Moreover, the side...

Understanding How Adjuvant Drugs Relieve Pain and Suffering

In addition to the basic pain relievers, other medications are often prescribed to enhance patient comfort. Called adjuvant drugs or co-analgesics, these drugs are auxiliary medications, most of which were developed for conditions other than pain, but can play an important role in the relief of pain. Adjuvant simply means helper these drugs may help counteract side effects of the primary pain reliever(s) or help relieve other distressing symptoms, such as nausea, constipation, or...

Confusion and Delirium

Many conditions can trigger confusion in patients with cancer. Unlike delirium, which is a more established condition, a confused patient will be mixed up from time to time, but overall behavior remains normal. The patient is not agitated, and even if he occasionally hallucinates or seems to be losing his mind, he becomes aware of these episodes. If this condition becomes more profound or the patient becomes agitated, then the patient may be described as delirious. Delirium, by definition, is...

Note for Chronic Pain Sufferers Who Dont Have Cancer

Although this book is about the pain and symptoms associated with cancer, much of the information presented is surprisingly relevant to people who don't have cancer but who suffer from unrelenting or progressive chronic pain. These materials include Chapters 3 and 4 on assessing pain and being an active health-care consumer, all of Part II that details medication use and much of Part III, including Chapter 12 on mind-body approaches to easing pain. Just as cancer pain is still often severely...

Good Pain Treatment Is Good Cancer Treatment

Regardless of the source of the pain, it should be treated, not only to make the patient more comfortable but, as discussed in Chapter 1, because it is harmful to health, impairs quality of life, and interferes with the ability to fight cancer. Remember suffering is needless and will only make things worse. Pain treatment should be a high priority, not relegated to the back burner. It is as essential to treat pain as it is to treat the cancer itself, because unrelenting pain can influence the...

Weak Opioid Medications for Cancer Pain

The following drugs are most commonly prescribed for moderate cancer pain when nonopioid drugs (NSAIDs) are no longer sufficiently effective. However, doctors often will maintain the use of a nonopioid medication to be used in combination with a weak (or strong) opioid because they relieve pain by different mechanisms thus, when used together pain-relieving effects are typically enhanced. As a result, lower doses of the opioid may be used with fewer concerns about side effects. Many of the...

Psychological Responses to Cancer

As we've said, about half of cancer patients adjust normally to being ill with cancer, leaving about half whose psychological problems may become debilitating. Of those, about two-thirds suffer from reactive anxiety and depression that is, new anxiety and depression that are a direct response to the illness. However, when in pain, patients are about twice as likely to develop anxiety and depression than those whose pain is well controlled.1 Undergoing chemotherapy may be a particularly...

The Typical Distress of Cancer Patients

As patients try to cope with their illness and its repercussions, they may experience a merry-go-round of changes. We will first discuss the most common ones, and later suggest how family members and other primary caregivers can help. From the moment a lump is spotted, a mysterious and insistent pain nags, or sudden weight loss is noticed, almost everyone experiences some anxiety. First, an unspoken fear nags that it could be cancer. If a doctor confirms it, new fears arise concerns about...

Cancer as a Post Traumatic Stress Disorder

When people believe the diagnosis of cancer is a life-threatening event, they may be thrown into a series of psychological changes that are similar to those triggered by combat, rape, physical, sexual abuse, or other traumatic events that are outside the range of everyday experience. These psychological changes are collectively called post-traumatic stress disorder (PTSD), and in the cancer patient may include attempts to avoid all thoughts or feelings associated with the illness forgetfulness...

List of Links Related to Cancer Pain Resources

National Cancer Institute Information Resources Pain Control Program from Cancer Supportive Care http Pain Management in Children with Cancer Handbook Available free at http www.childcancerpain.org Patt Center for Cancer Pain and Wellness Based in Houston, Texas, this Web site provides medical care for patients suffering from cancer pain or chronic pain, http www.cancerpain.org Persistent Pain After Breast Surgery Includes articles about cancer pain, discussion boards, and Ask the Expert, http...

Urination Problems

The urinary tract is particularly sensitive in the cancer patient problems such as burning during urination or a constant urge to urinate are fairly common. Symptoms of an infection include local discomfort, dark or strong-smelling urine, fever or chills, and low back pain. When a Bladder Infection Is Diagnosed If a bladder infection is present, encourage the patient to drink up to three quarts of fluid a day (especially water), avoiding coffee, tea, and other caffeine-containing products, as...

How Distress Aggravates Pain and Illness

First, let's look at how the stress of cancer can make pain and illness worse. Obviously, having cancer is enormously stressful. The disease turns a person's and the family's lives upside down, and in many ways the individual feels out of control. Stress bombards the cancer patient on all fronts worry and anxiety about the disease, its progression, its treatments, potential disabilities, and perhaps disfigurements concerns about its negative impact on the family's emotional, financial, and even...

Steroids or Corticosteroids

There are two general types of steroids. The anabolic steroids are abused by some professional athletes they have little medical use, especially in cancer patients. The glucocorticoids or corticosteroids, however, are used for many medical conditions, including problems related to breathing, arthritis, pain, and infection. Administered over a period of years, they often cause a multitude of side effects, some of which are serious, such as weight gain, diabetes, skin problems, osteoporosis, and...

Strategies to Relieve Pain

While there are many ways of addressing pain problems, each technique pertains to one of three basic strategies doctors use to relieve cancer pain. Strategy 1 Attacking the Source of the Pain Whenever possible, the first and best way to relieve cancer pain is to eliminate or modify the source of the pain by removing or shrinking the cancer that is causing the pain, with surgery, radiation, or chemotherapy (including hormones). However, these approaches are sometimes impractical and even unsafe....

Understanding Palliative Therapy

When cancer causes pain, the first thing a doctor will try to do is to eliminate or shrink a tumor as much as possible, using radiation, surgery, or chemotherapy, alone or in combination. Although the patient's comfort is important, it is considered secondary to curing the cancer, especially at the start of treatment, when chances for a cure are best. But even when a cure isn't possible, chemotherapy, radiotherapy, or surgery may be recommended to alleviate pain and other symptoms. Many cancers...

Agonist Antagonists and Partial Agonists

The opioids mentioned so far are those that are considered pure agonists, meaning that they reduce pain by the same mechanism, by binding to opioid receptors. Two other related classes of opioids, the agonist-antagonists and the partial agonists, are available, but their use is generally discouraged for treating cancer pain. These agents are also attracted to opioid receptors, but once bound have mixed effects, turning some on and others off. They tend to produce more mind-altering side effects...

Sleeping Problems

If the patient can't sleep, try to determine whether it's because of pain, anxiety, night sweats, fear of urinating, or other reasons. To help monitor a sleep problem, try to keep track of how long it takes to fall asleep, how long sleep lasts, how many times premature awakening occurs and why, whether returning to sleep is problematic, and how rested the patient feels in the morning. Counseling, applying practical tips, and using medication may help manage insomnia, especially when anxiety or...

Mouth or Throat Sores

Chemotherapy, radiation, reduced intake of liquids or food, altered hygiene, and infection can all contribute to mouth sores or inflammation in the mouth. The sores may be like canker sores or they can be open ulcers, both of which may bleed or get infected. They may make eating painful and difficult but are often overlooked. The need for mouth care may present an opportunity rather than be viewed as just a problem, according to some authorities. Sometimes, when patients are very sick, loving...

Skin Problems

Chemicals produced by the tumor, side effects of treatment, dehydration, and even anxiety or boredom may cause or aggravate dry, itchy skin, a condition known as pruritus. To relieve it, patients should Use water-based moisturizers and avoid oil-based ones. Use these moisturizers after bathing and every night. Drink plenty of fluids (eight to ten glasses a day). Protect skin from wind, heat, hot sun, and cold. Avoid hot baths and soap. Use soothing bath solutions that include cornstarch, baking...

How Cancer Pain Undermines Health and Treatment

To be struck with cancer, or to have a loved one afflicted with cancer, is one of the most frightening events imaginable. To endure the dehumanizing pain of cancer without relief is overwhelming. To helplessly witness that anguish in a loved one is heartbreaking. To discover later, however, that the suffering might have been prevented is perhaps the worst of all. Uppermost in the minds of many cancer victims are fears and anxiety about pain. We are now finally entering an era in which these...

Cutting the Wires Nerve Blocks and Neurosurgery Temporary Nerve Blocks

Nerve blocks can be as simple as the shot of novocaine dentists use to numb a tooth. By injecting a drug near the path of a nerve, you can block the transmission of painful signals before they reach the spinal cord and brain. Such blocks are used for minor surgery and sometimes for chronic pain, such as from a back injury. An epidural nerve block, used commonly for labor pain, provides more extensive pain relief because the anesthetic (numbing medicine) is injected into the epidural space, a...

Methods to Promote Relaxation

Because stress, muscular tension, spasm, distress, and the body's responses to these phenomena (sweating, increased blood pressure, changes in brain chemicals and blood flow, or heart rate) can increase pain and make it harder to deal with, techniques to reduce these negative feelings may help alleviate pain. Some conditions such as irritable bowel, headache, and muscle spasm may be direct results of tension states. Even when pain is unrelated to tension, relaxing muscles can prevent or...

The Fetzer Institute

For general information on mind-body research. 9292 West KL Avenue Kalamazoo, MI 49009 269-375-2000 E-mail info fetzer.org www.fetzer.org To obtain referrals close to your area, contact American Academy of Medical Acupuncture 800-521-2262 http www.medicalacupuncture.org American Association of Oriental Medicine 5530 Wisconsin Avenue, Suite 1210 Chevy Chase, MD 20815 301-941-1064 or 888-500-7999 Fax 301-986-9313 E-mail info aaom.org http www.aaom.org http www.medical-acupuncture.co.uk National...

Drug Therapy The Cornerstone of Pain Treatment

Who Pain Ladder 2016

Pain medications are used commonly for acute or chronic pain for patients of all ages, including infants and the elderly, and will relieve pain in about 90 percent of cases. The World Health Organization (WHO) began a revolution in cancer pain therapies with its recommended ladder of medications for the appropriate sequence of therapies. It suggests that doctors treat mild cancer pain with mild painkillers and progress to more potent ones as needed, adding supplemental medications that can...

Common Drugs Used for Cancer Pain and Foreign Names for the Drugs

Canada, South Africa, and other NSAIDs Feldene Candyl Fensaid Mobiiis Pirox Feldene Larapam Piroflam, Flamatrol Novonaprox, Naxen, Apo-Napro-NA, Apo-Naproxen (Can.) Proxen, Naproflam (Ger.) Naprius, Xenar, Primerai, Prexan (Italy) Traumox (South Africa) Voltarol Rhumalgan Diclomax Motifene Fortfen, Flexagen, Panamor, Sodiclo (South Africa) Orudis Oruvail, Ketovail Ketocid Alrheumat Apo- Sulin (Can.) R-Flex (South Africa) Combination products for mild to moderate pain (weak opioids) Aspirin +...

Why Cancer Hurts

Pain is caused either by the effects of the cancer treatments (such as chemotherapy, surgical scarring, and radiation), the effects of the tumor's growth (intruding on neighboring tissues or invading other tissues distant from the tumor's primary site), other conditions that occur along with the cancer (such as herpes zoster, commonly known as shingles, a condition that chemotherapy patients are more susceptible to, or back pain from prolonged bed rest), or side...

Breathing Problems

Difficulty breathing is generally referred to as dyspnea and may include a variety of altered patterns of breathing. Hyperventilation, or rapid breathing (sometimes also called tachypnea or hyperpnea), is a normal response to illness and stress, but it is an inefficient form of breathing. When breathing excessively fast, there is no time to take a deep breath. Most of these shallow breaths go only in and out of the mouth and throat without enough air getting to the lungs, where the actual...

Ways to Take Opioids

Although taking opioids by mouth is preferred, patients can't always reliably swallow pills or liquids. This may be because too many pills are required, patients' mouths are too dry, they are nauseated, their intestines are blocked, or they are unable to swallow. Many patients with advanced cancer are likely to use, at one time or another, two or three different methods for receiving medication as their condition changes. Liquid, syrup, lozenges, or tablets are usually preferred because...

Diarrhea

Diarrhea is relatively uncommon in cancer patients and may actually result from the overzealous use of laxatives. The presence of diarrhea may require the physician to perform a brief manual rectal examination to be certain there is not a blockage around which liquid stool is leaking. Diarrhea may occur in conjunction with chemotherapy (especially 5-fluorouracil 5-FUJand rinotecan CPT-11 or Camptosar ), or with radiation treatments to the abdomen or pelvis. It may persist for several weeks...