Despite our many progress and technological advances in medicine, cancer remains the second leading cause of death in the United States. However, Many are surviving a longer time than they did in the past and living full lives with cancer and in spite of cancer. Not everyone who is diagnosed with cancer will die from cancer, not right away, if at all. Did you know:
What is the best pain management approach that will work for you? To find out, it requires teaming up with your doctor and cancer care team.
Morphine has long been the ‘gold standard’ for the treatment of severe cancer pain. However, its side-effects, particularly sedation/drowsiness, and cognitive impairment have led to “opioid rotation” to alternatives such as methadone and hydromorphone. The 72-h transdermal patch, such as Fentanyl, does offer some advantages of reduced side-effects and increased convenience over oral morphine. However, morphine and its alternatives, are not the only way to treat cancer pain. Let’s start with the basics.
If you have been diagnosed with cancer and have any level of pain, there are several things that you need to know and do;
The World Health Organization program for cancer pain control recognizes that 1 in 5 patients with cancer has uncontrolled pain and has a ‘three-step ladder’ for the rational use of analgesics including morphine (there is also a recommended adaption to 4-step-ladder).
Though pain management can be tricky, listening to my patient is the most important approach to pain management. I take the time to explain the pain scale in a format the patient can relate to (an early throbbing mild headache could be a 2-3/10, an infected tooth ache could be a 5-6/10, birth pangs would be a 10+/10). Depending on the situation, I typically start with non-steroidal anti-inflammatory drugs (NSAIDS), or narcotic-like medication ( such as Tramadol), or fast acting morphine, or a nerve type medication (such as neurontin). Depending on frequency, long acting medicine can be used with fast acting for break through pain. Remember, never take any morphine type medication without something for constipation. Pain medications slow down the bowels and lead to constipation every single time!
What I have learned over the past 15 years, is that managing pain and prescribing pain medication for cancer requires a keen sense of awareness and a patient-physician partnership. Oncologist are made aware of the patient’s needs, pain level, allergies, etc., through in-depth discussion. For me, that also includes a “no-shame discussion” with the patient’s pharmacist as well, especially for the geriatric population (65yrs and older). There is a single template for prescribing pain medication when caring for patient diagnosed with cancer – everyone is different. Remember, the opioid crisis restrictions do not apply to the cancer population, because addiction is a rarity… and a patient told me a decade ago, “this pain is real, Doc!” Don’t suffer. Talk to your oncologist – they are there to serve you!
Remember, it is your life and you must become your own advocate!
Life is beautiful and God is awesome. And know, you are pure awesomeness!
Until next time,
Ipsa Scientia Potestas est ——— Knowledge itself is power!
Don’t forget to visit our website … HERE
Queen, Your Family Friendly Cancer Doc!