Japanese Journal of Clinical Oncology 2005 35(10):630; doi:10.1093/jjco/hyi170
© 2005 Foundation for Promotion of Cancer Research
Homepage of the Month
Naohito Shimoyama
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Introduction
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Homepages are redesigned or modified very frequently; therefore, please note that comments in this section are based on the contents of the homepage at the time of writing.
MD Anderson Cancer Center Pain Management (http://www.mdanderson.org/topics/paincontrol/)
This homepage is made for patients and their family in order to get accurate information on cancer pain and its treatments. It is emphasized in the homepage that about one-third of patients being treated for cancer have pain, and each patient's pain is different from others. It is also emphasized that pain should be the fifth vital sign and patients' pain should be monitored routinely by nurses like patients' temperature and pulse rates.
Most cancer patients who have pain want first to know the causes of the pain and second how the pain can be treated. The information on pain is concentrated in the section ‘Cancer pain basics’. This section is made up of five questions and the answers to the questions are as follows.
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1. What is cancer pain?
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There are many types of cancer pain which include pain from
the tumor, pain related to cancer therapy and others. It is
important for patients to know the causes of cancer pain because
they can give helpful information to their caregivers for making
up the treatment plan.
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2. How is cancer pain treated?
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It is emphasized that
90% of cancer pain is treatable with appropriate
methods. Not only pharmacotherapy but also other treatments
such as radiation, relaxation, biofeedback, imagery and other
non-drug treatments are effective against cancer pain if they
are used in combination with each other.
There are four types of pain medication for cancer pain management. Non-opioids such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) are used for mild to moderate pain. Opioids such as morphine, oxycodone and fentanyl are used for moderate to severe pain. Adjuvant analgesics such as antidepressants and antiepileptics are used for tingling and burning pain and steroids are used for pain caused by swelling. Pain medications should be used according to pain intensity and the nature of pain. Although there are various routes of administration of drugs, the oral route is recommended because patients can take analgesics anytime they want to relieve pain.
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3. What can you do to help control your pain?
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It is mentioned in this section that patients should talk with
their doctors and nurses about how much pain they feel, where
it is and what it feels like. It is recommended that patients
describe and discuss their pain.
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4. Pain medication and side effects
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All medications can have some side effects, but not all people
experience them. Cancer pain is usually treated with opioid
medication. Constipation, nausea and vomiting, and sleepiness
are the common side effects of opioid therapy which should be
treated if possible.
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5. Non-drug treatments for pain
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Non-drug pain treatments recommended are listed as follows:
biofeedback, breathing and relaxation exercises, distraction,
heating pad and hot or cold packs, hypnosis, imagery, massage,
pressure and vibration, transcutaneous electrical nerve stimulation
(TENS), and rest. Non-drug treatments should not be used instead
of pain medicine but used together with pain medication. When
the effect of medication is inadequate, radiation therapy, nerve
blocks, neurosurgery and surgery can be considered.
From the above information one can learn that good communication among patients and their families, doctors, and nurses is essential to achieve the best quality of life.
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Introduction
1. What is cancer...