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Managing cancer-related pain may require an integrative approach

Pain management
Managing cancer pain is designed to help improve your physical and mental well-being so you may be better able to face upcoming treatments.

Pain, whether caused by cancer or a side effect of treatment, is a significant issue for patients. One-third of cancer patients deal with pain, and that discomfort may interfere with their treatment schedule and hamper their quality of life.

But new approaches to pain management, including options that avoid the use of potentially addictive opioids, are changing how doctors treat cancer-related pain. With a multimodality, or integrative, approach to pain management, pain may be substantially reduced so you can focus on getting better and enjoying the good things in life.

Many patients may be unaware that pain management is actually a distinct branch of medicine focused on reducing pain and improving quality of life. Because pain tends to be prevalent among cancer patients, controlling it is an essential and highly valued component of care.

“Pain management is extremely important for cancer patients,” says Nathan Neufeld, DO, Pain and Palliative Care Program Specialist at Cancer Treatment Centers of America® (CTCA), Atlanta. “If you’re in pain, that discomfort tends to be in the forefront of your mind. It’s a constant reminder that you have cancer.”

Anything that aches, throbs or is tender may drain your mental and emotional energy and distract you from a positive, healing mindset and precious time with your loved ones. Managing cancer pain is designed to help improve your physical and mental well-being and put you in a positive frame of mind so you’re better able to face upcoming treatments.

“By controlling pain, we remove that constant reminder of cancer,” says Dr. Neufeld. “That alone gives patients a lot of hope and energy to fight the disease.”

Integrative care

Cancer pain is a complex issue, in part because it may have multiple sources with multiple causes. Cancer-related pain may be caused by:

  • A blockage in an organ, tube or blood vessel that may create poor blood circulation or a fluid buildup inside organs or vessels
  • A tumor pressing on an organ, bone or nerves
  • Multiple tumors in the body after a cancer has metastasized or spread
  • Stress that may produce muscle aches, joint pain and headaches

Some patients may have pain issues from unrelated conditions, such as arthritis or back pain, that existed before their cancer diagnosis.

Pain may also affect a patient beyond physical discomfort, Dr. Neufeld says, and have a psychological impact that may interfere with his or her sense of self. “Your identity can become the pain,” he says. “There’s a downward emotional spiral, and you may lose sight of the objective, which is survival.”

With such complexity and so much at stake, pain management may require more than one specialty. Pain management may produce better outcomes by integrating both medical and supportive care experts. Although narcotic painkillers may offer relief and are sometimes necessary, Dr. Neufeld says he makes it a priority to consider other pain management options in addition to narcotics.

Dr. Neufeld, who describes himself as a “pain quarterback” on a multidisciplinary team of experts, often turns to massage, physical therapy and other supportive care services in addition to medical options to treat pain. These services and other options, such as acupuncture, relaxation techniques or chiropractic treatment, may also help strengthen and stabilize a painful area of the body and help improve mobility.

“The goal of this integrative approach,” he says, “is to look at available procedures with limited side effects that can reduce pain and improve quality of life.”

The integrative team may also draw from different resources to provide comfort and customize therapy based on symptoms, preferences and specific cancer treatments. With multiple resources, you’re also more likely to find options that address initial barriers to pain management, such as contraindications with cancer treatment, drug intolerance and physical limitations.

The kind of treatment you receive for cancer pain may depend on the type and the severity of pain. Treatments may include:

  • Prescription medications—including opioids or other narcotics—for moderate to severe pain
  • Over-the-counter medicines like acetaminophen and nonsteroidal anti-inflammatories, such as aspirin and ibuprofen, for mild to moderate discomfort
  • Nerve-block therapies, which are numbing agents injected into the nerve involved in pain
  • Surgery, when a tumor is pressing on a nerve or other part of the body

Though such medical approaches to pain management may be helpful, they may also cause side effects, including nausea, itching and drowsiness.

Finding relief

For both patients and their caregivers, pain management may bring relief. “People are often in awe that there are many options to treat pain,” Dr. Neufeld explains.

This realization, especially when pain seems overwhelming, may help boost hope for patients and their loved ones and help patients return focus to quality of life and treatment outcomes.

Dr. Neufeld believes one of the most important impacts of helping patients get more comfortable is that they’re then able to improve the quality of their personal relationships. When they feel better physically, he says, they may better enjoy their time with families and loved ones. His goal in management, he says, is to keep patients alert, clear-minded and happy in “sound mind and spirit.”

Learn about mental health challenges before and after a cancer diagnosis.