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A common worry amongst patients diagnosed with cancer is that they will develop pain at some point during their treatment.
Chronic pain affects around 30-50% of patients during their treatment.
Chronic pain is not just a physical problem but can also have significant impact on wellbeing and mental health. This can vary between patients but in some individuals can lead to complete loss of independence. Almost half of those with chronic pain also suffer with depression.
Cancer-Related pain can affect people in a number of different ways. Similar to other types of chronic pain the symptoms will depend on the underlying cause for the pain. The pain may be mild or severe and continuous or sporadic.
Pain is multidimensional and can be described in terms of severity, time, location and character.
Chronic pain in cancer typically has an ill-defined, fluctuating course exacerbated by periods of acute ‘breakthrough pain’.
Most types of cancer-related pain can be classified as being due to ongoing tissue injury (nociceptive pain) or due to damage of the nervous system (neuropathic pain).
Cancer-related pain can be caused as a result of the cancer itself or due to the various treatments for cancer such as surgery, chemotherapy and radiotherapy.
Cancer-related pain is usually diagnosed by taking a thorough history and examination to identify the type of pain, severity, functional impact and context.
In neuropathic pain, nerve conduction studies and electromyography are frequently used to identify which nerves are affected.
A clinician may make recommendations for other investigations such as scans depending on the underlying cause of the pain.
Cancer-Related Pain Treatment
A holistic approach is often needed to treat cancer-related pain conditions. Physiotherapy, modifications to work and home environment and psychological therapies are important aspects of patient care in addition to medications.
Medical therapy is dependent on the underlying cause of pain, as addressing the underlying cause is an important component of treatment.
Simple painkillers are often first line treatment with stronger painkillers (e.g. codeine, tramadol and morphine) used in conjunction for severe pain. Some patients benefit from other bespoke treatments depending on the cause of their pain.
Medicinal cannabis can be considered when first line therapies have not achieved adequate symptom control.
