• Cancer Pain Syndromes

    Definition

    About one-third of people with cancer have pain. There are different types of cancer pain affected by:
    • The progression of the disease
    • The location in the body
    • The overall physical condition

    Causes

    Based on the cause of pain, researchers have defined different cancer pain syndromes, including:
    • Pain from the tumor—Tumors can press on bone, nerves, or an organ, resulting in pain.
    • Pain related to cancer therapy—This may include pain from: Pain unrelated to the cancer or treatment—This refers to pain in people with cancer that has nothing to do with the illness or its treatment. It may include:
    Chemotherapy
    Chemotherapy
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    Risk Factors

    Having cancer is the main risk factor for cancer pain.

    Symptoms

    Any type of pain experienced by a cancer patient can be considered cancer pain. The pain may be near or far from the location of the tumor. The intensity can vary. It may be chronic or off and on. The pain can be described as pressure, sharp, dull, throbbing, burning, stabbing, and achy.

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. Special tests may also be done to determine possible causes of the pain.
    Your doctor may need pictures of your bodily structures to look for structural problems such as bone fractures and lesions. This can be done with:
    Your doctor may need to evaluate you for nerve disorders. This can be done with:

    Treatment

    Talk with your doctor about the best plan for you. Your plan will depend on the type of pain you are having. It will also depend on how your cancer has been treated. Medications to treat cancer pain include:

    Non-opioids

    To treat mild to moderate cancer pain:
    • Acetaminophen
    • Nonsteroidal anti-inflammatory drugs (NSAIDs

    Opioids

    Often used to treat moderate to severe cancer pain:
    • Weak opioids
    • Strong opioids

    Other Medications

    Antidepressants, anti-epileptics, and steroids may be effective in relieving certain types of cancer pain. These types of medication may be of benefit if the pain is thought to be related to the central nervous system. This type of pain may be called either neuopathic or central.
    Antidepressants, anti-epileptics, and steroids may be effective in relieving certain types of cancer pain. These types of medication may be of benefit if the pain is thought to be related to the central nervous system. This type of pain may be called either neuopathic or central.

    Radiation Therapy

    Radiation therapy can be used to relieve bone pain. It can also help relieve pain caused by tumors compressing other structures.
    If you are diagnosed with cancer pain syndrome, follow your doctor's instructions .

    Alternative Treatments

    Acupuncture may be helpful in reducing cancer-related pain. Talk to your doctor to see if this is a good option for you.

    Prevention

    Usually, cancer pain is difficult to avoid. To manage your pain, the best thing you can do is talk with your doctor about any pain you have. Your doctor can help you make a plan to manage your pain.

    RESOURCES

    American Cancer Society http://www.cancer.org

    National Cancer Institute http://www.cancer.gov

    CANADIAN RESOURCES

    Canadian Cancer Society http://www.cancer.ca

    National Cancer Institute of Canada http://www.ncic.cancer.ca

    References

    Chronic cancer pain. DynaMed website. Available at: http://dynamed101.ebscohost.com/Detail.aspx?id=113832 . Updated December 27, 2012. Accessed January 23, 2013.

    Pain control: support for people with cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/coping/paincontrol/page1. Accessed January 23, 2013.

    VT Chang, et al. Update in cancer pain syndromes. Journal of Palliative Medicine . 2006;9(6):1414-1434.

    2/11/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Paley C, Johnson M, Tashani O, Bagnall A. Acupuncture for cancer pain in adults. Cochrane Database Syst Rev. 2011;(1):CD007753.

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