Pain is a common symptom among cancer patients. For patients, battling cancer already demands enormous effort, and having to endure the physical and psychological torment of cancer pain on top of that only adds insult to injury. For example, a patient with terminal lung cancer whose ribs have fractured due to the tumor feels pain every time he stretches his body, leaving him “not wanting to move, not wanting to leave the house” — exhausted in both body and mind, and in pain. His family also feels heartbroken yet helpless to do anything. Dr. Lee Yuk-ming, a specialist in pain medicine, says that with advances in medical technology, there are now more and more clinical treatment options for patients’ cancer pain, and as long as patients actively fight the disease, cancer pain need not be so frightening.
Dr. Lee points out that cancer pain among cancer patients is not uncommon. It is mainly caused by the tumor’s destruction of body tissues or organs, such as pain resulting from pathological fractures caused by bone metastases; or pain triggered during the course of cancer treatment, such as nerve damage caused by chemotherapy. Cancer pain can generally be divided into persistent pain and breakthrough pain. Persistent pain is generally continuous, whereas breakthrough pain refers to sudden, severe pain whose intensity is greater than that of persistent pain.
Compared with persistent pain, breakthrough pain can catch patients completely off guard, and its intensity can reach a peak. Dr. Lee notes that although the location of the pain may be the same, breakthrough pain can come on suddenly; although it lasts a shorter time, it is enough to make patients feel “worse than death.” To effectively control cancer pain, doctors decide on a treatment plan based on the cause of the disease and the patient’s level of pain.
A common approach to pain relief is the use of analgesic medication. So is there any difference between the medication used to control persistent pain and that used for breakthrough pain? Dr. Lee explains that doctors basically use drugs with different properties to control the two types of pain. The drugs used to control persistent pain have a longer-lasting effect, but they often take half an hour to an hour to take effect, so they are not suitable for controlling breakthrough pain. To control breakthrough pain, fast-absorbing drugs are needed. Currently, some strong analgesics are absorbed through the oral mucosa or nasal mucosa, taking effect relatively quickly, but their effect is shorter, making them more suitable for controlling breakthrough pain.
If the effect of the analgesics is unsatisfactory, or if the patient cannot tolerate the side effects, the doctor will use interventional treatment. Interventional treatment uses minimally invasive methods to target the nerve causing the pain and ablate (destroy) it. If the condition is suitable, the results can be very good, and the effect can last from six to nine months.
Dr. Lee says that in facing cancer pain, family members as caregivers naturally bear great pressure. In any situation, they should maintain a calm state of mind and consult more with the doctor about how to care for the patient.
Information provided by Dr. Lee Yuk-ming, Specialist in Pain Medicine
