Cancer Pain Management

Pain management for cancer patients

Millions of Americans today have a history of cancer; for most of them, living with cancer is the biggest challenge they have ever faced. One of the unfortunate realities of living with cancer is the physical pain. Not everyone with cancer will experience pain, but nearly 1 out of 3 people undergoing cancer treatment will experience pain at some point. Cancer pain can be managed with medication in addition to other therapies.

Pain is one of the most common issues cancer patients deal with. Cancer pain can affect a person's quality of life and ability to function, on top of what the cancer itself and treatment do to the body. Younger patients tend to deal with cancer than older patients, and the more advanced the cancer is, the more intense the pain. Even after treatment, people can still experience pain for some time.

However, patients are not alone in their fight against cancer and the pain that might result from it. If you are dealing with pain from cancer or cancer treatment, addressing your pain as soon as possible is essential to treat it appropriately. Cancer pain may not go away thoroughly after treatment. Still, an experienced pain management doctor can help reduce the pain levels and hopefully allow you to go relatively pain-free or with significantly lower amounts of pain than before.

How Does Cancer Develop

Cancer is abnormal cell growth that may spread to other body parts. Cancer can develop in any part of the body and can potentially cause pain.

Cells in the body grow, multiply (a process called cell division), grow old, and die, with new cells taking their place. When this process is disrupted, damaged cells multiply when they are not supposed to, and the cells form tumors. There are cancerous or benign tumors, and cancerous tumors spread into surrounding tissue:

Types of Cancer

There are over 100 types of cancer. Some types of cancers that start in specific cells are:

• Carcinoma: Carcinoma is the most common type of cancer, originating in the epithelial cells. Many cancers can occur in the breast, colon, and prostate are adenocarcinomas. Some cancers that form in the bladder, ureters, and kidneys are transitional cell carcinomas.
• Sarcoma: A type of cancer that occurs in the bones and soft tissues (i.e., muscle, fat, blood vessels, lymph vessels, and fibrous tissue such as tendons and ligaments). Osteosarcoma is the most common form of bone cancer.
• Leukemia: Cancers start in the bone marrow, and instead of forming tumors, abnormal white blood cells increase in the blood and overtake the normal cells. Leukemia can cause the body to struggle to control bleeding or fight off infections. There are four main types of Leukemia, including acute or chronic (based on the progression of cancer) and lymphoblastic or myeloid (based on the type of blood cell where the cancer forms).
• Lymphoma: Lymphoma is a type of cancer where abnormal lymphocytes gather in the lymph nodes and vessels. Lymphocytes are white blood cells that fight off disease. There are two major types of lymphoma: Hodgkin lymphoma and non-Hodgkin lymphoma. Hodgkin lymphoma is lymphocytes known as Reed-Sternberg cells and form from B cells. Non-Hodgkin lymphoma is a cancer that forms from B cells or T cells.
• Melanoma: Also known as skin cancer, starts in melanocyte cells, which produce melanin (skin pigmentation).

Causes of Cancer Pain

Cancer pain can arise from various sources and it often varies greatly from one person to another. Here are some common causes:

1. Tumor Pain:: As a tumor grows, it can press on nerves, bones, or organs, leading to pain. This pressure can disrupt the normal functions of these body parts and cause significant discomfort.
2. Pain from Cancer Treatments: Procedures such as surgery, chemotherapy (Spasms and stinging/itching), and radiation can also cause pain. This may be due to the therapy's direct impact on healthy tissues or side effects like mouth sores, diarrhea, or nerve damage.
3. Metastasis: When cancer spreads (metastasizes) to other parts of the body, it can cause pain in those areas. For instance, if cancer spreads to the bone, it can cause severe bone pain.
4. Infections or Inflammation: Pain in the joints and muscles of the body.
5. These can occur due to the cancer or its treatment, leading to pain.
6. Spinal cord compression: When a tumor spreads to the spine, it can press on the spinal cord. This compression can cause back or neck pain.
7. Chronic pain after cancer treatment
8. Mucositis: Sores or inflammation of the mouth.
9. Ostealgia: bone pain.
10. Peripheral neuropathy: numbness, tingling, swelling, or muscle weakness in the hands and feet. It is the result of nerve damage from certain types of chemotherapy.
11. Osteonecrosis, or Avascular necrosis: The death of bone tissue due to a lack of blood supply.
12. Phantom Pain: When a person has had an area of the body removed (arm, leg, breast, etc.) and feels pain where that missing body part is.
13. Post-Mastectomy Pain Syndrome: Post-mastectomy pain syndrome results from having breast cancer surgery to remove one or both breasts. Women who develop post-mastectomy pain syndrome have neuropathic pain in the chest wall, armpit, and arm, and it does not go away. Most women only have mild pain levels with PMPS, and it is estimated that 20% to 30% of women experience PMPS after surgery.

Risk Factors for Cancer Pain

While cancer pain can affect anyone with the disease, certain factors increase the risk:

1. Type of Cancer: Some types of cancer are more likely to cause pain than others. For instance, cancers of the bone, pancreas, and lung are often associated with significant pain.
2. Stage of Cancer: Patients with advanced stages of cancer are more likely to experience pain, as the cancer is more likely to have spread to multiple areas of the body. Stage 4 cancer pain management can help reduce pain symptoms.
3. Personal Pain Threshold: Everyone has a different threshold for pain. Some people may feel pain more intensely than others, which can make managing cancer pain more challenging.

Remember, every individual's experience with cancer pain is unique. Understanding the potential causes and risk factors can help guide effective pain management for cancer pain patients. Always consult with your healthcare provider for a personalized approach to managing cancer pain.

Cancer Pain Symptoms

Pain associated with cancer can manifest in various ways and differ greatly from one person to another. Understanding the signs and symptoms is an essential first step in managing this type of pain effectively.

What does pain from cancer feel like:

1. Constant or Intermittent Pain: The pain could be a constant ache or it might come and go. It can be localized in one area, or it may affect multiple parts of the body.
2. Sharp or Dull Pain: Some people describe cancer pain as sharp and stabbing, while others might experience it as a dull ache or heavy throbbing.
3. Nerve Pain: This can feel like a burning sensation, numbness, tingling, or "pins and needles". It often occurs when a tumor presses on nerves or invades nervous tissue.
4. Phantom Pain: This is pain that feels like it's coming from a part of the body that has been removed during surgery. It's common after operations like mastectomy or amputation.
5. Painful Scars: After surgery, some patients may experience pain in the area of the surgical scar.

Variation in Symptoms Based on Severity

The severity of cancer pain can vary greatly, and the symptoms can change based on how severe the pain is:

• Mild Pain: In cases of mild pain, you might experience discomfort but are still able to engage in normal activities. The pain might be more of a nuisance than a major disruption to your daily life.
• Moderate Pain: With moderate pain, the discomfort begins to interfere with your daily activities. You might find it hard to concentrate or perform tasks that were once easy for you.
• Severe Pain: Severe pain can be debilitating, making it difficult or impossible to engage in normal activities. You might have trouble sleeping, eating, or even moving.

Remember, everyone's experience with cancer pain is unique. If you are unsure of how to deal with cancer pain, it's important to consult with your healthcare provider right away. At Pain and Spine Specialists, we're dedicated to helping our patients find cancer pain relief and improve their quality of life.

Cancer Pain Treatment

If you or a loved one is experiencing chronic cancer pain, there are effective treatment options that can help. Our cancer pain management specialists offer various treatments that we personalize to each patient to give them the relief they need. Treatment for chronic cancer pain is specific to the individual, and treatments can include:

Injection Therapies

Injection therapies involve injecting medication directly into the area causing pain. These treatments can provide rapid relief from cancer pain:

• Epidural Steroid Injection: This involves delivering anti-inflammatory medication into the epidural space around your spinal nerves. This method can provide quick pain relief by reducing nerve inflammation.
• Facet Joint Injections: This procedure involves injecting a steroid into the facet joints of the spine to reduce inflammation and alleviate pain.
• Medial Branch Block: This is a type of injection that numbs the medial branch nerves connected to a specific facet joint. This can help determine if the joint is a source of pain.
• Stellate Ganglion Block: This involves injecting local anesthetic near the stellate ganglion, a group of nerves in the neck. It can help with pain and other symptoms in the upper body.
• Sacroiliac Joint Injections: These involve injecting a local anesthetic and a steroid medication into the sacroiliac joint. This can help alleviate pain caused by inflammation or injury in the joint.
• Lumbar Sympathetic Block: This is a type of nerve block that can help manage pain in the lower extremities.
• Trigger Point Injections: These are used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax.
• Hyaluronic Injections: These are used to treat knee osteoarthritis. They supplement the viscosity of joint fluid to relieve pain and improve mobility.

Advanced Interventional Procedures

We also offer advanced interventional procedures for more complex or persistent pain:

• Spinal Cord Stimulation: This involves sending a low-voltage electrical current to the spinal cord to control chronic pain.
• Intrathecal Pain Pump: This device delivers medication directly to the spinal cord, providing significant pain control with smaller doses of the drug and fewer side effects.
• Peripheral Nerve Stimulation: Similar to spinal cord stimulation, the electrical currents are sent directly to the nerves causing pain.
• Radiofrequency Ablation: This uses heat to reduce or stop the transmission of pain from specific nerves.
• Minuteman: This is a minimally invasive spinal fusion procedure that helps stabilize the spine and reduce pain.
• Minimally Invasive Lumbar Decompression (MILD): This involves removing parts of the bone or soft tissue to relieve pressure and reduce pain.
• Aurora Zip Lumbar Fusion: This is a type of spinal fusion surgery that can help alleviate chronic lower back pain.
• Vertiflex: This procedure involves inserting a small spacer to relieve pressure on the nerves and alleviate pain.
• Sacroiliac Joint Fusion: This is a surgical procedure that fuses the iliac bone to the spine to provide stability and reduce pain.
• The Intracept Procedure: This is a minimally invasive procedure that targets the basivertebral nerve to alleviate chronic low back pain.

Conventional Treatments for Cancer Pain

We incorporate conventional treatments into our comprehensive care plans:

• Cancer Pain Medication Management: Pain medicine for cancer patients involves using medications, both prescription and over-the-counter, to control pain.
• Referrals to Physical Therapy: Physical therapy can be used to help improve mobility and strength, and to manage pain.

Alternative pain relief for cancer patients

Through our sister company, Shakthi Health and Wellness Center, we offer alternative therapies:

• Acupuncture: This involves inserting thin needles into specific points on the body to relieve pain.
• Infrared Sauna: This uses infrared light to create heat that helps relax muscles and relieve tension and pain.
• Amethyst Biomat: This is a mat that uses far infrared rays and negative ions to promote relaxation and pain relief.
• IV Therapy: This involves infusing vitamins, minerals, and other nutrients directly into the bloodstream to improve overall health and wellness.
• Lymphatic Enhancement: This is a type of therapy that uses a machine to stimulate the lymphatic system and improve its function.
• Photobiomodulation: This is a non-invasive therapy that uses light to stimulate, heal, regenerate, and protect tissue.
• Transcranial Magnetic Stimulation: This is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression and other conditions.

Cancer Pain Relief At Home

In addition to pain medicine for cancer, there are several ways to manage cancer pain at home. These techniques can complement your medical treatment and help you maintain a better quality of life.

• Relaxation Techniques: Relaxation techniques such as deep breathing, visualization, progressive muscle relaxation, and meditation can help manage cancer pain. These methods can reduce stress and tension, promoting a sense of well-being that can help ease the perception of pain.
• Regular Exercise: While it may seem counterintuitive, regular exercise can actually help reduce pain. Light activities such as walking or stretching can help strengthen your body, increase your energy levels, and improve your mood, all of which can help in managing pain.
• Heat and Cold Therapy: Heat and cold therapy can also be beneficial. A warm bath or a heated pad can help soothe stiff, aching muscles, while an ice pack can help numb the area and reduce inflammation.
• Healthy Eating: Maintaining a healthy diet can also contribute to pain management. Certain foods have anti-inflammatory properties that can help reduce pain. Additionally, staying well-nourished can help keep your body strong and better able to fight off illness.

Our expert team at Pain and Spine Specialists is dedicated to helping you with the management of cancer pain. We'll work closely with you to develop a personalized treatment plan tailored to your unique needs and circumstances.

Cancer and Pain Management

Pain and Spine Specialists play a critical role in treating cancer pain. They utilize a variety of techniques to help manage cancer pain and improve the quality of life for patients dealing with cancer. Here's a summary of their role:

Comprehensive Evaluation:

Pain and Spine Specialists start by conducting a comprehensive evaluation of the patient. This includes a detailed review of the patient's medical history, physical examination, and diagnostic tests such as X-rays or MRI scans to pinpoint the exact source of the pain.

Personalized Treatment Plans:

Based on the evaluation, they develop a personalized treatment plan tailored to the patient's specific needs and circumstances. The plan may include a combination of medication management, interventional procedures, physical therapy, and alternative therapies.

Interventional Procedures:

These specialists are skilled in performing various interventional procedures to manage cancer pain. This can include nerve blocks, spinal cord stimulation, radiofrequency ablation, and injection therapies. These procedures can provide substantial relief from cancer-related pain.

Collaborative Care:

Pain and Spine Specialists often work in a multidisciplinary team alongside oncologists, surgeons, radiologists, and other healthcare professionals. This collaborative approach ensures all aspects of the patient's health are considered in managing their pain.

Ongoing Management and Support:

Managing cancer pain is an ongoing process. Pain and Spine Specialists provide continuous support and adjust treatment plans as necessary based on the patient's progress and any changes in their condition.

Education and Empowerment:

Pain and Spine Specialists also play a vital role in educating patients about their condition and treatment options. They empower patients to take an active role in managing their pain and improving their quality of life.