Pain in cancer may arise due to many reasons and is often the presenting complaint leading to the diagnosis of cancer. It may be
- Related to cancer itself or its spread to other body parts
- A late presentation due to side effect of treatments such as chemotherapy, radiotherapy and surgery
- A result of extra stress placed on other body parts for example shoulder pain due to using of a stick for walking
- A totally unrelated coincidental problem such as arthritis
Pain can be of differentiated into background pain (which is always present in the background and is managed with regular medications) and breakthrough pain (pain that breaks through your regular pain relief). Breakthrough pain may occur unprovoked or may be triggered by external or internal factors. In cancer patients, different types of pain may coexist. It is not just limited to pain arising from inflammation and tissue damage for example cancer of the pancreas spreading to neighboring organs and nerves leading to visceral and neuropathic pain respectively and a distant spread to bones producing bone pain. Different types of pain present differently for example
- Neuropathic/ Nerve pain is generally described as burning, shooting, electric shock-like, or stabbing pain with associated tingling or numbness. It may be a consequence of cancer itself or a result of treatments such as chemotherapy (chemotherapy-induced peripheral neuropathy- CIPN).
- Visceral Pain originates from the viscera (organs in the body cavity) and is generally described as deep aching, squeezing, and cramping sensation
- Bone pain presents as an aching, throbbing sensation. Some cancers have a preference to spread to bones
Pain Management
Pain relief needs to be tailored to the cause, severity, and duration of pain. In most cases, a reasonable control can be achieved by using a combination of methods. Multimodal, Multidisciplinary approach provides the opportunity to maximize pain relief and provide support not only for the physical needs but also for the emotional, spiritual, and social needs.
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