| Managing Cancer Pain
By:
Ms Lita Chew, Manager, Oncology Pharmacy, NCC
Having cancer does not always means having pain. But those who do can feel better with proper pain treatment.
There are many causes of cancer pain. It may be due to the effects of the cancer itself when the tumor presses on the bone, nerves or organ in the body. Treatment for cancer can also cause pain. For example, a person feels pain as a result of the operation to remove the cancerous growth. You may also experience pain that is not caused by the cancer or its treatment. Like everyone else, you can suffer pain from headaches, muscle strains, and other common aches and pains. Whatever the cause, pain can be relieved.
List of common pain relief medication
For mild to moderate pain |
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Non-opiods: Paracetamol and Non-steroidal Anti-inflammatory drugs (NSAID) such as aspirin and mefenemic acid. |
| For moderate to severe pain
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Opioids: Morphine, Pethidine, Codeine. |
| For tingling and burning pain |
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Anti-depressants: Amitriptyline, Imipramine, Nortriptyline,
Note: Taking these drugs does not mean that you are depressed. |
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Anticonvulsants: Carbamazepine, Phenytoin
Note: Taking these drugs does not mean that you have convulsion. |
| For pain caused by swelling |
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Steroids: Prednisolone, Dexamethasone. |
You can consult your pharmacist for more information on these medications.
How are medications best used to relieve pain?
Prevent pain from starting or getting worse is the best way to control it. To get the best effect from medication, you should: |
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Take your medication regularly, as prescribed. Do not wait until there is pain or when pain gets worse before taking your medication. |
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If certain activities worsen your pain, you may need to take extra dosages before these activities. Ask your doctor how and when to self-adjust the dosage of your pain medication. The goal is pain prevention. Once pain starts, it is harder to get it under control. |
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If certain medications or treatments do not work for you, there are other alternatives that you can try. For example, dosing schedules can be changed to suit your needs. You should consult your doctor or pharmacist to find out how these medications can best work for you. |
Common Side Effects
All medicines have side effects but not all patients will experience them. Some of the common side effects of pain relief medications are:
| Non-opioids (eg. NSAIDS) |
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Gastric pains
Take your medications with food to lessen the incidence of gastric pains. If you experience any ringing in the ear, headache, dizziness, confusion or if your stools appear darker than usual, you should consult your doctor immediately. |
| Opioids |
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Constipation
The best way to prevent constipation is to drink lots of fluids and eat more fruits and vegetables. Exercising will also help to prevent constipation. Your doctor will be able to give you a stool softener or a laxative to help move your bowels. Patient information leaflets on managing constipation is available at the Cancer Helpline |
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Nausea and vomiting
This usually occurs during the first few days of therapy. Your doctor will be able to give you some medication to stop these side effects. |
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Drowsiness or sleepiness
Some patients who take opioids feel sleepy when they first start on the medication. This usually lasts for a few days. Consult your doctor if this condition bothers you.
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Good communication between you and your doctor, pharmacist and nurse is very important in ensuring effective pain management. You can contact the Cancer Helpline at 6225 5655 to speak with a nurse counsellor and for a free information leaflet on managing cancer pain.
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