One of the most terrifying aspects of struggling with cancer is the pain associated with it. But there are some misconceptions surrounding cancer and pain. Having cancer does not always mean you will also be struggling with daily pain. There are many ways in which cancer manifests, grows, and shows its symptoms. Many people may discover they have a tumor – benign or otherwise – months or years after it had first started developing.
However, cancer pain does occur, and it tends to grow the more advanced the cancer is. Whether due to the cancer itself, the surgeries you have gone through for treatment, or certain medications, you may be struggling with pain as a result of your diagnosis. Dealing with that pain is important for many patients, as it gives them the continued mental strength to endure treatment and fight back against their cancer. In cases where the diagnosis has become terminal, cancer pain management and treatment are critical for ensuring quality of life in the last few months.
But cancer pain treatment does not always need to involve narcotics. Much of the controversy around opioids as of late has been due to a continued and growing drug abuse crisis throughout the United States, fueled by decades of prescription drug abuse. There are still serious concerns surrounding the efficacy of drugs like codeine, Vicodin, and Fentanyl. While they continue to be prescribed especially for terminal cases, research shows that more care should be taken to evaluate existing circumstances and seek out better long-term alternatives. The use of opioids in the treatment of long-term chronic pain – which can include cancer pain – doesn’t show a promising level of efficacy.
As with many other drugs, opioid medication tends to lose effectiveness over time. In rare cases, opioid use can lead to increased pain sensitivity (hyperalgesia) right after the drug wears off. Finding alternatives for patients struggling with long-term pain is of the utmost importance and represents the entire function of a pain management clinic.
Non-Narcotic Medication for Cancer Pain
In pill form, there are only a few alternatives to “strong pain medication,” which almost always involves opioids. Over-the-counter drugs can relieve minor headaches, help the body reduce inflammation of the joints and take some of the edge off certain aches and pains. These include drugs like acetaminophen (Paracetamol), ibuprofen, and aspirin.
Non-opioid analgesics available only via prescription are corticosteroids, specifically drugs like cortisone and prednisone. While these are also available through injection, they are usually prescribed to be taken orally, and are meant to reduce inflammation. There are side effects, however, and you can only take them under advisement of a medical professional with the appropriate prescription.
A newer non-opioid post-operative drug called Exparel (used as a local anesthetic in minor surgeries) is an alternative for 24-hour pain relief in certain forms of post-operative pain. Otherwise, most forms of non-opioid cancer pain treatment and management rely on many procedures and techniques for tackling and reducing long-term pain without a reliance on drugs or medication.
Before the discovery of anesthesia, analgesics (painkillers) and sterilization, surgery has always been very dangerous. It was by far the most feared option among all other medical procedures. No one wanted to be cut into, but we’ve intuitively known through centuries that some things can only be cured by making things just a little worse, for a short time. Surgeries finally became “pain-free” sometime within the transition between the 19th and 20th century, and infection rates dropped through dedicated cleanliness and sterilization. The public opinion of surgery and surgeons drastically shifted, from butcher to savior.
Since then, we’ve come to understand that, as miraculous as surgeries are, they should still be a last resort. Minimally-invasive medical interventions utilizing certain chemicals and techniques can be just as effective and much less risky in lowering a patient’s cancer pain. These non-drug techniques include:
Utilizing x-ray imaging and a quick local anesthesia, a doctor leads a long needle into the point of origin for a patient’s pain and numbs it using an anesthetic medication that blocks the pain coming from a specific part of the body, often in the spine. It may take several procedures for this technique to take its full effect.
Using radio waves to burn the specific nerve responsible for the pain, stopping the pain from signaling to the brain. This procedure can result in lasting pain relief, for up to a year.
Peripheral Nerve Stimulation
By sending several low-voltage signals straight into the nerves in a painful area of the body, the pain seems to stop on a temporary basis. As with other forms of stimulation, it’s not quite understood why this works, but it may have something to do with utilizing the right level of electrical signals to “interrupt” the nerve signals from the nerve to the brain, or it may be related to a release in endorphins caused by the stimulations.
Spinal Cord Stimulation (SCS)
A little more invasive than an injection, SCS treatment involves attaching a small device to an area of the spine, causing a tingling feeling akin to a massage of physical touch. This internal device can be remote-controlled to specifically activate when a patient is feeling pain, by way of an external remote control given by their physician.
Lifestyle Changes & Their Importance
The treatment and management of cancer-related pain is usually a long-term process. Interventions such as the above can help provide instant and lasting relief when the nerves go a little haywire as a result of treatment or the cancer itself. However, there are many other things that a person can do to stop the pain from spreading. Regular physical therapy, water therapy, relaxation techniques, weekly or daily massages, as well as psychological help – from therapy to journaling – can make a huge impact on a patient’s quality of life and can also help them through the pain.
Lifestyle changes such as reducing the consumption of certain foods, restricting calories, and eating more nutrient-dense foods can help a patient improve their overall health. Such changes can also reduce the risk of developing additional diseases and assist the patient in feeling healthier (and better) as a result of a more rigorous lifestyle.