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    Treating Cancer-Related Pain

    Laura Pauckner, FNP Deaconess Comprehensive Pain Center 09/10/2018
    All of us know someone who either has either had cancer or has passed from cancer.  Unfortunately, pain is a common complication of cancer, making an already difficult journey even worse. The good news, however, is pain that is caused by cancer can be treated. Once under control, patients experience a better quality of life.
     
    What causes cancer-related pain?
    • Effects of treatment, such as nerve damage/neuropathy from chemotherapy, or nerve damage/burns from radiation therapy.
    • The cancer tumor(s) themselves. Tumors can press on nerves, or invade healthy tissue, resulting in pain. 
    • Metastatic cancer in particular can be painful. Metastasis is when cancer spreads. Metastasis to bone, for example, is often quite painful, as is metastasis to the brain.

    Some cancers don’t cause pain at their original site; others can cause pain because of the size and location of a tumor. Examples include:
    • Brain tumors - In the brain, the growing tumors lead to pressure inside the skull, which causes significant pain and can affect balance, vision and mental function.
    • Cancers of the pancreas, ovary, colon, liver/bile duct, stomach, etc. – These cancers can cause pain because of pressure they put on the abdomen and/or low back.
    • Bone cancer - In bone, the cancer damages the bone tissue, resulting in a deep, searing-type of pain.
     
    How do you treat cancer-related pain?
    Pain specialists generally prescribe a combination of medication and interventional pain treatment to help cancer patients address their pain.

    Medications can include anti-inflammatories, non-steroidal anti-inflammatories, acetaminophen, opioids, and compound creams.

    Interventional pain treatments include:
    • Epidural steroid injections: An epidural is a steroid injection that can be placed in the cervical, thoracic, or lumbar areas of the spine. The steroid works to decrease inflammation and/or swelling which will help decrease pain. These injections can be used for cancers that can press on the spine such as liver, kidney, colon, breast, lung and/or pancreas.
    • Intercostal nerve blocks are used for patients who have chest wall or rib pain. These are typically performed due to rib fractures associated with bone cancer.
    • Ganglion of impar blocks are used to treat rectal and genital pain. These can be used for cancers affecting the colon or tailbone region.
    • Spinal cord stimulation can be used for patients who have neuropathy of the hands and feet from chemotherapy. A spinal cord stimulator is an implantable device that sends electrical current to the nerves of the spinal cord. This sensation can decrease pain such as numbness, tingling, and burning sensations.
    • Kyphoplasty, which is most easily described as injecting a type of cement in and around the collapsed vertebrae of the spine, can be used for compression fractures that can occur with bone cancer.
    • Intrathecal pain pumps can be used to give patients medications thru an implantable pump 24/7. This pump delivers medication thru a targeted drug delivery and allows lower doses of medications to be used, leading to fewer drug side effects.
    Each patient will experience cancer and cancer-related pain in different ways. That’s why it’s important to talk to your pain specialist about your health concerns.

    Our team at the Deaconess Comprehensive Pain Centers will work with you to find the best combination of treatment options to reduce pain and increase the quality of your daily life. 
     
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