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Cancer Pain Management Myths

by Rob Yates, MPAS, PA-C

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Once you hear your doctor say, “I’m sorry, but you have cancer,” your life is changed forever. With that diagnosis, a number of fears immediately surface. One of the most feared symptoms of cancer and its treatment is pain. Here are six common myths about cancer-related pain.

Myth #1 “Being diagnosed with cancer means that I will suffer in pain.”
While you may experience pain at some point, not everyone who has cancer has pain that limits their daily activities. Many effective treatments for pain are available to keep you from living in severe pain. These include pills, patches, intravenous injections, and procedures such as epidural and intrathecal catheters and nerve blocks.

Myth #2 “If I take strong pain medications, I will become addicted.”
The risk of becoming addicted to opioid (narcotic) pain medications is the same as it was before cancer. If taken for pain as prescribed by your physician, the risk of addiction to pain medications is low.

The goal is to keep your pain within the “therapeutic window.” Inside this window, your pain is usually mild, and you are able to do your daily activities without the pain stopping you.

Author of Article photo

Rob Yates

Myth #3 “If I take pain medications now, they will not work for me later.”
A natural response to taking opioid medications is that our bodies develop tolerance. This means that a dosage adjustment may be necessary in order to get the same pain relief. This is entirely normal and is not a reason to live in pain.

Myth #4 “I expect my pain to be completely taken away.”
It would be ideal to have your pain go away altogether, yet for pain that has been around for more than a few weeks, it may not be realistic. The goal is to keep your pain within the “therapeutic window.” Inside this window, your pain is usually mild, and you are able to do your daily activities without the pain stopping you.

Too often, we wait until after the pain has become severe to take our pain medication. Subsequently, it takes longer and more medication to bring the pain back under control. I recommend what I call the “John Wayne Technique of Pain Management” – you head the pain off at the pass, pard’ner! In John Wayne’s western movies, once the bad guys get away, it takes John the entire movie to get them behind bars. Pain is very similar in that if you wait until it gets away from you, then it may take several hours and more medication for the pain to improve. However, you can head it off at the pass by taking your pain medication before it becomes severe and by taking it prior to doing any activity that may stir up your pain.

Myth #5 “If I complain about my pain, my doctor will think I’m not a good patient, or I won’t be allowed to receive my cancer treatment.”
It is very important to keep all your symptoms under control, including pain. In order to help you, your doctors need to know about the pain you are experiencing. Uncontrolled pain can mean an unpleasant trip to the emergency room and a hospital stay. This certainly could delay any treatment for your cancer.

Myth #6 “Strong pain medications will have unpleasant side effects.”
The most common side effects from opioid medications are drowsiness, nausea, and constipation. Drowsiness goes away in a few days, and nausea and constipation can be managed with treatment.

If you have more medication in your body than what is required for your pain, this can be referred to as “above the therapeutic window.” The extra opioid medication has no pain to treat, thus it acts like a little boy with nothing to do. The extra medication can cause “mischief,” such as involuntary muscle jerking, drowsiness, confusion, hallucinations, or slowed breathing. Therefore, it is important to communicate with your doctor how well your pain is (or is not) being managed.

There is no need to fear cancer pain. It can be managed with the many different treatments available today.

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Rob Yates is a cancer survivor as well as a physician assistant and midlevel provider supervisor in the department of Pain Medicine at The University of Texas MD Anderson Cancer Center in Houston, Texas.

This article was published in Coping® with Cancer magazine, November/December 2012.