Pain is the most common cancer related symptom that requires special attention and management. According to WHO, cancer pain is a multi -dimensional construct related to physical,emotional, social, and spiritual aspects affecting the quality of life of the patients. Comprehensive management of cancer pain requires proper assessment of the disease and the effects of cancer on patients emotional and psychological well-being. The intensity of pain needs to be scored on a scale of 0-10.
The WHO Step Ladder is the most widely practiced approach for the management of cancer pain. The first step starts with NSAIDS medications like aspirin, diclofenac and acetaminophen. If the pain persists, then second step is to administer weak opioids like tramadol and codeine. Tramadol is the most widely used analgesic for cancer pain as it as less side-effects and is kidney safe. If the pain persists or worsens, then strong opioids are used like morphine, fentanyl and oxycodone. Morphine is a very effective analgesic but is not easily available over the counter. Many doctors use fentanyl instead of morphine which has added advantage of a trans-dermal patch. Addition of other medications like anti-depressants, anxiolytics and steroids often help in relieving neuropathic pain.Sometimes, pain is not relieved by above medicines also, the invasive techniques like nerve blocks, epidural analgesia, radiation or other surgical interventions may be required.
Management of cancer pain is the most difficult part in any cancer treatment especially in terminal stages. It requires team work and often the whole family along with the patient needs to be counselled so that the patients quality of life is not affected.
Recent Comments