Doctor describes ways to combat post-cancer pain -
More and more people survive their cancer. Unfortunately, sometimes survival can come with pain. Although many people do not feel any pain after cancer treatment, some may have the embarrassing chronic pain. The niggling pain reminds them of their cancer each time they perform a daily task, such as writing a grocery list. But in a very few cases the pain can be so severe that prevents people from enjoying life, they fought so hard to preserve. Fortunately, the cancer survivors in pain may find relief. In a review article published this month in the "Journal of Clinical Oncology," Esme Finlay, MD, and colleagues describe the means to fight against pain after cancer treatment.
"There are many ways to treat post-cancer pain," says Dr. Finlay, who is a doctor at the University of New Mexico Cancer Center. "The purpose of this article is to educate all types of providers who see patients after their cancer is cured." Dr. Finlay hope awareness that cancer survivors can have chronic pain after treatment guide more people to seek help. It also hopes that greater awareness will encourage oncologists, teams of survival, and primary care physicians to work together better if a cancer survivor needs of different types of assistance pain management Dr. Finlay said. "We need to help cancer survivors are active participants in their functional and post-treatment life."
Cancer survivors may have pain from the surgery, especially if the surgeon had to cut the nerves to remove their tumor. For example, women who undergo a lumpectomy or mastectomy may feel a shooting or burning sensation in their chest wall. Many patients with head or neck cancer, too, may have pain after their surgery if they needed neck surgery to remove lymph nodes. The pain can even persist for years after surgery.
Cancer survivors may also have the pain of their chemotherapy drugs. "Some chemotherapies are toxic to our nerves," says Dr. Finlay. "Over time we get cumulative nerve damage in the fingers and toes. People can have chronic burning, numbness or discomfort. "
Apart from nerve damage, cancer survivors may also have lymphedema, the painful swelling that results when fluid accumulates in the tissues where it should not lymph changes in drainage when the surgeon removes the lymph nodes and the tumor.. lymph nodes can not drain as they did and cancer survivors may also have pain or difficulty moving body parts that have been cut to remove a tumor.
the review paper describes many different methods to fight against pain. Dr. Finlay uses the methods in his practice at the UNM Cancer center. " in my practice, I often have to use drugs against very strong pain to get people through their treatment, "says Dr. Finlay." Sometimes this means [using] opioid pain medications. But we do not want people to be on strong opioids for a long time if they do not need. "Opioids such as morphine or oxycodone can be addictive and have side effects and risks with the use in the long term. "Specialists of chronic pain really try to use non-opioid strategies," she said, "whether it be drugs or physical or psychological interventions, such as acupuncture, physical therapy, or cognitive behavioral therapy for pain management. "
Dr. Finlay uses a non-addictive group of drugs that relieve nerve pain. It also prescribes physical therapy to relieve pain and lymphedema after surgery and radiotherapy. The physiotherapist Dr Finlay and his colleagues at the UNM Cancer Center refer to specialized in physical therapy for cancer survivors and lymphedema therapy. Dr. Finlay also has close links with the UNM Center for Life and refers his patients there for massage and acupuncture if necessary.
Like many oncologists, Dr. Finlay follows patients for at least five years after cancer treatment. For most patients, the pain subsides within the first two years. For some, however, the pain persists and can be very serious. "With chronic pain and symptoms, it is important that people transition to a primary care doctor who understands the issues of pain," she said. "If the pain is really complex, they need to use a multidisciplinary pain clinic." UNM has a multidisciplinary pain clinic with physical therapists, pharmacists, psychologists and many doctors trained in the management of the pain.
"pain makes people less functional," says Dr. Finlay. "I think most people need to know is to ask for help if they have chronic pain after the cancer. They need to know there are many different ways to treat pain. Just because the cancer is gone does not mean you 're going to be 100 percent how you were before you were treated. "The survivors should not suffer in silence.
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