You may experience pain related to your cancer, its treatment or other coexisting diseases such as arthritis. Pain assessment is an important part of any medical evaluation, and pain management is an important part of care. Left untreated, pain can suppress the immune system, delay healing and lead to depression. When pain is accompanied by persistent depression - for example, if you feel depressed every day for two weeks - it's also important to seek medical advice. Depression is an illness that needs to be treated even when you're undergoing therapy for other conditions.
Your doctor should assess your pain and ensure that it's managed throughout your treatment and recovery.
Pain management often includes a combination of medications and nondrug options to provide relief.
Acute and Chronic Pain
There are two main types of pain: acute and chronic. It's important to talk with your doctor about any pain you feel.
Acute pain is nature's signal that causes you to change a harmful behavior or seek medical attention. For example, if you step on a piece of glass or lean against a hot surface, you experience acute pain. Your body might also react by increasing your heart rate, blood pressure and breathing rate. Acute pain strikes suddenly, is not long lasting (less than three months and ends once an injury has healed.
Chronic pain, on the other hand, can last for months or longer. There's no useful purpose for chronic pain; it changes the nervous system and, therefore, is considered a disease. It can begin suddenly or gradually. The pain can be constant or come and go, and it worsens over time. Unlike acute pain, there's usually no stress response of increased heart rate, blood pressure and breathing rate. Left untreated, it can suppress the immune system and delay healing. Chronic pain places an emotional and physical burden on patients and caregivers.
The term "breakthrough pain" describes a brief, sometimes severe, flare of pain that a person who's taking pain medication may experience. In other words, the pain "breaks through" the regular pain medication schedule. Breakthrough pain can start as pain medication is wearing off, before the next dose is due or from a pain-producing activity or event (such as remaining in the same position for too long or making certain sudden movements). It can occur even when you follow the correct dose and schedule for your pain medicine. Tell your doctor if you have episodes of breakthrough pain.
Don't Delay Seeking Pain Care
It's essential that you seek pain treatment early to avoid additional health problems later. According to the American Pain Foundation and other experts, studies show that people with cancer may delay seeking the pain relief they deserve because they fear that addressing the pain may distract their doctor from treating the cancer. Furthermore, they:
- falsely believe relief isn't possible and pain is an inevitable part of cancer
- may not want to acknowledge the pain because they're afraid it's a sign of disease progression or recurrence
- worry about becoming addicted to pain medicine
- mistakenly believe that early pain relief may mean the drug won't work in the future
- want to appear strong and brave
Assessing and Managing Pain
Pain assessment is an important part of any medical evaluation. It's as important as measuring blood pressure, pulse, breathing rate and body temperature. Unrelieved pain may cause needless suffering and:
- limit your ability to work, exercise, sleep and perform everyday tasks (such as going to the grocery store, getting dressed)
- weaken your immune system, making it harder to heal and fight infection
- reduce your appetite
- lead to anxiety and depression, which can worsen pain sensation
- place a strain on relationships with family and friends
- reduce intimacy with a partner
You may find it difficult to talk about your pain or have trouble finding the right words to describe how your pain feels. But your doctor can use pain assessment tools to help you describe how you feel. The tools he or she may use include:
- a list of words that you can choose from to describe your pain, such as "dull," "stabbing," "pounding," "tender," "on-the-surface," "deep," "prickling" and "crushing"
- a numeric pain scale from which you can rate your pain by picking a number from 0 (no pain) to 10 (worst pain imaginable)
- a visual scale to help you explain your pain's intensity or where you feel the pain, such as using a "faces" pain rating scale that has drawings of faces with expressions ranging from smiling (no pain) to tearful (the worst pain)
Describing Your Pain
To help describe your pain to your doctor, try answering the following questions suggested by The American Pain Foundation:
- Where is your pain located? Does it occur in one or multiple areas?
- When does the pain occur and how long does it last? Are there certain times of the day that are worse than others, and is the pain constant, or does it come and go?
- What makes the pain better or worse? Have you found ways to ease the pain by applying heat or cold, or sitting or lying in certain positions?
- Are there any other related symptoms, for example, numbness, depression or nausea?
- What are examples of pain you experience during your daily life that can help your doctor understand how your pain is affecting you? For example, are there any activities you can no longer perform because of your pain?
- How does the pain feel? Is it dull, aching, sharp, burning?
Before visiting your doctor, put together a list of any questions you may have about your pain and its treatment. For help in deciding what questions to ask, download a list of questions to ask your doctor about pain.