Many cancer pains are caused by the pressure of the cancerous mass on bones, nerves or other organs.
Sometimes these pains are related to cancer treatment, for example, chemotherapy drugs may cause burning or numbness in the organs. Of course, it should be noted that all pain in cancer patients is not necessarily due to cancer. Involvement of different organs may cause different types of pain.
Pain caused by nerve involvement: If the cancerous mass presses on the spinal cord or peripheral nerves, the patient may experience pains with special features, which are called neuropathic pain. Features such as burning sensation, tingling and burning sensation, deadly arrow, etc. Sometimes these pains occur after surgery to treat cancer. In fact, nerve damage may occur during surgery to remove a cancerous mass. Sometimes nerve damage may occur after treatments such as chemotherapy or radiotherapy.
Pain caused by bone involvement: In case of invasion of cancer cells into bone tissue and destruction of bone cells, the patient will feel a vague and unpleasant pain but with a relatively specific location. This type of pain is called somatic pain.
Analgesia from soft tissue involvement: Pains caused by involvement of internal organs such as kidneys or muscles. For example, kidney involvement may manifest as back pain. The location of this type of pain is usually bright and clear (pin point).
phantom pain:It means feeling pain in a limb that has been severed and no longer exists externally. For example, feeling pain in a leg that has been amputated due to sarcoma. The cause of this pain is not yet known correctly, but the remaining parts of the brain that were responsible for that part of the body in the past are considered to be the cause of this feeling. Of course, these pains usually decrease or disappear after time passes, but sometimes They remain for years and their intensity does not decrease. Surgical techniques are also effective in this type of pain.
referred pain: Sometimes the pain caused by an organ in the body is felt in another part of the body. For example, the involvement of the liver may show itself as shoulder pain, and this is due to pressure on the nerves that innervate parts of the shoulder.
Treatments:In addition to common treatments to reduce the volume of malignancy, such as radiotherapy, surgery and chemotherapy (which are sometimes the cause of pain), in cases of milder pain, you can benefit from anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, etc.
In the treatment of more severe pain, it may be necessary to use narcotics, such as morphine and...
In cases such as neuropathic pain, different groups can be used such as: anticonvulsants and antidepressants.
Medicines such as corticosteroids are among the medicines used to reduce swelling and pressure effects of the tumor, which will naturally reduce pain.
Non-pharmacological treatments such as physiotherapy, biofeedback, relaxation exercises can also help along with other treatments.
Interventional pain management: They are an important and effective part of pain control in cancer patients. This part includes blocking or inhibiting the transmission of pain messages by the involved nerves, which, depending on the type of involvement, may be done with drugs such as steroids, alcohol, phenol, or the use of radiofrequency waves. For example, in upper abdominal malignancies such as pancreatic cancer, the patient's pain can be controlled to a great extent by blocking the celiac ganglion, or in controlling cancer pains in the pelvis, the patient can be helped by inhibiting the hypogastric plexus. .
Among the other therapeutic devices that are included in this section is the spinal cord stimulation, which is actually a thin fiber for working around the spinal cord. This fiber is connected to an electric stimulator that is implanted under the skin and by producing special waves around the spinal cord, it inhibits the transmission of pain messages to the brain.
Also, intrathecal pumps are among other treatment options. In fact, certain drugs, including narcotics, are placed in a small source under the skin, and this source is directed into the cerebrospinal fluid (CSF) by a catheter, and the pain is suppressed by releasing the drug into it.
Of course, it should be noted that any of the treatment options may be considered at the doctor's discretion and according to the type and location of malignancy.
Author: Dr. Hossein Arjamand