Menü
Cancer is a universal health problem of modern life, and can cause pain as it grows by destroying or pressing on nearby structures in the body, such as nerves, organs and bones. Cancer that has spread from its original site (primary tumour) can move to other parts of the body (metastasis), where it can also damage nearby structures and cause pain. The pain symptoms experienced by patients with cancer can vary from person to person and can range from mild to severe chronic pain.
Pain can be caused by the cancer itself or by the cancer treatments used to fight it, such as chemotherapy, radiation therapy and surgery. Even today, when different treatment modalities are available, 46% of patients do not receive adequate pain management at the time of death. For this reason, the World Health Organisation has defined cancer pain as a personal right and emphasised that this pain must be relieved.
More than 80% of cancer pain can be controlled by pain management specialists. The aim of pain treatment in cancer is to prolong the patient’s pain-free sleep time, to ensure pain relief at rest, and a pain free life while standing or moving. By providing these, it is to contribute to the patient’s active and quality life as much as possible.
Apart from the physical characteristics of cancer pain, psychological and social consequences of cancer pain also affect the patient’s quality of life. Therefore, it is important to control psychological and social effects during the treatment phase. Evaluation and re-evaluation are of great importance in the treatment of cancer pain. This is important both for monitoring the effectiveness or inadequacy of the treatment and for the recognition of pain of different localisation and character as the disease progresses. Painkillers, interventional pain management procedures, cognitive and behavioural approaches can be used in the treatment.
There are also some barriers to an appropriate approach to cancer pain. The most important of these is the fear of drug addiction in the patient. This concern manifests itself in the form of confusion of psychological and physical addiction, ignorance about drug tolerance and exaggerated expectation of side effects by patients and their relatives. Insufficient prophylactic and therapeutic approaches to an opioid side effect such as constipation, for which tolerance does not develop, also constitute an obstacle to appropriate analgesic treatment approaches in cancer patients.
When determining the treatment method, it is essential to make the decision together with the patient and his/her family, to ensure the patient’s active participation in the treatment, and to inform the patient about side effects. Obtaining the opinions of the relevant departments about pain is of great importance in the evaluation before the treatment plan.
The stepwise pain treatment recommendations of the World Health Organization in 1986 are accepted worldwide and can be modified according to minor differences in approach from centre to centre and from country to country. Chemotherapy, radiotherapy and surgical methods used for the treatment of cancer also contribute to the reduction of pain with the tumour-shrinking effects they provide.
In conclusion, there are many different approaches to improve the patient’s quality of life in the treatment of cancer pain. In these patients, the most effective treatment approach should be planned with the participation of the patient, the patient’s relatives and the physician, taking into account the location, intensity and character of the pain, the type of cancer and the psychosocial status of the patient.
