{"id":5471,"date":"2023-05-12T22:13:58","date_gmt":"2023-05-12T14:13:58","guid":{"rendered":"https:\/\/www.columbiaasia.com\/malaysia\/?post_type=health-article&#038;p=5471"},"modified":"2024-04-01T09:07:03","modified_gmt":"2024-04-01T01:07:03","slug":"managing-the-pain-that-is-caused-by-cancer","status":"publish","type":"health-article","link":"https:\/\/www.columbiaasia.com\/malaysia\/health-articles\/managing-pain-caused-cancer\/","title":{"rendered":"Managing the Pain that is Caused by Cancer"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"5471\" class=\"elementor elementor-5471\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b92652c e-con-full e-flex e-con e-parent\" data-id=\"b92652c\" data-element_type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f1e3b51 elementor-widget elementor-widget-text-editor\" data-id=\"f1e3b51\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#69727d;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#69727d;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<p>Certain cancers are more painful than most.\u00a0<br \/><br \/>And most types of cancer, especially in the later stages (stage 4), are painful.\u00a0<br \/><br \/>Among the most painful types of cancer are bone cancer, head and neck cancer, and brain and spinal cord cancer.\u00a0<br \/><br \/>The presence of pain depends mainly on the location of the cancer and the stage of the disease.\u00a0<br \/><br \/>Pain in cancer may arise from a tumour compressing or infiltrating nearby body parts; treatments and diagnostic procedures; or changes to skin, nerves and other tissues caused by a hormone imbalance or immune response.\u00a0<br \/><br \/>However, the pain from most types of cancer can be controlled.\u00a0<br \/><br \/>While most cancer pain can be managed with pharmacological treatment (using drugs such as opioids, anti-neuropathics, anti-depressants, etc), about 10% to 20% of cancer pain would need other methods, such as interventional pain management techniques and other non-pharmacological techniques like psychosocial management, physiotherapy techniques, and traditional and complementary medicine.\u00a0<br \/><br \/>Pain management is important in palliative care.\u00a0<br \/><br \/>Palliative therapy represents active care for patients whose illness is not responding to the curative treatment.\u00a0<br \/><br \/>It aims to provide comfort and prevent the suffering of patients, especially towards the end of their life.\u00a0<br \/><br \/>Thus, treatment of the pain presents an important integral part of palliative care.\u00a0<br \/><br \/>Proper pain management can achieve a better quality of life for patients and their families.\u00a0<br \/><br \/>Meanwhile, poor pain management has been shown to increase complications and reduce a patient\u2019s life expectancy.\u00a0<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e4a674a elementor-widget elementor-widget-spacer\" data-id=\"e4a674a\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-column .elementor-spacer-inner{height:var(--spacer-size)}.e-con{--container-widget-width:100%}.e-con-inner>.elementor-widget-spacer,.e-con>.elementor-widget-spacer{width:var(--container-widget-width,var(--spacer-size));--align-self:var(--container-widget-align-self,initial);--flex-shrink:0}.e-con-inner>.elementor-widget-spacer>.elementor-widget-container,.e-con>.elementor-widget-spacer>.elementor-widget-container{height:100%;width:100%}.e-con-inner>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer,.e-con>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer{height:100%}.e-con-inner>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer>.elementor-spacer-inner,.e-con>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer>.elementor-spacer-inner{height:var(--container-widget-height,var(--spacer-size))}.e-con-inner>.elementor-widget-spacer.elementor-widget-empty,.e-con>.elementor-widget-spacer.elementor-widget-empty{position:relative;min-height:22px;min-width:22px}.e-con-inner>.elementor-widget-spacer.elementor-widget-empty .elementor-widget-empty-icon,.e-con>.elementor-widget-spacer.elementor-widget-empty .elementor-widget-empty-icon{position:absolute;top:0;bottom:0;left:0;right:0;margin:auto;padding:0;width:22px;height:22px}<\/style>\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fa460f2 elementor-widget elementor-widget-heading\" data-id=\"fa460f2\" data-element_type=\"widget\" id=\"subtopic01\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h3 class=\"elementor-heading-title elementor-size-default\">Proper assessment required<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e71082a elementor-widget elementor-widget-text-editor\" data-id=\"e71082a\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Patients with cancer pain need to undergo a comprehensive assessment of their pain.\u00a0<br \/><br \/>This is the first step to achieving successful cancer pain management.\u00a0<br \/><br \/>Similar to other clinical assessments, a complete pain assessment requires a detailed medical history, physical examination and relevant investigations.\u00a0<br \/><br \/>The assessment aims to determine the nature and pathophysiology of the pain, severity of the pain, impact of the pain on functions and quality of life, and the response to interventions.\u00a0<br \/><br \/>From the assessment, a plan can be formulated to help treat the patient\u2019s pain.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6fe3e5e elementor-widget elementor-widget-spacer\" data-id=\"6fe3e5e\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-942855e elementor-widget elementor-widget-image\" data-id=\"942855e\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.23.0 - 15-07-2024 *\/\n.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=\".svg\"]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block}<\/style>\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"836\" height=\"300\" src=\"https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2023\/05\/ha-managing-2.1.png\" class=\"attachment-full size-full wp-image-5478\" alt=\"\" srcset=\"https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2023\/05\/ha-managing-2.1.png 836w, https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2023\/05\/ha-managing-2.1-300x108.png 300w, https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2023\/05\/ha-managing-2.1-768x276.png 768w\" sizes=\"(max-width: 836px) 100vw, 836px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ee2a6fb elementor-widget elementor-widget-spacer\" data-id=\"ee2a6fb\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b94481a elementor-widget elementor-widget-heading\" data-id=\"b94481a\" data-element_type=\"widget\" id=\"subtopic02\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Methods of pain management<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-055892b elementor-widget elementor-widget-text-editor\" data-id=\"055892b\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Managing cancer pain is highly complex. It can be divided into pharmacological treatment, anti- cancer treatments, non-pharmacological methods and interventional techniques.\u00a0<br \/><br \/>Pharmacological treatment includes using drugs such as opioids (e.g. morphine), drugs to treat neuropathic pain (anti-epileptics, antidepressants etc), and steroids.\u00a0<br \/><br \/>Non-pharmacological methods include exercise therapy, psychosocial therapy, and traditional and complementary medicine (e.g. acupuncture).\u00a0<br \/><br \/>Anti-cancer treatment includes radiotherapy and chemotherapy.\u00a0<br \/><br \/>Meanwhile, there is a wide range of interventional techniques available for the relief of cancer pain.\u00a0<br \/><br \/>These methods should be considered when conventional therapy, as mentioned above, fails to provide adequate pain control.\u00a0<br \/><br \/>Examples of interventional techniques are nerve blocks, neurolysis, and insertion of an intrathecal morphine pump.\u00a0<br \/><br \/>A nerve block is done by injecting local anaesthetics \u2013 sometimes combined with steroids \u2013 to block sensation to an area of the body.\u00a0<br \/><br \/>For instance, if a patient has bone cancer of the arm, we would inject local anaesthetics around the nerve that supplies the arm in order to stop the pain sensation there.\u00a0<br \/><br \/>However, the application of local anaesthetics may not last long due to the drugs\u2019 limited time effect, thus, this is usually done for diagnostic purposes.\u00a0<br \/><br \/>Neurolysis is a technique that is used to alleviate pain.\u00a0<br \/><br \/>It is done either by using chemical agents (e.g. alcohol or phenol) or thermal techniques (e.g. radiofrequency ablation) on the nervous system.\u00a0<br \/><br \/>Neurolysis is only used when the disease has progressed to a point where no other pain treatments are effective.\u00a0<br \/><br \/>And an intrathecal pump is a device that delivers small quantities of pain medication such as morphine, directly to the spinal fluid.\u00a0<br \/><br \/>When these drugs are used and delivered in smaller doses, it may minimise the side effects often experienced with larger oral doses of the same medications, and patients may also experience better pain relief.\u00a0<br \/><br \/>Patients who should be considered for these interventions include those with significant pain from locally- advanced disease, severe neuropathic pain, and severe pain on movement.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-59af942 elementor-widget elementor-widget-spacer\" data-id=\"59af942\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b5f0265 elementor-widget elementor-widget-heading\" data-id=\"b5f0265\" data-element_type=\"widget\" id=\"subtopic03\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Challenges in pain management<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7698af4 elementor-widget elementor-widget-image\" data-id=\"7698af4\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"400\" height=\"300\" src=\"https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2023\/05\/ha-managing-3.1.png\" class=\"attachment-full size-full wp-image-5482\" alt=\"\" srcset=\"https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2023\/05\/ha-managing-3.1.png 400w, https:\/\/www.columbiaasia.com\/malaysia\/wp-content\/uploads\/2023\/05\/ha-managing-3.1-300x225.png 300w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ae0ff33 elementor-widget elementor-widget-spacer\" data-id=\"ae0ff33\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-850505e elementor-widget elementor-widget-text-editor\" data-id=\"850505e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>There are barriers to effective pain management in cancer patients, including:<\/p><ul><li>Restrictive policies governing healthcare practice.<\/li><li>Regulatory scrutiny when prescribing controlled substances.<\/li><li>Lack of knowledge among patients, healthcare providers and caregivers about cancer pain management.<\/li><li>The use of religious and cultural strategies to cope with pain.<\/li><li>Inadequate attention to pain in certain patient populations, and<\/li><li>Patient concerns about addiction and the harmful effects of pain treatment.<\/li><\/ul><p>Although effective cancer pain management is highly recommended, the patient\u2019s cultural beliefs may ingrain a deep pain tolerance, thus discouraging effective treatment of cancer pain.<\/p><p>Some cultural and religious beliefs may discourage the use of certain pain management methods, such as medications, while others uphold alternative therapies or spiritual practices to cope with pain.\u00a0<\/p><p>Some examples would be:\u00a0<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8b6d3bf jteHAblockquote elementor-widget elementor-widget-text-editor\" data-id=\"8b6d3bf\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><strong>Belief in karma<\/strong><\/p><p>In many cultures, pain and suffering are perceived as a result of past actions and may be necessary for spiritual growth. \u00a0<\/p><p>This belief can result in patients not seeking treatment or not reporting their pain because they feel that it is deserved. \u00a0<\/p><p>\u00a0<\/p><p><strong>Belief in spiritual healing<\/strong><\/p><p>Spiritual practices such as prayer or meditation, are believed to be more effective at managing pain than medications.\u00a0<\/p><p>While these practices can provide some relief, they may not be sufficient for more severe or chronic pain. \u00a0<\/p><p>Some also believe that certain medications or medical procedures are \u201cimpure\u201d or interfere with spiritual purity.<\/p><p>\u00a0<\/p><p><strong>Fear of addiction<\/strong><\/p><p>Some cultures and religions view pain medications as addictive, and therefore, discourage its use.\u00a0<\/p><p>This can result in patients not receiving adequate pain relief because they are afraid of becoming addicted to such medications.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f5cb23b elementor-widget elementor-widget-spacer\" data-id=\"f5cb23b\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7856f54 elementor-widget elementor-widget-heading\" data-id=\"7856f54\" data-element_type=\"widget\" id=\"subtopic04\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Relieving the suffering<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-237bcae elementor-widget elementor-widget-text-editor\" data-id=\"237bcae\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Expertise in pain management techniques is continuously growing. \u00a0<br \/><br \/>Hence, healthcare professionals should be aware of their roles and appropriately refer their patients to specialists who are trained in pain management where available.\u00a0<br \/><br \/>To a cancer patient, the pain he or she feels can stand in the way of positive treatment outcomes.\u00a0<br \/><br \/>When the pain is managed and becomes bearable \u2013 if not gone altogether \u2013 the patient\u2019s focus can shift from one of suffering to one of hopefulness.\u00a0<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-55ec4f3 elementor-widget elementor-widget-spacer\" data-id=\"55ec4f3\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-64bf17b elementor-widget elementor-widget-text-editor\" data-id=\"64bf17b\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"color: #808080;\">This article first appeared in <a href=\"https:\/\/www.thestar.com.my\/lifestyle\/health\/2023\/05\/10\/managing-the-pain-that-is-caused-by-cancer\" target=\"_blank\" rel=\"noopener\">The Star, 10 May 2023.<\/a><\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Certain cancers are more painful than most. <\/p>\n<p>And most types of cancer, especially in the later stages (stage 4), are painful. <\/p>\n","protected":false},"author":2,"featured_media":5476,"template":"","topic":[161,97],"language":[137],"class_list":["post-5471","health-article","type-health-article","status-publish","has-post-thumbnail","hentry","topic-anesthesiology","topic-cancer","language-en"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Managing the Pain that is Caused by Cancer - Columbia Asia Hospital I Private Hospital in Malaysia<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.columbiaasia.com\/malaysia\/health-articles\/managing-pain-caused-cancer\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta 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