Cancer pain is quite complicated. The cancer itself can often cause a combination of acute or chronic pain and most often in cancer pain the pain is caused by the tumour pressing on adjacent bones, nerves or other organs in the body. Often the chemotherapy and radiotherapy treatments can cause nerve damage, and this can cause a different form of a very severe nerve pain that can affect the feet and the hands called cancer chemotherapy related peripheral neuropathy. This can be quite a difficult condition to solve and if original cancer treatment is still ongoing, then success rates can be very varied.
Nevertheless, there are different strategies that can be used depending on whether we think the cancer pain is due to a nerve pain or a bone pain or it’s coming from the soft tissues surrounding the tumour or whether this is a referred pain.
How can a pain consultant help?
The pain consultant often has access to a multidisciplinary team of physiotherapists, psychologists, occupational therapists and nutritionists, and with the help of this team, we can often come up with a more personalized individual strategy that is tailor made for each patient.
Cancer pain treatments could involve optimizing the nerve pain tablets. It could also involve exploring any nutritional aspects as we now understand that the change in the immune system because of chemotherapy or the cancer itself can lead to pain as well. Other treatments that could be pursued would include nerve blocks, use of TENS machines, high dose chilli (capsaicin) plasters for localized pain, and the use of injection-based interventions including intrathecal pumps and morphine implants. With one of these or a combination of such treatments, patients can often get a much better quality of relief.