Cancer pain is experienced by up to half of all cancer patients. 80% of patients in whom the disease has passed into a dangerous and neglected stage, note moderate or severe pain. It is noteworthy that physical suffering can persist for a long time even after the complete cure of this disease.
Causes
Cancer pains occur in a variety of places, they are not always directly related to the place that is affected by a benign or malignant tumor. There are a large number of reasons for this - it is damage to nerves or pain receptors that are located in a place directly affected by a tumor, diagnostic or therapeutic manipulations. In some cases, this pain syndrome provokes several factors at once.
Depending on the reasons, modern doctors divide cancer pain into three types.
- Nociceptive. These are the pains in cancer when a tissue or organ is struck mechanically, chemically, or by temperature. In this case, severe irritation of pain receptors occurs, from which the impulse is transmitted to the brain, causing a feeling of strong and persistent pain. In this case, pain receptors are located in the bones, skin, and internal organs. In some cases, this can lead to the appearance of so-called reflected pain, when, due to the mixing of nerve fibers from somatic and visceral organs at the level of the cerebral cortex and spinal cord, reflexes are not able to clearly reflect the pain. Because of this, the patient is not able to accurately determine the place where he has pain, cannot even describe the nature of his feelings.
- Cancer neuropathic pain occurs if the peripheral nervous system of the brain or spinal cord is damaged. For example, against the background of chemotherapy or due to participation in the tumor process of the nerve plexuses and nerves.
- Psychogenic pain occurs when a patient with cancer has no organic reason for the pain, or it is disproportionately strong. At the same time, the psychological component is of great importance, the understanding that stress only enhances the patient's uncomfortable state. This is why cancer pain occurs so often and in completely different places.
Types of pain
Specialists distinguish several types of pain, dividing them into three main types.
- Acute pain: occurs when tissue damage. Over time, it can decrease if the affected area gradually heals. Moreover, a full recovery may take from three months to six months.
- Chronic pain: may last more than one month. It is caused by permanent tissue damage. Its intensity is greatly influenced by the psychological nature.
- Breakthrough pain: characterized by a sudden and sharp increase in the intensity of chronic pain. This occurs when additional provoking factors appear. For example, back pain in spinal cancer is aggravated due to metastases with each change in the patient’s body position. This type of pain is especially difficult to treat because of its inconsistency and unpredictability.
Here are some pains that can occur in patients with cancer. It is important that their character can be both episodic and permanent.
Lungs
Now we will consider what types of pain can occur in various cases with different types of cancer, as well as what effective drugs they can be affected.
Pain with lung cancer is one of the main symptoms of this ailment. This is one of the most common malignant oncological diseases. At the same time, you need to understand that pain occurs already at those stages when the disease began to spread to neighboring organs and tissues.
Symptoms of the disease that you should pay attention to in the early stages are a hoarse voice, frequent coughing, loss of appetite, chronic fatigue and shortness of breath, weight loss, wheezing in the lungs, which is accompanied by noisy breathing.
Pain in lung cancer is emotional and sensory in nature. Often this is due to the fact that the tumor affected the tissue. In some cases, several factors influence it simultaneously. In this regard, it is worth noting that the approaches to treatment should be comprehensive, take into account all the pathological links of malaise.
There are three main reasons that can cause pain with this cancer:
- the tumor itself begins to put pressure on neighboring organs and tissues, damaging them;
- metastatic process (metastases go to the bones);
- damage to the pulmonary wall.
In addition, hormonal treatment or chemotherapy may be the cause.
Gastric oncology
Pain in gastric cancer occurs due to the development of a tumor, since at the early stage this ailment, as a rule, does not manifest itself at all. The location of the initial tumor is determined by observation. For example, when the pain appears immediately after eating, then the tumor is located directly next to the esophagus. If it occurs after an hour, then the bottom of the stomach is affected by cancer, and if after one and a half to two hours, then it is pyloric cancer.
The onset of metastasis is evidenced by pain in cancer of the stomach, which began to spread to the lumbar region, shoulder, back, or heart. In some cases, the disease proceeds without painful symptoms, they can also be aching, mild, of varying intensity, or sudden, stitching, cutting.
Pain can be accompanied by a constantly pressing sensation or a feeling of fullness. In some situations, the appearance of pain is in no way associated with eating, but is constantly present, on the contrary, causing loss of appetite.
Breast
When the mammary gland is affected, cancer is only rarely accompanied by pain. At the early stage of this ailment, there are no symptoms at all, and tumor growth occurs completely unnoticed even for the patient himself.
Unlike a cyst, which causes severe discomfort during palpation, pain with breast cancer is almost never.
Unpleasant sensations are accompanied only by one of its aggressive forms, known as diffuse-infiltrative. It begins to develop initially as chronic non-lactational mastitis, the skin turns red, the mammary gland swells, which causes severe and long-lasting pain.
Also, with Paget's cancer, sore nipples appear.
Uterus
The first symptoms of an oncological formation in the uterus are itching, white and bloody discharge that appears after physical exertion, and the general state of discomfort.
Only when the tumor begins to develop does pain in uterine cancer arise. Drawing sensations occur in the lower abdomen, the menstrual cycle and urination are disturbed.
Over time, the pain becomes chronic, strong and sharp discomfort appear, as a rule, during walking.
At the advanced stages of the disease, the plexuses of the pelvis are compressed, which is also accompanied by pain in cervical cancer in the lower back, the sacral region. Then, when the tumor already begins to spread to the pelvic organs, not only urination, but also bowel movement is impaired. Pain in cervical cancer appears in the legs, back, legs while constantly swelling. Fistulas connecting the vagina and intestines may appear.
Intestines
The frequency and intensity of pain in bowel cancer directly depends on the location of the dangerous neoplasm, as well as on the stage at which the source of the lesion is located.
At the very beginning, when the tumor is still developing, pain symptoms are absent altogether, since no severe tissue damage occurs. Only in rare cases does discomfort appear during bowel movements. You should definitely pay attention to such symptoms, rushing to a specialist for help. In this case, you have a chance to recognize a deadly disease at an early stage and stop it.
In the second stage, pain in colon cancer begins to be permanent and aching. The tumor grows and spreads, as a result of which the intestinal lumen may be partially blocked. At this stage, the cancer is easily confused with pancreatitis, gastritis or colitis, starting to get rid of the symptoms, while the root cause is only developing.
In the third stage, the tumor spreads even more, which causes a constant dull pain that does not go away. During a bowel movement, it changes its character, becoming sharp and cramping.
At the final stage of this oncological disease, the patient is tormented by acute and severe pain, which practically no pain medication is able to stop. The patient simply suffers.
Pancreas
An oncological disease developing in the pancreas is a rather rare diagnosis, but it is worth recognizing that recently the number of patients with this dangerous pathology is constantly increasing. This organ is located in the abdominal cavity between the spine and stomach. It produces a large number of important enzymes and hormones that contribute to the digestion process.
The danger of this ailment, like most other malignant neoplasms, is that at the initial stage no noticeable clinical signs appear in the patient. As a result, in most cases it is possible to detect it only with a great delay. With the growth of cancer cells in the pancreas, clogging and squeezing occurs, so all clinical signs are the result of these processes.
A person will feel pain in pancreatic cancer when the tumor begins to compress the nerve trunks. Moreover, in the later stages, the neoplasm overlaps the splenic vein, pancreatic and bile ducts, and the duodenum 12. Because of this, the pressure in the bile ducts increases significantly. Then the obvious symptoms of pancreatic cancer arise: colorless feces, non-infectious jaundice, itching on the skin, enlarged gall bladder and liver, dark urine.
When cancer cells enter the pancreas into the duodenum, the contents of the intestine pass through. Between the ribs and under the sternum there is a feeling of fullness, there is a burp with the smell of a rotten egg, vomiting, dry skin.
Finally, as a result of poisoning with toxins, the patient loses his appetite, feels the general weakness of the body.
Back pain
With various types of cancer, severe discomfort can occur in the back. Doctors diagnose cancer in about one percent of patients who have this problem. Therefore, you should always closely monitor the state of your health, carefully monitor any atypical changes. It is worth considering that even back pain can be caused not by fatigue, but by a malignant neoplasm.
For example, lower back pain in cancer in the fair sex is a striking symptom of ovarian cancer, and in men, the bladder or prostate.
With the formation of metastases in the bone tissue, pain passes to the limbs and the back itself. Often with back pain, doctors find cancer in the lungs or pancreas.
Oncology Anesthesia
When treating a patient suffering from cancer, doctors not only try to eliminate the root cause of the disease, but also improve the quality of human life. This can be done with pain relief.
In the treatment of various types of pain syndromes of varying intensity, drug therapy is the main way. In practice, a three-stage anesthesia system is used, based on the patient taking narcotic and non-narcotic analgesics. This allows you to achieve good results in the treatment of even chronic pain syndrome in cancer patients.
This method consists in the sequential administration of analgesics of increasing strength in combination with adjuvant therapy. It is important to start receiving drugs at the first sign of pain, while the body has not yet formed a complex chain reaction, which will be characterized by chronic pain. It is important that the transition to the next level is carried out only if all other classes have already demonstrated their inefficiency.
At the first stage of anesthesia, non-steroidal anti-inflammatory drugs are considered the most effective. At the second stage, when the pain manifests itself moderately and relatively constantly, they are replaced by drugs containing a combination of weak opiates and non-narcotic analgesics. Examples include Tramadol, Dionin, Prosedol, Promedol, Tramal. At the same time, Tramadol is the most popular among all of the above, as it is convenient to use and demonstrates the greatest effectiveness.
At the third stage of pain, you should start taking narcotic analgesics. Among them, doctors usually prescribe Morphine, Buprenorphine, Omnopon, Fentanyl.
It should be noted that at any stage of this analgesic therapy, analgesics are taken strictly in time, exactly as the doctor prescribes in his recommendations. In the process of taking drugs, the dose can be adjusted depending on the strength of the pain and their type. When a drug becomes ineffective for a particular patient, it is replaced with an alternative agent that has a similar or even similar strength. In this case, the patient should be recommended as a more powerful one, since the psychological factor will play not the last place in this situation.
As analgesics for pain relief in oncology, many experts also recommend taking corticosteroids. In general, they are able to raise a person’s mood and improve his appetite. These drugs have an effective anti-inflammatory effect. Most often they are used for pain that is caused by intracranial hypertension, nerve compression, as well as an uncomfortable condition in the bones.
Modern oncologists use various technologies to relieve pain. Among them are:
- epidural administration of local anesthetics;
- all kinds of nerve blockade;
- neuroleptic administration of drugs - the so-called chemical neurolysis;
- epidural or subarachnoid administration of opioids;
- all kinds of vegetative blockades;
- taking drugs at trigger points;
- analgesia, which the patient can control;
- neurosurgical intervention.
In cases where the source of the pain syndrome is a local malignant neoplasm, conduction or epidural anesthesia is used using pumps of various infusions.
In the fourth stage of cancer, anesthesia is one of the few factors by which a doctor can influence the patient's condition. In some cases, it is possible to reduce pain, and in others to completely prevent suffering. This gives the terminally ill patient additional time that he can spend with his family and friends. The last days of his life in this case are not overshadowed by painful symptoms.