Pain is one of the most common symptoms associated with cancer and remains one of the greatest fears of cancer patients. But thanks to new understanding of the mechanisms of cancer pain and better analgesics, cancer pain can be effectively controlled in 70 - 90% of patients through oral medications or skin patches. In the remaining patients, pain can usually be controlled by other means.

What causes cancer pain?

More than two-thirds of cancer pain syndromes are a result of tumor progression, and up to one-third of patients experience pain related to therapy. In a small proportion of patients, pain during cancer comes from other conditions they may have, such as arthritis. Physicians prescribe treatment for pain based on certain characteristics of an individual's pain.

What drugs are used for control?

The most important drugs for controlling cancer-related pain are opioids, which are narcotics such as morphine. "Weak" opioids, such as Darvon or Tylenol with codeine are often used, but the trend is toward the judicious use of more potent opioids earlier in the disease. Physicians are realizing that most cancer patients can handle strong pain relievers without "getting hooked."

Other drugs, referred to as adjuvant analgesics, also play an important role, either alone or when combined with an opioid in lower doses. Nonsteroidal anti-inflammatory agents (NSAIDS), for example, are considered first-line therapy for mild to moderate cancer pain. When combined with an opioid, NSAIDS produce very good pain relief, and less narcotic is required. NSAIDS are especially helpful for bone cancer, bladder spasms, intermittent pain, and pain associated with inflammation, infection, or skin ulcers.

Some adjuvant agents were developed for reasons other than pain relief but have been found to be effective at combating pain. Such pain relievers include anticonvulsants, antidepressants, steroids, and some other drugs. Anticonvulsants are used for nerve pain that is intermittent and has "shooting" or "electrical" features.

Antidepressants are first-line treatment for constant, steady nerve pain and "shooting" pain that does not respond to anticonvulsants. Corticosteroids help relieve pain caused by inflammation, bulky tumors, or tumors near nerves, and they may help reduce nausea and improve mood and appetite. Ritalin may reduce the sedation caused by narcotics, improve pain relief, and relieve depression.

Cancer Services at the Health Alliance

The Health Alliance continues to be a leader in cancer care, using a multidisciplinary approach in the diagnosis, treatment, prevention, education and research of cancer. Our diverse health care team includes physicians and specialists in all areas of cancer care including medical oncology, radiation oncology, surgical oncology, gynecological oncology, as well as nurses, social workers, physical and occupational therapists, nutritionists, psychologists and many others. In addition, Health Alliance physicians and world-renowned cancer researchers in our facilities offer internationally recognized services in neuro-oncology, head and neck oncology, stem cell transplantation and clinical cancer research. The Health Alliance offers a holistic approach to cancer care not only recognizing the physical needs of our patients, but also recognizing and supporting the emotional and spiritual needs of them and their families.

Through the collaborative efforts of the cancer centers throughout the Health Alliance, patients and their families receive the most comprehensive and highest quality cancer care available. Our continued commitment to provide the best possible patient care includes clinical research studies, programs of cancer prevention, cancer information services, commitment to community services and outreach activities, programs of research training and continuing education for health care professionals.