To Catch a Thief
Why you should address pain -- before it robs you blind
For people with cancer, the old saying "no pain, no gain" couldn't be more wrong.
The evolving field of pain research has focused much of its early work on cancer, giving doctors more options to ease the impact pain has on quality of life. We talked with Carmen Green, M.D. about her findings and her tips for managing pain.
Q. Tell us about your research.
A. Far more people are surviving their cancer. That's good news. However, the prevalence of pain is increasing. We wanted to know how prevalent cancer-related pain is and whether there are differences in consistent or breakthrough pain based upon race or gender. We use the term "break-through pain" to describe brief flares of moderate to severe pain. To our surprise, we found that minorities and women experience more consistent pain as well as break-through pain. This is problematic since pain impacts health and decreases quality of life.
Q. Why do minorities and women experience more pain?
A. Studies suggest that minorities and women are less likely to have their pain assessed. They face additional barriers in accessing quality health care. Even if their pain is assessed, they may not receive quality pain treatment. This doesn't mean that men are getting great care when it comes to pain. Overall, health-care providers are not well-educated about pain's impact or how to treat it well. The deleterious effects pain have on the individual and society has gotten onto the nations radar screen only relatively recently.
Q. When should people talk to their doctor about pain?
A. Patients should always talk with their doctors about how they are feeling and their concerns. When pain interferes with daily activities and quality of life, it's especially important. For example, if you don't want to do things because they cause pain, it's time to see the doctor. Pain impacts your physical, social and emotional health. It can cause you to feel depressed and anxious or cause sleep, family or work problems. If that's happening, it's certainly time to see the doctor.
Q. What kinds of treatments are available?
A. We have a whole tool box for treating pain. It can be as basic as applying ice or heat or observing what makes the pain better or worse. We might consider relaxation training, counseling, physical therapy, nerve blocks or surgery. For others, medications ranging from Tylenol to much more potent options might be considered. There are many options available to control pain.
Q. Should people be concerned about becoming addicted to pain medications?
A. People often confuse the word "addiction" with "dependence." The definitions and treatment for these conditions are very different. Addiction rarely occurs when someone is using pain medication for a legitimate purpose. Sometimes people may say, "Gosh, this drug makes me feel loopy." That's a different issue. In that case, we need to try another dose or another medication. We often use medications to control pain in conjunction with psychological counseling developed specifically for people with cancer./p>
Q. What would you say to someone who is reluctant to admit he or she is experiencing pain?
A. Pain is a thief. It has the ability -- kind of like cancer -- to take away your relationships and your ability to feel good. There is no reason to live with pain when we have the ability to control pain. We need to bring it out of the shadows and into the light so that everyone feels comfortable discussing pain and its impact with their health-care providers. We can control pain and we can improve quality of life for people living with cancer. That's a huge and important improvement to enhance the rest of an individual's life, no matter whether you expect to live days or many years.
Continue reading the Winter, 2009 issue of Thrive.
Learn more about cancer and treatment-related pain:
- Chemotherapy and Nerve Changes
- Getting Back to Your Life as Usual: How physical therapy and occupational therapy during and after cancer treatment can help recovery
- Dispelling Myths on the Treatment of Cancer Pain
- Pain Control: Support for People With Cancer from the National Cancer Institute [pdf]