Cancer Pain

What is oncologic pain?

Oncologic pain refers to the pain that cancer patients may suffer, either due to the progression of the disease itself or due to associated treatments and pathologies.

Around 30-50% of cancer patients have pain and in advanced stages of the disease it can reach 70-90%. In patients with advanced cancer, 70% of pain has its origin in the progression of the disease itself, while the remaining 30% is related to treatments and associated pathologies.

Some oncological diseases are painless in themselves and only the appearance of complications are the cause of pain, as also occurs in other diseases not related to cancer.

Types of cancer pain

Depending on different factors different types can be distinguished:

According to duration:

  • Acute pain is the painful sensation limited in time (e.g., fracture of a bone).
  • Chronic pain is the typical pain of a cancer patient. It is defined as pain that lasts more than 3 months. This type of pain often causes psychological disturbances in patients (depression and other mood disorders).

According to its pathogenesis:

  • Neuropathic pain: produced by involvement of the central nervous system or by lesion of the peripheral nerve pathways. The patient describes it as a pain with a sensation of heat or burning (burning), stabbing, “like an electric shock”, tingling.
  • Nociceptive pain: it is the most frequent and is divided into somatic and visceral pain.
  • Psychogenic pain: it is produced due to psychological alterations of the patient (fear, anguish…). It is characterized by poor response to the usual analgesics.

According to its location:

  • Somatic pain: Produced by stimulation of the so-called somatic nociceptors. It is characterized as a pain that the patient localizes precisely.
  • Visceral pain is a variety of deep pain, which is produced by the stimulation of visceral nociceptors. This pain is characterized by being poorly localized and radiating diffusely, sometimes distant from the original affected area.
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According to the course:

  • Continuous pain: is that which does not disappear with time.
  • Breakthrough pain: it is the sudden and transient exacerbation of pain of short duration that appears on the basis of a stable persistent pain. It is characterized by high intensity and rapid onset.

What are the causes of oncologic pain?

The casuistry of pain depends on the type of cancer the patient suffers from, but broadly speaking these generic causes can be distinguished:

  • Pain due to tumor growth and infiltration: this is the most frequent cause of pain in cancer patients. The characteristics of the pain will depend on the type of structures that infiltrate (bones, viscera or nerves).
  • Pain associated with cancer treatment: post-chemotherapy pain, post-radiotherapy, post-operative, after pleurodesis, associated with diagnostic procedures…
  • Pain associated with the general weakening of the patient.
  • Non-cancer concomitant pain: a patient diagnosed with cancer may suffer pain due to another cause not associated with his oncological disease.

Treatments for cancer pain

The choice of treatment depends on the specialist. This choice is made on an individual basis, taking into account the characteristics of the pain, such as its intensity and the stage of the disease.

There are several ways. One of them consists of eliminating the cause of the pain by means of:

  • Surgery
  • Chemotherapy
  • Radiation
  • Relaxation techniques, which reduce body tension and relax the muscles.
  • Physiotherapy is also useful. Massages can relieve contractures, they also reduce anxiety.

If this is impossible, analgesics can usually control the pain.

  • PCA pumps (patient-controlled analgesia).
  • nerve block
  • neurostimulation

Pain often increases anxiety and affects psychologically. This fact ends up affecting pain control itself, so it is necessary to take time to improve one’s emotional response in order to improve pain control.

It is important to seek psychological support, either directly with a psychologist, or by joining patient associations or forums, which facilitate contact with people who are going through or have gone through a similar experience.