Pain from cancer experiences up to half of all oncologist patients. 80% of patients in whom the disease has passed into a dangerous and advanced stage note moderate or severe pain. It is noteworthy that physical suffering can persist for a long time even after the disease is completely cured.
Reasons
Pain in cancer occurs in a variety of places, not always they are directly related to the place that is affected by a benign or malignant tumor. There are a large number of reasons for this - this is damage to the nerves or pain receptors that are located in the place directly affected by the tumor, diagnostic or therapeutic manipulations. In some cases, this pain syndrome is provoked by several factors at once.
Depending on the causes, modern doctors divide cancer pain into three types.
- Nociceptive. These are the pains in cancer that occur when a tissue or some organ is damaged by mechanical, chemical or thermal means. At the same time, it happensstrong irritation of pain receptors, from which the impulse is transmitted to the brain, causing a feeling of severe and unceasing 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 the so-called referred 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 display pain. Because of this, the patient is not able to accurately determine the place where he hurts, cannot even describe the nature of his sensations.
- Neuropathic pain in cancer occurs when the peripheral nervous system of the brain or spinal cord is damaged. For example, against the background of chemotherapy or due to the involvement of nerve plexuses and nerves in the tumor process.
- Psychogenic pain occurs when a patient with cancer has no organic cause for the pain, or it is disproportionately severe. At the same time, the psychological component is of great importance, the understanding that stress only increases the patient's discomfort. This is why cancer pain occurs so often and in so many different places.
Types of pain
Specialists identify several types of pain, subdividing them into three main types.
- Sharp pain: occurs when tissue is damaged. Over time, it may decrease if the affected area gradually heals. In this case, 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 dramatic increase in the intensity of chronic pain. This happens when additional provoking factors appear. For example, back pain in spinal cancer increases due to metastases with each change in the position of the patient's body. This type of pain is particularly difficult to treat because of its volatility and unpredictability.
Here are the types of cancer pain patients can experience. It is important that their nature can be both episodic and permanent.
Light
Now let's look at what types of pain can occur in certain cases with different types of cancer, as well as what effective drugs can affect them.
Pain from lung cancer is one of the main symptoms of this disease. This is one of the most common malignant oncological diseases. At the same time, one must understand that pain occurs already at those stages when the disease began to spread to neighboring organs and tissues.
Symptoms to look out for in the early stages - 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.
The pain of lung cancer is both emotional and sensory. Often this is due to the fact that the tumor has affectedfabrics. In some cases, it is influenced by several factors at the same time. In this regard, it is worth noting that treatment approaches should be comprehensive, taking into account all the pathological links of malaise.
There are three main reasons why this cancer can cause pain:
- the tumor itself begins to put pressure on neighboring organs and tissues, damaging them;
- metastatic process (metastases go to the bones);
- lung wall injury.
Also, hormonal treatment or chemotherapy could be the cause.
Gastric oncology
Pain in stomach cancer occurs due to the development of a tumor, since at an early stage this disease, as a rule, does not manifest itself at all. Determining the location of the initial tumor is carried out through observation. For example, when pain appears immediately after eating, it means that the neoplasm 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 this is cancer of the pylorus.
The onset of metastasis is indicated by the pain of stomach cancer that has begun to spread to the lower back, shoulder, back, or heart. In some cases, the disease proceeds without any painful symptoms at all, they can also be aching, mild, of varying intensity, or sudden, stabbing, cutting.
Pain can be accompanied by a constant pressing sensation or a feeling of fullness. In some situations, the appearance of pain is in no way associated with food intake, but is present all the time,on the contrary, causing loss of appetite.
Breast
When the mammary gland is affected, oncological disease is only rarely accompanied by pain. At an early stage of this disease, there are no symptoms at all, and the growth of the tumor occurs completely unnoticed even by the patient himself.
Unlike a cyst, which causes severe discomfort when palpated, breast cancer is almost never painful.
Unpleasant sensations are accompanied by only one of its aggressive forms, known as diffuse-infiltrative. It begins to develop initially as chronic non-lactational mastitis, the skin becomes very red, the mammary gland swells, which causes severe and long-lasting pain.
Nipple pain also occurs with Paget's cancer.
Uterus
The first symptoms of oncological formation in the uterus are itching, white and spotting that appear after physical exertion, a general state of discomfort.
Only when the tumor begins to develop, there are pains in uterine cancer. Pulling 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, while walking.
At the progressive stages of the disease, the plexuses of the small pelvis are compressed, which is also accompanied by pain in cervical cancer in the lower back, sacrum. Then, when the swelling startsspread to the pelvic organs, not only urination is disturbed, but also defecation. Pain in cervical cancer appear in the legs, back, legs are constantly swollen. Fistulas may appear connecting the vagina and intestines.
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, there are no pain symptoms at all, since no severe tissue damage occurs. Only in rare cases, there is discomfort during defecation. It is imperative to pay attention to such symptoms, hastening for help to a specialist. 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 constant and aching. The tumor grows and spreads, as a result, the intestinal lumen may be partially blocked. At this stage, oncological disease is easily confused with pancreatitis, gastritis or colitis, starting to get rid of 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 illness, the patient is tormented by acute and severe pain, which he is unable toto stop almost any anesthetic drug. The patient is simply constantly suffering.
Pancreas
Oncological disease that develops in the pancreas is a rather rare diagnosis, but it is worth recognizing that recently the number of patients with this dangerous pathology has been 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 aid in the digestive process.
The danger of this disease, like most other malignant neoplasms, lies in the fact 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. When cancer cells grow in the pancreas, blockage and compression occur, so all clinical signs are the result of these processes.
Pain in pancreatic cancer a person will feel when the tumor begins to press the nerve trunks. Moreover, in the later stages, the neoplasm overlaps the splenic vein, pancreatic and bile ducts, and duodenum 12. Because of this, the pressure in the bile ducts increases significantly. Then the obvious symptoms of pancreatic cancer appear: colorless feces, non-infectious jaundice, itchy skin, enlarged gallbladder and liver, dark urine.
When cancer cells from the pancreas enter the duodenum, the patency of the contents throughintestines. 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 a 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 present with such a problem. Therefore, you should always closely monitor your he alth, carefully monitor any atypical changes. It should be borne in mind that even back pain can be caused not by fatigue, but by a malignant neoplasm.
For example, back pain associated with cancer in the fair sex is a clear symptom of ovarian cancer, and in men it is a symptom of bladder or prostate cancer.
With the formation of metastases in bone tissues, painful sensations pass to the limbs and the back itself. Often with back pain, doctors find cancer in the lungs or pancreas.
Pain relief in oncology
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 anesthesia.
In the treatment of various types of pain syndromes of varying intensity, drug therapy is the main way. In practice, it is applieda three-stage anesthesia system based on the patient taking narcotic and non-narcotic analgesics. This makes it possible 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 taking drugs at the first sign of pain, before the complex chain reaction that will be characterized by a chronic pain syndrome has formed in the body. It is important that the transition to the next stage is carried out only if all other classes have already demonstrated their inefficiency.
Non-steroidal anti-inflammatory drugs are considered the most effective in the first stage of pain relief. At the second stage, when the pain is moderate and relatively constant, they are replaced by drugs containing a combination of weak opiates and non-narcotic analgesics. An example is "Tramadol", "Dionin", "Prosedol", "Promedol", "Tramal". At the same time, the most popular among all of the above is "Tramadol", as it is convenient to use and demonstrates the greatest efficiency.
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, analgesicsare taken strictly on time, exactly as the doctor prescribes in his recommendations. In the process of taking drugs, the dose may be adjusted depending on the strength of pain and their type. When a drug becomes ineffective for a particular patient, it is replaced by an alternative drug that has a similar or even similar strength. At the same time, it should be recommended to the patient as more powerful, since the psychological factor will play an important role in this situation.
As analgesics for pain relief in oncology, many experts also advise taking corticosteroids. In general, they are able to cheer up a person and improve his appetite. These drugs have an effective anti-inflammatory effect. They are most often used for pain caused by intracranial hypertension, nerve compression, and bone discomfort.
Modern oncologists use various technologies to relieve pain. Among them it is worth mentioning:
- epidural administration of local anesthetics;
- all kinds of nerve blocks;
- neuroleptic administration of drugs - the so-called chemical neurolysis;
- epidural or subarachnoid administration of opioids;
- all kinds of autonomic blockades;
- taking drugs at trigger points;
- Patient controlled analgesia;
- neurosurgical intervention.
In cases where the source of pain is a local malignant neoplasm,conduction or epidural anesthesia is applied using various infusion pumps.
In the fourth stage of cancer, pain relief is one of the few factors a doctor can use to influence a patient's condition. In some cases, it is possible to reduce pain, and in others - to completely prevent suffering. For a terminally ill patient, this gives 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.
