Cancer Pain :Effective Pain Management

Cancer Pain :Effective Pain Management

Pain is a major symptom of cancer and occurs at all stages of the disease. In addition, pain is usually a hallmark of progression or metastatic spread, and 65 to 85 percent of people with cancer have pain when they develop advanced disease. In 10 to 20 percent of cancer cases, pain is difficult to treat, frustrating, and poorly controlled. Currently, opioid pharmacotherapy is the principal weapon in the fight against cancer pain; but when less invasive treatments are unsuccessful, invasive interventions should be added to optimize pain relief. Interventional pain procedures target neural and non-neural pain generators and neural blockade techniques provide excellent pain relief for neuropathic, sympathetic, nociceptive somatic, or visceral pain. Neural blockade techniques are broadly categorized into non-neurolytic and neurolytic blocks.

The management of patients with cancer pain can be a challenging task, even for physicians trained in cancer pain management Effectively relieving pain in cancer patients requires a range of treatment alternatives, including neural blockade when the patient’s pain no longer responds to opioid analgesia. The type of neural block selected is determined by the location and mechanism of the pain, the physical status of the patient, the extent of tumor spread, and the technical skill and experience of the person performing the intervention. Non-neurolytic blocks can provide safe and effective analgesia for the less serious conditions indicated above. Neurolytic blocks, with their potential for complications, are reserved for select patients who are unresponsive to standard analgesic pharmacotherapy and/or are at a more advanced stage of disease. However, few would question that aggressive intervention is often appropriate. Neurolytic nerve blocks offer an excellent option for the physician in the fight to control cancer pain. Such blocks can be easily utilized to help provide cancer pain relief in most of patients at the utmost needed times.

For all these and many like them Dr. Neeraj Jain`s massage is “pain is real and treatable- there is no merit in suffering” “No one needs to suffer as so many good and effective treatments are now available at specialty pain clinics”. You must see a pain specialist if you still suffer from pain after a month of conservative treatment. Sooner your pain is managed better are the overall results.

The interventional pain procedures produce immediate pain relief, can be performed with ease by pain physicians without anesthesia as outpatient or daycare and adequate duration of pain relief obtained and suitable for surgically unfit & debilitated patients, procedure can be repeated safely if required.
In the absence of proper education among health care professionals and lack of awareness in the public mind in India, there is misuse of painkillers resulting in high incidence of complications like gastritis, kidney failure, bone marrow depression and bleeding from gut which can be catastrophic.

Though skills, advanced equipments are available, still pain relief is not available to majority of its population. At least a million people in India suffer unrelieved cancer pain. The number of people suffering other chronic pain conditions is anyone’s guess. Paradoxically, India stands high chance to become the health destination for pain management for the world, by using interventional pain therapies and very effective traditional therapies unique to India.
Pain is 5th vital sign as per W.H.O. Pain is now understood as primary medical condition.

Pain Medicine, a super-specialty, deals with the management of these difficult chronic painful disease states including treatment of cancer pain. A majority of complex chronic painful states, unresponsive to conventional treatment are being successfully treated at Pain Clinics. The very concept of a Pain Clinic is based on the conviction that the effective management of difficult pain conditions is possible only through well-coordinated efforts of a specialist possessing knowledge and skills to diagnose and treat pain.

Thus, Pain Clinics are specialized areas that are now assuming the role of an essential service as they meet a need unmet by any previously existing medical facility.

Despite these startling statistics pain still remains inappropriate & inadequately treated. Although tremendous scientific & technological advances have been made, the knowledge & techniques are highly underutilized. This is due to lack of dissemination of information to clinicians. “It’s easy to be paranoid when you hurt like hell and you are on the mercy of healthcare system”.
The interventional pain procedures produce immediate pain relief, can be performed with ease by pain physicians without anesthesia as outpatient or daycare and adequate duration of pain relief obtained and suitable for surgically unfit & debilitated patients, procedure can be repeated safely if required.
In the absence of proper education among health care professionals and lack of awareness in the public mind in India, there is misuse of painkillers resulting in high incidence of complications like gastritis, kidney failure, and bone marrow depression.

Unfortunately awareness about pain management among medical professionals is very limited. In contrast to USA and other developed countries Indian medical community is not aware of interventional pain management techniques which can be helpful for many patients suffering from intractable cancer & chronic pain.
It is cruel to deny people in pain access to effective pain treatment. People should not be suffering needlessly.

“Pain is real & treatable – There is no merit in suffering!”

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