Ask CancerCare

A. If you feel that your aunt’s pain is not being adequately managed by medication she is currently taking, it is important that you consult with her medical team about this matter.

Excellent pain management and a wide array of pain medications are available. It may be that all that’s needed is for her doctor to change the dosage or frequency of her medication.

However, your aunt’s medical team must continually be informed of her pain level. Don’t assume that they are aware of the level of pain she is experiencing. Doctors often have to rely on their patients and caregivers to tell them whether or not the medications are meeting their needs at any given time.

If your aunt’s medical team is not asking about her pain or pain management, it is up to you to speak up and raise your concerns with them. If they feel that there is nothing they can do to ease her pain further, consider asking them for a referral to a pain clinic or pain specialist.

In addition to the resources I’ve already mentioned in other responses, more information about pain management can be found in a chapter of The Caregiver Resource Directory.

Q. I’m worried about taking pain medications. Could I become addicted?

A. Fear of becoming addicted is common among people who are prescribed medications for cancer pain. This fear can keep some patients from talking with their doctor about the pain they are in. It can also keep them from following their doctor’s orders about when and how often to take their medicines. Some people may even skip some of their doses because they are afraid of “getting hooked.”

It is true that you may experience physical symptoms of withdrawal when your pain medication is stopped. Some common symptoms might include feelings of irritability and agitation. This is called physical dependence, and it is a normal response to taking a pain medication. It is not a sign of an addiction. Addiction is a psychological, or emotional, dependence on a drug.

Sometimes our bodies can become used to the medicines that we are taking. This is described as building up a “tolerance” to your medication. It means that the pain medications that used to work may no longer help relieve your pain.

Building a tolerance to your pain medications is usually not considered a problem. Your physician can simply change the dosage of your medication or prescribe a new medication for you. Again, it is important that you keep your doctor informed as to what works and what doesn’t in easing your pain.

Your physician will work very closely with you when prescribing your schedule of pain medication. Remember: It is important to talk with your doctor about any concerns or fears you may have. This will help ensure that pain medications are used safely and effectively.

A. Both you and your mother should speak to her medical care team about the pain she is experiencing and ways to manage it. Her doctor needs to know about her level of pain and must continue to reassess it with each visit. If you have already spoken to the medical team, but feel that the pain has not been adequately managed, ask your doctor for a referral to a pain clinic, where you can consult with a pain specialist whose sole concern is controlling and managing the pain associated with cancer. Remember, pain management is an integral part of cancer treatment, so speak up!

Here are some additional resources that may be helpful in addressing your mother’s pain and pain management:

• CancerCare’s telephone education workshop, “Controlling Cancer Pain:  What You Need to Know to Get Relief” can be listened to or downloaded from our website. 
• CancerCare’s Connect booklet on managing pain  offers useful information and suggestions.
• CancerCare also has a fact sheet on pain management, “Opening the Door to Effective Pain Management: Getting the Facts and Getting Help.”
• For tips on how to communicate with your doctor, see CancerCare’s fact sheet, “Doctor, Can We Talk? Tips for Communicating with Your Health Care Team.” [español]

Other resources include:

• The American Pain Foundation’s “Links to Find a Pain Doctor,” which can help you locate a pain specialist or program near you. People with cancer and their caregivers can also refer to cancer-pain.org.
• PainAid, an interactive section of the American Pain Foundation’s website:  http://www.painfoundation.org/PainAid/page.asp?file=page_home.htm.
• The American Pain Society’s website, www.ampainsoc.org, also offers useful information on pain management.

A. Pain is a message your body sends saying that it needs help. Pain medications can offer you relief. But first, you’ll need to tell your doctor how you feel. The more accurately you can describe your pain to your doctor, the better your doctor will be able to help you. Rating your pain on a scale from zero (no pain) to 10 (worst pain) can be an effective way of measuring and describing your pain to your doctor.

To make sure you receive effective pain management:

• Tell your doctor immediately about any pain you are experiencing. NEVER allow your pain to build up over time. Pain needs to be monitored and assessed at each doctor visit.
• Write down any questions you may have about your pain and how to manage it BEFORE your visit to your doctor. And, be sure to write down the answers your doctor gives you.
• Bring someone with you to your appointment. Having another person there who can give you emotional support, ask questions, and remember information can help you better address and manage your pain.
• Be specific and describe your pain in detail to your doctor. Don’t assume your doctor knows how you feel. Tell your doctor what your pain feels like, when it is at its worst, and when it appears to ease up, if it does.
• Keep a pain diary or journal. Record such things as when and where the pain occurs, what makes the pain worse, what provides relief, and how the pain affects your quality of life.

Remember, you are the expert on your pain, and your doctor is there to help you. Effective pain management is about TEAMWORK. So, get involved and be an active participant in your care.