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Pain Control: Support for People with Cancer
    Posted: 01/24/2008



Introduction






What You Should Know About Treating Cancer Pain






Types and Causes of Cancer Pain






Talking About Your Pain






Your Pain Control Plan






Medicines To Treat Cancer Pain






Medicine Tolerance and Addiction






Other Ways To Control Pain






Your Feelings and Pain






Financial Issues






Reflection






Resources






Pain Control Record






How to Use Imagery






Before You Go to the Pharmacy






For More Information



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Talking About Your Pain

Pain control is part of treatment. Talking openly is key.

Talking about your pain.

Describe and rate your pain.

Here are some ways your health care team may ask you to describe or rate your pain:

Share your beliefs.

Pain control is part of treatment. Talking openly is key.

"At first I tried to be brave. Now I realize that the only way to handle my pain is to be open and honest about it with my health care team. It's the only way I can stay on top of it and keep it under control." - Janie

Controlling pain is a key part of your overall cancer treatment. The most important member of the team is you. You're the only one who knows what your pain feels like. Talking about pain is important. It gives your health care team the feedback they need to make you feel better.

Some people with cancer don't want to talk about their pain. They think that they'll distract their doctors from working on ways to help treat their cancer. Or they worry that they won't be seen as "good" patients. They also worry that they won't be able to afford pain medicine. As a result, people sometimes get so used to living with their pain that they forget what it's like to live without it.

But your health care team needs to know details about your pain and whether it's getting worse. This helps them understand how the cancer and its treatment are affecting your body. And it helps them figure out how to best control the pain.

Try to talk openly about any other medical problems and fears you have. And if money worries are stopping you, be sure to read the Financial Issues section. There may be ways to help you get the medicine you need.

Tell your health care team if you're:

  • Taking any medicine to treat other health problems
  • Taking more or less of the pain medicine than prescribed
  • Allergic to certain drugs
  • Using any over-the-counter medicines, home remedies, or herbal or alternative therapies

This information could affect the pain control plan your doctor suggests for you. If you feel uneasy talking about your pain, bring a family member or friend to speak for you. Or let your loved one take notes and ask questions. Remember, open communication between you, your loved ones, and your health care team will lead to better pain control.

Talking about your pain.

The first step in getting your pain under control is talking honestly about it. Try to talk with your health care team and your loved ones about what you are feeling. This means telling them:

  • Where you have pain
  • What it feels like (sharp, dull, throbbing, constant, burning, or shooting)
  • How strong your pain is
  • How long it lasts
  • What lessens your pain or makes it worse
  • When it happens (what time of day, what you're doing, and what's going on)
  • If it gets in the way of daily activities

Describe and rate your pain.

You will be asked to describe and rate your pain. This provides a way to assess your pain threshold and measure how well your pain control plan is working.

Your doctor may ask you to describe your pain in a number of ways. A pain scale is the most common way. The scale uses the numbers 0 to 10, where 0 is no pain, and 10 is the worst. You can also use words to describe pain, like pinching, stinging, or aching. Some doctors show their patients a series of faces and ask them to point to the face that best describes how they feel.

No matter how you or your doctor keep track of your pain, make sure that you do it the same way each time. You also need to talk about any new pain you feel.

It may help to keep a record of your pain. See Pain Control Record for an example. Some people use a pain diary or journal. Others create a list or a computer spreadsheet. Choose the way that works best for you.

Your record could list:

  • When you take pain medicine
  • Name and dose of the medicine you're taking
  • Any side effects you have
  • How long the pain medicine works
  • Other pain relief methods you use to control your pain
  • Any activity that is affected by pain, or makes it better or worse
  • Things that you can't do at all because of the pain

Share your record with your health care team. It can help them figure out how helpful your pain medicines are, or if they need to change your pain control plan.

Here are some ways your health care team may ask you to describe or rate your pain:


A scale numbered from 0 to 10 with 0 being no pain, 5 being moderate pain, and 10 being worst possible pain.
A scale listing pain as follows: none, mild, moderate, severe, very severe, and worst possible.
A line that begins with 'no pain' and ends with 'pain as bad as it could possibly be.'
A series of 6 faces with the happiest face being 'no hurt' and the saddest face being 'hurts worst.' The 4 faces in between range in severity of pain.

0-10 Numeric Pain Intensity Scale, Simple Descriptive Pain Intensity Scale, and Visual Analog Scale (VAS): Acute Pain Management Guideline Panel. Acute Pain Management in Adults: Operative Procedures. Quick Reference Guide for Clinicians AHCPR Pub. No. 92-0019. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services.

"Faces" Pain Scale adapted with permission from Hockenberry MJ, Wilson D, Winkelstein ML: Wong's Essentials of Pediatric Nursing, ed. 7, St. Louis, 2005, p. 1259. Used with permission. Copyright, Mosby.

Share your beliefs.

Some people don't want to take medicine, even when it's prescribed by the doctor. Taking it may be against religious or cultural beliefs. Or there may be other personal reasons why someone won't take medicine. If you feel any of these ways about pain medicine, it's important to share your views with your health care team. If you prefer, ask a friend or family member to share them for you. Talking openly about your beliefs will help your health care team find a plan that works best for you.

"It makes sense. If you don't tell someone about your pain, then no one can help you! And the pain won't go away by itself." - Joe

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