Delivering Better Pain Relief for Cancer Patients
The Cancer Pain Program at UW Carbone Cancer Center uses a team approach to reduce acute or chronic pain in cancer patients. This program offers early pain management treatment which helps manage pain and other cancer-related symptoms before they become severe.
Anesthesiologists, oncologists, including palliative care specialists, and rehabilitation providers work together to deliver better pain relief, restored function, less opioid consumption and less drug toxicity.
Peggy Kim, MD, provides interventional treatments in conjunction with standard pain treatment to provide optimal pain relief. She explains the causes and treatment of cancer pain.
What is Cancer Pain
Q: What causes cancer pain and what pain is unique to cancer patients?
A: : Cancer pain can be caused directly by the cancer itself, for example, if the mass is pressing on a nerve. But the treatments we use can also have their own unfortunate side effects. Radiation can sometimes lead to changes to tissue and nerves and people can have long-lasting pain. Chemotherapy can sometimes lead to neuropathy, where the hands and feet feel tingling or pain. Surgery can sometimes lead to scar tissue formation or swelling around nerves or pain from cutting through nerves.
Q: What pain treatment options are there for a cancer patient?
A: It's important for patients to know that there are often several options or combinations of treatments to help them with their pain. They can be prescribed medications or be referred to physical therapy, a physical medicine and rehabilitation (PM&R) doctor, acupuncture, or health psychology. The area in which I specialize involves some of the newer technologies or interventions. The intervention could be an injection, such as a steroid injection near a nerve. Or, it could be neurolysis, where nerve endings are killed to reduce pain. I also implant devices such as spinal cord stimulators.
It is important to know that treatment options depend on the type and location of pain, and where the patient is in their cancer journey. With certain types of interventions, for example, nerve killing, there are very small but real risks of paralysis or weakness, so we tend to reserve that treatment for end-of-life pain management. For patients who have no evidence of disease but still have pain due to their cancer treatment, we would usually choose an intervention that carries less risk, for example, a steroid injection followed by physical therapy. We work with patients to identify the interventions that are available and appropriate for their pain, and then to identify the risk-benefit balance that is right for them.
Q: When should a patient seek treatment for their pain?
A: I think patients are sometimes hesitant to bring up pain with their oncologist because they think they need to focus on the cancer treatment plan and next steps, or they feel pain is just something they will have to live with. Any time a patient is concerned about pain they are experiencing, be it a sharp, debilitating pain or less intense but chronic one, they should definitely talk with their oncologist or primary care physician. And earlier is better than later – sometimes we see patients too late and some interventions are no longer options.
Peggy Kim, MD, received her medical degree from Case Western University, Cleveland, OH. She completed her residency at Massachusetts General Hospital, Boston, MA and a fellowship in pain management from The University of Texas MD Anderson Cancer Center, Houston, TX. Her broad range of interventional procedures includes basic diagnostic blocks to advanced interventional and implantable procedures.
Date Published: 07/11/2017