As estimated by the World He alth Organization (WHO) - in 50-80 percent In cancer patients, this pain is either not treated at all or is treated incorrectly. In Poland it is estimated that approx. 50 thousand people suffer from cancer pain. sick.

WHO has developed principles of treating pain in patients with advancedcancer . The basic rule of this scheme is the assumption that weakerpainrequires weaker drugs, and as the pain worsens, the drugs should become stronger.

How to ease the suffering of a person with cancer?

Basic analgesics are divided into three groups - according to the steps of the analgesic ladder.

  • Grade 1(mild pain) - These are simple pain relievers, non-steroidal anti-inflammatory drugs (NSAIDs), and acetaminophen. The following are used in the treatment of cancer pain: Diclofenac, Ketoprofen, Metamizol (pyralgine), Paracetamol and others.
  • 2nd degree(moderate pain) - these are weak opioids, possibly combined with group I non-opioid drugs. The most commonly used mild opioids are Codeine and Tramadol.
  • III degree(severe pain) - these are strong opioids administered with a non-opioid drug. These are morphine, sliced ​​fentanyl and pethidine.

Rules for administering painkillers to cancer patients

The effectiveness of cancer pain treatment depends on adherence to two most important principles.

First of all, drugs are not administered when the patient starts to hurt, but at specific intervals to keep the concentration of the drug in the body constant, which helps to anticipate the pain and prevent its worsening.

Step 1 drugs are usually given every 4 hours, morphine tablets - every 12 hours, fentanyl patches - every 3 days.

Second - the drug should be changed to a stronger (higher grade) drug when it becomes ineffective, i.e. the pain persists or worsens.

Why is cancer pain treatment so important?

Pain relief is important for two reasons. First, it relieves unnecessary suffering. Secondly, it prevents the destructive impact of pain on the lifestyle of a patient with a diagnosed cancer.

Pain not only takes away the will to live and hampers all activity, but also faith in the effectiveness of basic treatmentdiseases. To avoid this, pain should be treated as intensively as the underlying disease.

Is it true that pain only occurs in the acute phase of the disease?

Pain may accompany cancer at any stage of its development, but it does not have to be that way. American specialists in the treatment of pain believe that it occurs in the early stages of the disease. At the time of diagnosis, it is felt by 40-50 percent. sick with:

  • breast cancer,
  • prostate cancer,
  • colon cancer,
  • rectal cancer,
  • ovarian cancer i
  • cancer of the cervix.

Pain as an early symptom of neoplastic disease occurs in 60-70 percent. patients with lung cancer and pancreatic cancer. The pain frequency increases to 65-100 percent. in patients with metastases or locally advanced neoplasms.

Simplifying the problem, it can be assumed that pain and cancer are not synonyms, but 3/4 of patients inform the doctor that they feel pain.

Do you need to be afraid of morphine?

Pain is more physically and mentally degrading than opioids, and thus morphine. Meanwhile, in Poland, morphine is used as a last resort when the patient is unable to bear the pain. Morphine consumption in Poland in 1992 did not exceed 85 kg, and in 2000 it was already 260 kg. This does not mean that our doctors administer it too hastily. On the contrary - in the West it is applied to the sick 4 times more often than in Poland.

Patients often do not want morphine themselves, because they think that it is administered only in hopeless cases and that it is a drug that is addictive and destructive. Unfortunately, many doctors equate morphine used in analgesic therapy with drugs and condemn severely ill patients to additional suffering.

Morphine, if administered in the right doses and under the supervision of an experienced anesthesiologist, relieves suffering and, according to research, is rarely addictive. Doctors have at their disposal ever more modern and safer morphine preparations. We already have opioids in tablets that work for 12 hours and fentanyl patches that are effective for 3 days.

Cancer pain categories

  1. Pain caused by cancer or its metastases.This group includes pain caused by tumor growth, compression of the tumor on nerves, metastases to bones, skin or parenchymal organs.
  2. Pain resulting from anti-cancer treatment.Typical symptoms of this group of pains are pain after operations, amputations and the so-called phantom pains. You may also feel pain when you are taking chemotherapy orirradiation. In the latter case, the pain comes from damaged mucosa or skin.
  3. Pain associated with wasting the organism.This is where suffering comes from bedsores, constipation in the stool, inflammation of the mucosa in the mouth or esophagus.
  4. Neoplastic pains also include pains that occur in patients with malignant neoplasms, but are not directly related to the underlying disease. These are headaches, pains in the lumbar spine, pains in the joints, which are also very common in people not suffering from cancer. Regardless of the cause, any type of pain should be effectively combated.

Category:

Oncology