Pain Relief Pharmacy

There are many things you can do at home to reduce your cancer pain, manage side effects, and feel better in your mind and body. Follow your doctor’s advice. Talk to your doctor about any home treatment you want to try.

You may find that drugs you can buy without a prescription are enough to ease your pain at times. Acetaminophen, such as Tylenol or Panadol, relieves pain. Anti-inflammatory drugs, such as ibuprofen and aspirin, relieve pain and also decrease swelling.

If you have had kidney or liver disease, gastrointestinal bleeding, or a stomach ulcer, talk to your doctor before you take any of these drugs. Be sure you know how to safely use these drugs.

Other home treatments for pain include:

• Heat or cold therapy to relieve painful areas of the body.
• Stretching, yoga, and exercises to help maintain strength, flexibility, and mobility.
• Behavioral treatments, such as relaxation, biofeedback, meditation, or guided imagery.
• Healing touch and massage.
• Education and emotional support. Your doctor can refer you to the social services department of your local cancer treatment center or hospital.
• Complementary therapies, such as acupuncture, aromatherapy, prayer, and humor therapy.

Pain medicine can cause many side effects. To help manage these side effects at home, try the following:

• Home treatment for nausea or vomiting includes watching for and treating early signs of dehydration, such as a dry mouth, sticky saliva, and reduced urine output with dark yellow urine. Your doctor also may prescribe medicines for nausea and vomiting. For more information on how to deal with these side effects, see:

  Controlling nausea and vomiting caused by chemotherapy.

• Home treatment for diarrhea includes resting your stomach and watching for signs of dehydration. Talk to your doctor before using any medicine for diarrhea.
• Home treatment for constipation includes gentle exercise along with drinking enough liquids and eating lots of fruits, vegetables, and fiber. Many pain drugs can cause constipation or make it worse. Check with your doctor before using a laxative.
• Home treatment for fatigue includes making sure you get extra rest. Let your symptoms be your guide. You may be able to stick to your usual routine and just get some extra sleep.

You are the only one who knows how your cancer pain feels. You may need different combinations of treatments. Don’t be surprised if your pain control plan needs to be changed often. Don’t let that discourage you. Be honest and specific about what does and does not work for you. Staying on top of your pain and in control of your pain will improve your quality of life during every stage of your disease.

Nonprescription drugs

Drugs that you can buy without a doctor’s prescription may be enough to relieve your pain at times. Acetaminophen, such as Tylenol or Panadol, relieves pain, while other drugs such as ibuprofen and aspirin relieve pain and also decrease swelling.

Prescription drugs

Drugs that need a doctor’s prescription may be stronger or work differently than nonprescription drugs. Follow your doctor’s orders about taking them. Prescription drugs include:

• Anti-inflammatory drugs and corticosteroids.
• Bisphosphonates, to slow bone changes related to cancer.
• Narcotic painkillers.
• Drugs for depression, to treat burning pain. Plus, they can help you sleep.
• Certain drugs for seizures, to help control nerve pain, like burning and tingling.

Other treatment options

Other types of treatments that may work for you are:

• Physical treatments, such as healing touch, massage, heat or cold, and braces or splints.
• Stretching, yoga, and exercises to help keep up your strength, flexibility, and mobility.
• Behavioral treatments, such as cognitive behavioral therapy (CBT), relaxation, biofeedback, meditation, or guided imagery.
• Education and emotional support. Your doctor can refer you to the social services department of your local cancer treatment center or hospital.
• Complementary therapies, such as acupuncture, aromatherapy, prayer, and humor therapy.

What to think about

One of the most important things you can do is to keep track of your pain and how your treatment is working. A pain control diary can help you do this. It can also help you tell your doctor exactly what your pain is and how it should be treated as it changes.

Many people worry about becoming addicted to narcotic painkillers. If narcotic painkillers are used for longer than a week or so, they can cause your body to keep expecting the medicine. This is called a drug dependency. Dependency is not the same as addiction. Addiction is a behavioral disorder in which a person has a craving for the drug. This craving may not even be related to the level of pain. But narcotic drugs rarely cause addiction when they are used under a doctor’s care. Talk to your doctor if you are worried.

Your pain may be harder to treat if you are depressed or anxious. Talk to your doctor about how to relieve stress and anxiety.

End-of-life issues

The goal of managing your cancer pain is to be as free from pain as possible and to continue your normal activities, such as work, hobbies, and recreation. But a time may come when treatment of your condition is no longer effective. Your doctor will be able to help you answer questions or address concerns about maintaining your comfort. Hospice workers can care for you in your own home. For more information, see the topic Hospice Care.

You may find it helpful and comforting to state your health care choices in writing, with an advance directive or living will, while you are still able to make and talk about these decisions. Think about your pain control options and which kind of treatment will be best for you. You may wish to choose a health care agent, someone to make and carry out decisions about your care if you become unable to speak for yourself. For more information, see the topic Care at the End of Life.

The following health professionals can help treat cancer pain:

• Internist
• Family medicine physician
• Surgeon
• Medical oncologist
• Radiation oncologist
• Anesthesiologist
• Nurse practitioner
• Physician assistant
• Neurologist

Your pain may be managed by a team that may include doctors (including pain or palliative care specialists), nurses, psychologists, social workers, and pharmacists. Be sure that all the members of your health care team know about any changes in your pain control diary. You may wish to use one person, such as your medical oncologist, as a “team leader” who will make sure that all team members share information.

If you have cancer, call your doctor if any of the following occur:

• You have new pain.
• Your drugs or other treatments are no longer working.
• Your pain medicine is not working long enough after each dose.
• You have new symptoms, such as having a hard time walking, eating, or urinating.
• You have side effects, such as nausea or vomiting, constipation, or diarrhea.
• Your pain makes it hard for you to do your daily activities, such as eating or sleeping.

The type of cancer pain you feel depends on the type of cancer you have and how it affects your body. For example:

• Deep, aching pain. A tumor that presses on your bones or grows into your bones can cause deep, aching pain. Bone pain is the most common type of cancer pain.
• Burning pain. A tumor that presses on a nerve can cause a burning feeling. Sometimes chemotherapy, radiation, or surgery damages nerves and causes burning pain. Nerve pain is the second most common type of cancer pain.
• Phantom pain. Pain that is felt in the area where an arm or a breast has been removed is phantom pain. Although the body part is gone, nerve endings at the site still send pain signals to the brain. The brain thinks the body part is still there.

Acute pain is bad pain that lasts a short time. Chronic pain is pain that comes and goes for a long time. It is a side effect of the cancer or treatment. Chronic pain can range from mild to severe.

Not everyone feels pain in the same way. Only you can describe how much pain you have. The key to getting your pain under control is being able to tell your doctor what it feels like and what does and doesn’t work for you.