Pain Management

People with blood cancer may experience pain from their cancer or as a side effect of their treatment. Acute pain is short-lived and usually due to a recognizable injury or illness. Chronic pain is more long-lasting and may vary in its intensity. Pain management is any approach or combination of approaches that are used to relieve pain, and the term is more commonly used to describe strategies for chronic pain. Managing pain is important as chronic pain can potentially wear down the immune system, slow the body’s ability to heal, and may lead to or contribute to depression.^1,2 Pain also can have a negative impact on a person’s quality of life, making it difficult sleep or to participate in daily activities including work and social life.³

Cause of pain for people with blood cancer

Blood cancer itself can cause pain, like aches in the arms, legs, or joints, abdominal pain, or pain in the bones like the back or ribs.^2,3 Other causes of pain in people with blood cancer may be as a result of treatment. Surgery or radiation can cause acute pain. Chemotherapy drugs may cause mouth sores that can cause pain in the mouth and throat. Some chemotherapy medications can also cause peripheral neuropathy, a type of nerve damage that can cause pain, burning, tingling, numbness or weakening of the arms, hands, feet, or legs. Any type of pain may be worsened by other symptoms a person is experiencing, like fatigue or depression.³

Strategies for pain management

It’s important for people dealing with blood cancer to communicate their symptoms of pain to their healthcare team. While pain is common among people with cancer, it is not something that anyone needs to suffer through, and there are many effective strategies for managing cancer pain.

Medications

For mild to moderate pain, doctors may recommend certain over-the-counter pain medications, but patients should always check with their doctor before taking any over-the-counter medications for pain to make sure they are safe for them to take. Moderate to severe pain may require stronger medicines. For moderate to severe pain, stronger medications may be used, such as opioids like morphine, codeine, hydrocodone, oxycodone, methadone, or fentanyl. Some people may be prescribed a combination of medicines to treat their pain. Other medications that may be used to relieve specific types of pain include certain antidepressants or antiepileptics. In addition to their other effects, these medications can potentially help ease physical pain.^2,4

Non-medication options

In addition to pain medication, many patients embrace complementary practices that are non-traditional, like mind-body approaches. The mind-body connection recognizes that emotional, mental, and behavioral factors can directly affect our health, and mind-body techniques can improve quality of life and may help reduce symptoms of disease. The mind-body connection does not imply that the mind is the cause of cancer, and studies that have looked at a connection between stress and cancer have not found one. However, researchers have found that mind-body techniques such as mindfulness and meditation can have benefits, such as reducing stress and improving mood in cancer patients.^5-7 It is important that patients tell their doctors about any complementary practices they may take part in to ensure that nothing interferes negatively with their treatment for blood cancer, however, many of these approaches can be used along with traditional therapies.

Complementary approaches that can help ease or relieve pain include:

• Massage
• Acupuncture
• Hypnosis
• Meditation
• Breathing exercises
• Biofeedback
• Heat or cold^3,4,7