As the earliest and most experienced subjective internal sensation in everyone’s life – “pain” – is a problem we often meet. However, due to the long-term people’s understanding of pain is relatively one-sided, that pain is only a symptom of the disease, as long as the disease is cured, the pain will disappear, so there are still many patients who are suffering from pain. Expert: Only 30% of Cancer Pain Patients in China Get Effective Pain Pain is the most common symptom related to cancer, and it is also the symptom that patients are most afraid of. Due to certain misunderstandings among patients and their families, only 30% of cancer pain patients in China have their pain effectively relieved. According to statistics, there are about 3.37 million new cancer cases in China every year, and 20% of the new cancer patients suffer from cancer pain, about 50% of the progressive cancer patients suffer from cancer pain, and 80%-90% of the terminal patients suffer from cancer pain. Chongqing is not an exception. At present, there are about 130 patients hospitalized in the Department of Medical Oncology of Chongqing Cancer Hospital, most of whom are middle- to late-stage cancer patients, and about 60% to 70% of them need standardized treatment of cancer pain in addition to anti-tumor treatments, such as chemotherapy, radiotherapy and targeted therapy. Correct understanding of cancer pain Avoiding six major misunderstandings Long-term pain will seriously affect the quality of life of patients and their families, such as poor sleep and diet, and cause patients to develop depression, anxiety, anger, fatigue, anorexia and other adverse emotions, and will lead to a decline in patients’ immunity, hindering the smooth progress of anticancer treatment. Therefore, it is very important to correctly recognize cancer pain and its related treatment. Myth 1: Tumor control is more important than pain control Many people wrongly think that cancer pain is something that patients have to bear, and that it will naturally be painless after the tumor is cured. Or they think that pain treatment is only a symptomatic treatment, which can only improve the symptoms and has little significance; anti-tumor treatment is the fundamental treatment. They think that controlling tumor is more important than controlling pain, and only use analgesics when the pain is severe, and the analgesic treatment can make the pain partially relieved. But in fact, for patients, pain control is as important as tumor control. The earlier the treatment, the better the result, and it is best to synchronize the two. Because only when the pain is well controlled, the patient’s state will be good, which is more conducive to the treatment of the tumor. Myth 2: Only use analgesics when the pain is severe For patients with pain, timely and on-time medication will be safer and more effective, and the strength and dose of analgesics required is also the lowest. In addition, long-term pain will also cause a series of pathophysiological changes, affecting the patient’s emotional and psychological health, and even the emergence of pain caused by the sympathetic nerve dysfunction associated with neuropathic pain, manifested as nociceptive hypersensitivity and abnormal pain and other intractable pain. Therefore, pain should not be delayed and should be treated promptly. Myth 3: Non-opioids are safer Opioids interact with center-specific receptors to relieve pain. However, high doses can lead to rigor mortis, coma and respiratory depression. Many people mistakenly believe that opioids are unsafe and are reluctant to use them. However, the truth is that the use of opioids is safer and more effective for patients who require long-term treatment with analgesic medications. In patients who have not been previously treated with opioids, respiratory depression and central nervous system adverse effects may occur with high doses of opioids. However, if the dose of medication is titrated correctly, adverse drug reactions can be avoided. Myth 4: Injecting Dulcolax if you can’t take the drug The World Health Organization (WHO) has listed Dulcolax as a drug that is not recommended for cancer pain treatment. The analgesic strength of Dulcolax is only 1/10 of that of morphine, and its metabolite desipramine has a long clearance half-life, which takes about 13 hours to be completely discharged from the body, and has potential neurotoxicity and nephrotoxicity. Continuous use of Dulcolax will not only not increase the pain relief effect, but also will cause a large amount of accumulation of nortriptyline in the body, severely stimulate the central nervous system, so that the patients appear delirium, tremor, confusion, convulsions and other mental anomalies and respiratory difficulties, especially for those with renal insufficiency, and the toxic side effects are even greater. Some studies show that long-term use of Dulcolax for pain relief, patients are prone to addiction. Myth 5: Vomiting should be discontinued after taking the drug Vomiting, sedation and other adverse reactions generally appear only in the first few days of the drug, a few days after the symptoms can disappear on their own. For the adverse reactions of opioids, active preventive treatment can reduce or avoid the occurrence of adverse reactions. Since opioids have the adverse reaction of respiratory depression, many clinicians worry that patients with lung cancer and metastatic lung cancer may have lower tolerance to opioids due to poor lung function. However, in fact, patients with lung cancer pain can safely use opioid painkillers. This is because the dyspnea caused by lung disease is the result of lung lesions, and the respiratory depression by opioids is the central effect of drugs, which does not aggravate lung lesions. Myth 6: Discontinuation of the drug too quickly will definitely appear withdrawal symptoms Clinical practice has proved that as long as the pain of cancer patients is controlled or eliminated, the amount of opioid analgesics can be reduced or discontinued at any time, and there will be no withdrawal symptoms.