As the earliest and most subjective internal sensation that every person experiences in his or her life, “pain” is a problem that we often encounter. However, due to the long-standing one-sided understanding of pain, people think that pain is only a symptom of disease and will disappear as long as the disease is cured, so there are still many patients who are suffering from pain.
Only 30% of cancer pain patients in China get effective pain relief
Pain is the most common cancer-related symptom, and also the most feared symptom by patients. Due to certain misunderstanding of patients and family members, only 30% of cancer pain patients in China have got effective pain relief.
According to statistics, there are about 3.37 million new cancer cases in China every year, 20% of new cancer patients have cancer pain, about 50% of progressive cancer patients have cancer pain, and 80%-90% of terminal cancer patients have cancer pain.
Proper understanding of cancer pain avoid six misconceptions
Long-term pain can seriously affect the quality of life of patients and their family members, such as poor sleep and diet, causing depression, anxiety, anger, fatigue, anorexia and other adverse emotions, and can lead to the decline of patients’ immunity, which hinders the smooth progress of anti-cancer treatment. Therefore, it is important to have a correct understanding of cancer pain and its related treatment.
I. Controlling tumor is more important than controlling pain
Many people mistakenly believe that cancer pain is something patients have to bear, and it will naturally stop once the tumor is cured. Or they think that pain treatment is only a symptom treatment, which can only improve the symptoms and has little significance; anti-tumor treatment is the root of the problem. They think that controlling tumor is more important than controlling pain, and analgesics should be used only when the pain is severe, and 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 effect, and it is better to do both simultaneously. Because only when the pain is well controlled, the patient’s condition will be good and it is more conducive to the treatment of tumor.
Only use analgesics when the pain is severe
For pain patients, timely and timely medication is safer and more effective, and the strength and dose of analgesics needed are also the lowest. In addition, long-term pain can also cause a series of pathophysiological changes that affect the emotional and psychological health of patients, and even sympathetic nerve dysfunction associated with neuropathic pain due to pain, manifesting as nociceptive hypersensitivity and abnormal pain and other intractable pain. Therefore, the appearance of pain should not be delayed and should be treated promptly.
Third, non-opioid drugs are safer
Opioids relieve pain by interacting with central specific receptors. However, high doses can lead to miosis, coma and respiratory depression. Many people mistakenly believe that opioids are unsafe and are reluctant to use them.
In fact, however, opioids are safer and more effective for patients who require long-term analgesic medication. Respiratory depression and central nervous system adverse effects may occur with high doses of opioids in patients who have not received prior opioid therapy. However, if the dose is correctly titrated, adverse drug reactions can be avoided.
Fourth, can not take the drug to inject dulcolax
The World Health Organization (WHO) has listed Dulcolax as a drug not recommended for cancer pain treatment. The analgesic effect of Dulcolax is only 1/10 of morphine, and its metabolite, norethindrone, has a long clearance half-life, taking about 13 hours to be completely discharged from the body, and has potential neurotoxicity and nephrotoxicity.
Continuous use of dulcolax not only does not increase the effect of pain relief, but also causes a large accumulation of norethindrone in the body, which can seriously stimulate the central nervous system and cause delirium, tremor, confusion, convulsions and other mental abnormalities and respiratory difficulties, especially for those with renal insufficiency, the toxic side effects are even greater. Some studies have shown that long-term use of dulcolax for pain relief, patients are prone to addiction.
V. Vomiting should be stopped after taking the drug
Vomiting, sedation and other adverse reactions generally appear only in the first few days of medication, the symptoms can disappear on their own after a few days. For the adverse reactions to opioids for active preventive treatment, can reduce or avoid the occurrence of adverse reactions.
Since opioids have the adverse effect of respiratory depression, many clinicians worry that patients with lung cancer and metastatic lung cancer may have reduced tolerance to opioids due to poor lung function. However, in fact, patients with lung cancer pain can safely use opioid painkillers. Because the dyspnea caused by lung diseases is due to lung lesions, and the respiratory inhibition by opioids is the central effect of drugs, which does not aggravate the lung lesions.
Sixth, stopping drugs too quickly will definitely lead to withdrawal symptoms
Clinical practice proves that as long as the pain of cancer patients is controlled or eliminated, they can reduce or stop the use of opioid analgesics at any time and will not have withdrawal symptoms.