What causes pain symptoms in cancer patients? A: Some of the factors that cause pain symptoms in cancer patients are from the cancer itself, some are from the cancer treatment process itself, and some are caused by other factors such as arthritis that is not related to the cancer. Is there a way to feel better? A: Yes. First, you have to avoid activities that can make your pain worse. Second, you can try to relax, for example, you can do relaxation exercises or meditation. If the pain flares up, it is important to keep a record of the symptoms and how they were managed at the time. This way, your doctor can use the information in your records to treat the pain symptoms and get better. Information that is generally recorded includes the dose of medication you are taking, how much the pain symptoms have decreased and how long the pain has lasted. When describing pain symptoms, you can rate them on a scale of 1 to 10 – with 1 being almost no pain and 10 being unbearable pain. When do I need to call a doctor or nurse? A: You may seek help from a doctor or nurse if: 1. the nature or location of the pain has changed; 2. the pain is chronic and worsens or does not improve after treatment. What kind of medication is effective for cancer pain? A: Doctors usually use a drug called an “opioid” to treat cancer pain. Opioids are sometimes called “narcotics”. These drugs include morphine, hydrocodone, and fentanyl. Generally, opioids work in two ways: 1. They have a slow onset of action but a long duration of action (several hours after taking the drug). These drugs are made as oral extended-release tablets or skin patches. 2. Fast-acting and short-acting drugs are used to treat sudden onset or worsening of pain. These drugs are made as oral immediate-release tablets, solutions, agents that dissolve quickly on the tongue, and aerosols that can be passed through the mouth or nose. Doctors usually prescribe two types of opioids to treat patients with cancer pain. Most patients take an opioid extended-release agent daily to prevent pain. If the pain flares up while you are just taking an opioid extended-release, you can take an opioid immediate-release medication to control the pain. Depending on your symptoms and other comorbidities, your doctor may also prescribe some other types of medications to treat the pain. In most cases, people use other medications in combination with opioid medications, including: 1. acetaminophen or a class of drugs called “nonsteroids,” which include ibuprofen and naproxen. 2. 2, drugs commonly used in other situations, some of the drugs used to treat other problems can also help treat certain types of cancer pain. Examples include steroids, antidepressants and medications for bone problems. These medications are often used in combination with opioids to treat patients with cancer pain. Are there any other pain medications I should know about? A: You should know that: 1. It is important to take opioid extended-release medications as prescribed, even if you do not feel pain. And the purpose of treatment is to control your pain, not to treat pain episodes. If you don’t feel pain it means the pain medication is working. 2. You need to let your doctor or nurse know if the medication you are taking can help treat the pain or if it will last long at this dose. Depending on the situation, your doctor may increase your dose, increase the frequency of taking the medication, or prescribe a different medication. 3. Opioids have side effects. Common side effects include constipation, drowsiness, and nausea. Let your doctor or nurse know that you are having side effects. That way, he or she can treat your side effects or change your medication. 4. You need to keep your opioid medications safe in case they are stolen. Someone may steal opioids and sell them to earn illegal income. 5. You cannot be addicted to opioids. When patients take higher and higher doses to treat pain, there is often a fear of addiction, but this is not the case. This may be because the condition requires or has a high “tolerance” to the drug, when a higher dose of the drug is needed. Tolerance is when the body adapts to the drug, so it doesn’t work as well as it used to. Tolerance is not the same as addiction. Are there other ways to treat pain? A: Yes. If medication is not enough to relieve the pain, talk to your doctor or nurse about other treatment options. Depending on the symptoms and the cause of the pain, he or she may recommend a program. This may include medication injections into the painful area, or destruction of the nerves that are causing the pain. He or she may also recommend that you use a physical therapist, a mental health professional or a non-traditional medicine specialist. Non-traditional medicine includes treatments such as acupuncture and massage.