Pain associated with malignant tumors, especially advanced cancer, is common in clinical practice. According to the incomplete statistics of the World Health Organization, there are about 7 million new cancer patients worldwide every year, and about 30%-50% of them have different degrees of pain. In China, about 60% of patients with various stages of cancer have different degrees of pain. Since pain has a great impact on patients’ quality of life, cancer pain relief treatment is of great significance. In clinical practice, how to control cancer pain well so that patients can be pain-free is not only a matter that clinicians face every day, but also a big issue that patients and their families are very concerned about.
Pain is a subjective feeling of the body to harmful stimuli, and pain is not only a physiological response, but also a subjective psychological experience. There are many reasons for the occurrence of cancer pain, such as tumor destroying skin and bone membrane, tumor invading nerves, mucous membrane invasion, fear and anxiety, pain caused by radiation damage, etc. Among them, pain directly caused by cancer accounts for about 50%, cancer-related pain accounts for about 25%, pain related to cancer treatment accounts for about 20%, and pain not related to cancer accounts for about 5%.
The purpose of cancer pain treatment is to relieve patients’ pain, eliminate pain and improve patients’ quality of life. WHO, the World Health Organization, established an expert committee on cancer pain treatment in 1982, and the experts agreed that most cancer pain patients can be made pain-free by using existing pain medications and knowledge of cancer pain, and proposed the three-step pain relief therapy, which is now the basic method for treating cancer pain. In 1991, the Ministry of Health of China issued the “Basic Principles of Three-step Pain Relief Therapy for Cancer Patients”, which marked the formalization of cancer pain treatment in China.
There are many ways to treat cancer pain, and currently, comprehensive treatment is advocated in clinical practice.
I. Etiological treatment: actively treat the primary disease, and use surgery, chemotherapy and radiotherapy to remove the primary tumor lesion.
Analgesic drug therapy – is the main method of cancer pain treatment.
1.Preferred oral medication: simple and non-invasive, administered in a stepwise manner, on time and individualized.
2. Rectal administration: Patients with upper gastrointestinal tract diseases or obstruction can use rectal suppositories for direct rectal administration, and the efficacy is quite good.
3.Dermal administration: When the patient can neither take the medicine orally nor anally, the patient can use Doregis transdermal patch on the skin to relieve pain and change it every three days, which is convenient and hassle-free and good effect.
4.Injectable medication: patients with severe pain can also be given morphine injections to relieve pain.
Third, the auxiliary medication.
1, corticosteroids: anti-inflammatory and pain relief, increase appetite, improve mood and reduce neuroedema. However, it should be noted that the drug cannot be used continuously for too long.
2.Anti-convulsant drugs: they are more effective for patients with cancer accompanied by neuropathic pain.
3.Anti-depressant drugs: the combined use of drugs is effective for cancer patients with depression.
4.Anti-arrhythmic drugs: they are effective for patients with neuropathic pain.
Other methods
1, radiation pain relief: patients with painful bone metastases, in addition to oral drug pain relief and bisphosphonate drug application, radiation therapy is a good pain relief treatment, the patient almost controlled the pain after four or five times of radiation therapy, stop taking painkillers.
2.Nerve block therapy: When cancer is accompanied by nerve destruction or infiltration, general pain relief therapy does not work, then nerve block therapy can be performed to relieve pain.
3.Psychotherapy: Some cancer patients are not in obvious pain, but their pain is aggravated by psychological disorder, so we should give good psychological intervention to these patients to eliminate their worries and relax, which can get good pain relief effect.
In conclusion, cancer pain treatment is a purposeful, planned, targeted, step-by-step, individualized and comprehensive treatment. After a comprehensive assessment of the patient’s condition, we should choose a reasonable treatment method and formulate an individualized pain relief treatment plan to relieve cancer patients’ pain to the maximum extent, reduce adverse reactions and improve patients’ survival quality while prolonging their survival time.