Coping with Cancer

Dr. Jonathan López examines patient Bereniece Wilson.

Cancer patients may experience pain, but what causes it can depend on the kind of cancer, how advanced the cancer may be, its location and even its treatment, according to Jonathan López, M.D., hematologist/oncologist with the NorthBay Cancer Center. Either way, cancer patients should rest assured that there are an array of medications and treatments available to help them cope with whatever may come their way.

Is one kind of cancer more painful than another? It depends on several factors, Dr. López notes. “In the early stages of breast cancers, for example, a patient may not feel pain. But, if a cancer has metastasized—to bone or the liver, for example—that could cause pain in those areas. Pancreatic cancer, in its early stages, is also painless but later in the disease process patients will report a boring pain in the abdominal area that can radiate to the back. They may also experience weight loss, nausea and vomiting,” he adds.

Sometimes the pain comes from where tumors are located. “If there is a tumor on the liver, for example, and it grows enough to push and rub against other organs or the ribs, this can cause enough pain to bring someone in to the doctor,” he notes.

A sudden onset of painful sinuses is what brought Bereniece Wilson to an Oakland doctor in November 2011.

“I was in a tremendous amount of pain,” she recalls. Her diagnosis was Nasopharyngeal carcinoma (sinus cancer). She came under the care of Dr. López in December because she has a daughter living locally and she needed family support.

“She was in a terrible amount of pain, was not sleeping, had nausea and vomiting and was just miserable. I started her on medications, and that initially helped,” he says.

Bereniece then underwent a series of radiation and chemotherapy treatments in January. “And that, along with the combination of the pain medications, has really helped her the most,” Dr. López says.

“I’m really feeling good now,” she says. “I’m done with my treatments, and I have no pain. The medications were able to just break it down.”

While Bereneice’s cancer treatments helped her feel better, others may experience uncomfortable side effects.

“Some medications can cause a burning or numbness in the hands and feet, indigestion or an irritation in the mouth,” Dr. López notes. Fortunately, these side effects are in many cases short-lived.

It is critically important for cancer patients to be honest with their doctor about their aches and pains—all of them—even if they consider them to be minimal or think it’s not important enough to bother the doctor over.

“If I know my patient is experiencing pain somewhere, I can monitor it. It may be normal, or not. It may be a sign the cancer has spread, or is a result of the treatment. If we know what is causing the pain, we can find the underlying cause and then work to eliminate it.”

When it comes to confessing to discomfort, men are the worst, Dr. López jokes. “I’ll ask him how he’s doing, he says he’s fine and then I look over to the spouse, who is maybe frowning or shaking her head. I will investigate that body language,” he stresses.

He also counts on his nurses to pass along any comments. “Often, patients feel more comfortable telling the nurses about their pain,” he observes. “People tell them their troubles and I count on our nurses to fill me in.”

And please don’t avoid mentioning pain because you’re afraid you’ll become addicted to medications, he requests. “Cancer-related pain can be severe, but we need to get control of it. Pain can cause depression, which can worsen the pain, causing a downward spiral or more problems. Pain control helps prevent this. It really is a quality-of-life issue.”

Tips for Managing Cancer Pain

  • Notify your doctor right away if you have any new pain, or if it is getting worse or if the pain medication is not working.
  • Take your medication on a regular schedule as instructed. Don’t skip doses or wait for pain to get worse before taking the medication.
  • Take the medication even if you are not feeling any pain. It is more difficult to get your pain under control if you wait for it to occur.
  • Let your doctor know if you experience side effects, such as constipation, nausea, vomiting or drowsiness.
  • Help your doctor to determine the right pain control methods by keeping track of where the pain is typically located, how it feels, if there is anything that makes it worse or better, or if there are changes in levels of pain based on time of day or level of activity.

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