- Hi, I'm Emily Mackler, and I'm a clinical pharmacist
that works at the University of Michigan Cancer Center
in the Symptom Management and Supportive Care Clinic.
And today we're gonna talk about pain management
and dispel some myths surrounding the treatment of pain.
Unfortunately, pain is a symptom
that many patients with cancer may experience
at some point during their diagnosis
or treatment of their disease.
In many cases, we're able to control the pain,
and how we control it can vary from patient to patient.
And so it's very important for you to work
with your healthcare provider
and talk to them about goals of pain management for you.
For instance, we may have patients that,
their goal of managing their pain is to allow them
to sleep better at night,
or perhaps their goal of managing their pain
is to allow them to do certain activities during the day
without experiencing the pain during those activities.
So, really defining what your goals are
can help your healthcare provider treat you
as best as possible.
People often associate the treatment of cancer pain
with opioids or narcotics, and we'll talk a little bit
about the myths surrounding those agents in a minute.
But besides narcotics or opioids,
there are many other ways that we can manage cancer pain.
Sometimes, just the management of your cancer itself
can help to eliminate or decrease pain that you experience.
In other cases, we can do an interventional procedure
that may have nothing to do with taking oral medications,
but can prevent or block some of the pain
that you're experiencing in a particular area.
And so those are just two examples of ways
that we can manage pain, but we have multiple other avenues
of treating them.
Many of our patients have expressed to us
that they have concern when they take narcotics or opioids,
because they have concern that they'll become addicted.
We hear from patients who may have
a history of addiction in the past,
say perhaps to alcohol or to other products,
that they're very concerned that they'll become addicted
to their pain medications.
Addiction really is a psychological dependence
on these medications, for reasons other than
the therapeutic reason of you taking it
to manage your pain, and for that reason,
the risk or the potential for a cancer patient with pain
to become addicted to opioids is incredibly low.
In fact, these drugs are very important in managing pain,
and allowing, as I indicated earlier,
allowing patients to be able to improve
their quality of life or meet some other goals
as far as activity level or being able to sleep better.
So we don't really see the psychological addiction
occurring with these medications and cancer patients.
Another concern or myth that we hear from patients
that we treat within our clinic is that
they don't wish to start managing their pain
until they feel like it's really bad.
There's a concern that patients will run out of options
for their pain medications if they begin treatment now,
and that's definitely not true.
We have a lot of room to go as far as changing doses
of the medications that we give patients,
although patients don't, as I indicated earlier,
develop an addiction to the medication,
the tolerance can develop.
But in those cases, we can modify dosing
or modify the types of drugs that we give you
and that can, again, be eliminated
and you can achieve good pain control
regardless of when you started your pain medication.
And so that's a myth that we frequently try to dispel
is that we don't want patients waiting too long
to treat their pain, and we really don't see
that they run out of options,
as we have many available interventions
or medications that are available to you.
So besides narcotics or opioids,
we have an array of medications and other treatments
that we may use for the treatment of pain.
Some patients are very surprised when they hear
that they may be started on a medication
that is typically used to treat epilepsy,
or a seizure disorder, or for instance,
a medication that's generally used to treat depression,
also can treat and modify patients' pain.
So when your provider assesses your pain
and sees what type of pain that you have,
you may see that, as opposed to just being on
an opioid agent, that you may be on that in combination
with an anti-depressant or another type of medication.
It's important to use these other drugs
to help manage your pain because they treat your pain
in different ways.
And so we often call that adjuvant therapy
and add that on to the standard opioid treatment.
In other ways, this is useful
because it also may decrease the amount
of opioid therapy you need over time,
if these other mechanisms work well for you.
I also mentioned in the beginning
that we can use other interventions
and so we have, within our Symptom Management Clinic,
and working in the Cancer Center,
a pain management service that can look at
if there are procedures that might be helpful to patients.
We also know that in some cases,
massage therapy might be useful,
or other means of treating pain
that may not be medication-related alone.
All of these things are important to consider
and we encourage you to talk to your healthcare provider
about ways of treating and managing your pain, again,
about what your pain control goals are
and how we can help you to achieve those
to the best of our ability.
If you have any more questions about this,
or have any other thoughts regarding your pain control,
please contact your healthcare provider,
or feel free to make an appointment
in the Symptom Management Clinic.