CANCER PAIN
CANCER PAIN
Pain is perception of nociception or painful stimuli. This is due to activity in the afferent nervous system induced by tissue damage related chemicals. Cancer pain is a complex phenomenon, it includes not only nociception but there is a significant element of suffering. The intensity of pain has no relation to degree of tissue damage; it is influenced by affective and cognitive ability of the individual.
In more than two third of the cases, cancer pain is due to direct invasion of sensitive structures by tumor cells. Bone pain, neuropathic pain and visceral pain has different origins. Surgery, radiation and chemotherapy also cause pain. 10% patients have pain unrelated to cancer or its treatment.Nevertheless it has to be addresses aggressively at the earliest so that quality of life remains reasonably satisfactory.
70 % to 90 % of cancer patients with pain can be treated conservatively with WHO three- step ladder. Those with severe unrelieved pain or with debilitating side effects of pharmacological treatment can benefit from regional anaesthetic technique. Diagnostic local anaesthetic blocks are used for determining the pain pathway.
Permanent neurolytic block can lead to dramatic pain relief, besides numbness and motor block which may be distressing so diagnostic block is performed first. Reflex muscle spasm due to invasion of deep tissues by the tumor is relieved by trigger point injections of local anaesthetic in cancer patients. Though oral opioids are used for pain relief in cancer patients, side effects remain a problem. Continuous infusion of Intrathecal and epidural opioid via catheter is used for pain relief. Small doses of betamethasone, intrathecal is effective in patients with vertebral bone metastases. It provides long lasting pain relief without adverse effects, thus patient can perform daily activities with good quality of life.
Invasion or compression of nerves by growing malignant tumours can increase pain. Local instillation of steroid in the plexus, or nerve or epidural/ Intrathecal can provide good pain relief. Neurolytic agents are used to destroy nerve tissues in order to provide good pain relief in cases of malignancy induce pain where life expectancy is short. Peripheral nerve neurolysis works well for a single nerve distribution related pain whereas sympathetic plexus block is effective in non-dermatomal distribution of pain. Stellate ganglion, celiac plexus, lumbar plexus, superior hypogastric plexus and ganglion Impar plexus block neurolysis is done to treat sympathetically mediated pain of the specific area.
Intrathecal neurolysis of the dorsal root can provide sensory block without motor blockade though it requires patient co operation, proper positioning and selection of neurolytic agent.
Phenol in glycerine, alcohol, glycerol, ammonium compounds, vallinoids, botulinum and hypertonic saline is used as neurolytic agent.
Relief from cancer pain requires constant support from the clinician for the individual and family. We at Aadarsh Pain Clinic are providing day care support for cancer patients for relief of Pain.
Opening Hours
Mon - Sat : 9.00 AM - 5.00 PM
Sunday : CLOSED
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+919410029175 , +917983445471
Address
Aadarsh Pain Clinic & Palliative Care Centre
E-37, Shastri Nagar, Meerut 250004
Email Us
info@aadarshpainclinic.com
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Monday – Saturday: 9.00Am – 5:00PM | Sunday – Closed