Dr. Harish . A. Motwani

With every passing day, there are new advancements in the field of medicine, and cancer care is no exception either. A condition that still frightens the mass has come a long way in terms of cure and management. Cancer is life threatening but when diagnosed in the early stages, can be cured with proper medical intervention.

Many cancer patients experience pain which is caused as a result of the disease or as the result of the treatments for cancer. When the cancer spreads or the malignant tumor increases in size, it puts pressure on the surrounding (bones, tissues, etc.) which intrigues the pain. The cancer treatments like chemotherapy, radiation therapy, and surgery may also cause pain in the patients.

Here is an account on managing pain during cancer.

Treatment for Cancer Pain
Cancer pain can be dull, sharp, or achy. It can be constant or intermittent and can be mild, severe, or moderate. There are several over-the-counter or prescription medicines available in the market which can reduce the pain caused by the growing tissues or the treatments/therapies. A few such pain relievers include aspirin, acetaminophen, and ibuprofen.

Treatment According to Severity
For pain which is mild or moderate, you can opt for Non-opioids which are anti-inflammatory medicines and can be bought without the prescription from the drug counters. If you are having moderate to severe symptoms of pain, then you may be prescribed opioids like hydromorphone, hydrocodone, fentanyl, etc.

For burning and tingling sensation, antidepressants like imipramine or the trazodone, etc., can provide relief. You must not confuse antidepressant with medicines for depression; these are for pain management as well. You can also opt for the antiepileptics drugs which can reduce the burning or tingling sensation of cancer and have it doesn’t refer that you get seizures. If there is swelling, then steroids are the option for you to control the swelling and the pain caused from it.

Ways to Take Medicines for Cancer Pain
Most of the medications that your doctor would prescribe you have to be taken orally if not directed otherwise. The medications are usually in the pills form. If the patient, for any reason, is not able to take the drugs orally, then he/she may have to take them as rectal suppositories and even transdermal patches.

It can also be injected into your body through an intravenous opening in which the needle with the medicine is inserted directly into the veins. There is also a subcutaneous process where the medicine is injected with a small needle just under the first layer of your skin.

Studies report that often cancer pain is under-treated. A common reason is the reluctance of the patients to speak about the pain. Other reasons for not opting for pain medications are the fear of addiction and side-effects.

Cancer pain management is indeed an important part of the cancer treatment, and the goal is to manage the pain at a bearable level. And, the best part is that the goal is often achieved.
 

Patients with metastatic renal cell carcinoma (RCC) to the brain have a very poor prognosis of three months if left untreated. SRS is an effective treatment modality in numerous patients. This case exemplifies the utility of stereotactic radiosurgery (SRS) in prolonging survival and maintaining quality of life in a patient with RCC. 

• This 64-year-old female patient initially presented to her primary care physician 22 months after a left nephrectomy for RCC with complaints of mild, intermittent headaches and difficulty with balance. An MRI revealed five cerebellar lesions suspicious for intracranial metastasis. The patient's first GKRS treatment targeted four lesions with 22 Gy at the 50% isodose line. She underwent a total of seven GKRS treatments over the next 60 months for recurrent metastases to the brain. 
• 72 months and 12 months have now passed since her brain metastases were first discovered and since her last GKRS treatment, respectively, and this woman is alive with considerable quality of life and no evidence of metastatic reoccurrence. This case shows that repeated GKRS treatments, with minimal surgical intervention, can effectively treat multiple intracranial lesions in select patients, prolonging survival and avoiding iatrogenic neurocognitive decline while maintaining a high quality of life.

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