Cancer Pain Conditions We Treat
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Bone Metastasis Pain
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Post-Surgical / Post-Radiation Pain
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Nerve Infiltration Pain
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Visceral Organ Pain
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Breakthrough Pain
Bone Metastasis Pain
Overview
Bone metastasis occurs when cancer spreads to the bones, producing deep, aching pain that worsens with movement or at night. Without proper control, it can severely limit mobility and lead to pathological fractures.
Symptoms
- Persistent, dull bone pain — often nocturnal
- Local tenderness or swelling
- Pain triggered by weight-bearing or movement
- Fatigue and sleep disturbance
- Occasional numbness or weakness if spinal involvement exists
Diagnosis
- Imaging: X-rays, bone scan, CT, or MRI to confirm lesions
- Blood Tests: Calcium and alkaline-phosphatase levels
- Clinical Assessment: Pain mapping, fracture-risk scoring
- Oncology Collaboration: Integration with existing cancer-treatment plan
Treatment
- Medication Management: Stepwise use of non-opioid and opioid analgesics following the WHO pain ladder, along with adjuvant agents (bisphosphonates, calcitonin).
- Interventional Procedures: Image-guided nerve or plexus blocks; vertebroplasty/kyphoplasty for spinal lesions; radiofrequency ablation for focal metastases.
- Radiation Therapy: Targeted palliative radiation reduces tumour bulk and pain.
- Supportive Care: Physiotherapy, orthotic braces, nutrition, and counselling.
Post-Surgical / Post-Radiation Pain
Overview
Pain following cancer surgery or radiotherapy can persist due to tissue fibrosis, nerve injury, or radiation-induced inflammation. Early recognition and multimodal therapy prevent chronic pain syndromes and functional limitations.
Symptoms
- Burning or shooting pain at or near the treated site
- Skin sensitivity or tightening
- Stiffness and restricted movement
- Tingling or numbness around scars or radiation fields
Diagnosis
- Clinical assessment of pain distribution and severity
- Imaging to rule out recurrence or infection
- Nerve conduction studies if neuropathic pain suspected
- Pain-impact evaluation on sleep and daily activities
Treatment
- Medical Management: Topical analgesic patches, neuropathic-pain modulators, anti-inflammatory medication.
- Interventional Approaches: Local nerve or plexus blocks under imaging guidance; radiofrequency ablation for chronic radiation-fibrosis pain.
- Physiotherapy & Rehab: Range-of-motion exercises, scar mobilisation, lymphatic drainage.
- Psychological Support: Address anxiety, body-image distress, and pain-related fear.
Nerve Infiltration Pain
Overview
Tumours compressing or invading nerves create severe, burning, or shooting pain, often accompanied by weakness or sensory loss. Common in head-neck, pelvic, and lung cancers, this pain demands urgent specialist attention.
Symptoms
- Continuous burning or electric-shock sensations
- Pain radiating along the affected nerve path
- Muscle weakness or numbness
- Allodynia (pain from light touch)
Diagnosis
- Neurological examination
- Imaging (MRI / CT) to identify compression or invasion
- Diagnostic nerve block to confirm source
- Collaboration with oncology and radiology teams
Treatment
- Pharmacotherapy: Combination of opioids, anticonvulsants, and corticosteroids.
- Interventional Techniques: Selective nerve or plexus blocks (brachial, lumbosacral, celiac, hypogastric).
- Adjunct Therapies: Physiotherapy for mobility; psychological support for coping.
- Oncologic Coordination: Radiation or chemotherapy for tumour reduction when indicated.
Visceral Organ Pain
Overview
Visceral pain arises from internal organs such as the liver, stomach, or intestines affected by cancer. It is deep, poorly localised, and often accompanied by nausea or fullness.
Symptoms
- Deep abdominal or thoracic pressure-like pain
- Pain radiating to back or shoulders
- Bloating, nausea, or early satiety
- Weight loss and fatigue
Diagnosis
- Clinical correlation with imaging (CT, MRI, Ultrasound)
- Diagnostic celiac or splanchnic plexus block
- Assessment of gastrointestinal or hepatic involvement
Treatment
- Medication Regimen : Opioids with adjuvants (antispasmodics, antidepressants).
- Interventional Procedures : Celiac Plexus Block or Splanchnic Nerve Block for upper-abdominal pain; Superior Hypogastric Plexus Block for pelvic-organ pain.
- Nutritional & Palliative Support : Diet modification, enzyme supplementation, counselling.
- Monitoring & Follow-up : Regular reassessment for evolving tumour load or complications.
Breakthrough Pain
Overview
Breakthrough pain (BTP) is a sudden, intense flare of pain that “breaks through” despite otherwise stable pain control. It can be spontaneous or triggered by movement, coughing, or emotional stress.
Symptoms
- Rapid-onset, short-duration pain episodes
- Occurs on top of background pain
- Associated anxiety, breathlessness, or sweating
- May happen several times daily
Diagnosis
- Pain-diary tracking: frequency, triggers, and duration
- Medication-review to ensure optimal baseline therapy
- Rule out new pathology or inadequate analgesic dosing
Treatment
- Pharmacologic Management : Fast-acting opioids or transmucosal fentanyl for
rescue therapy; adjustment of background medication. - Interventional Options : Targeted nerve or plexus blocks for recurring site
specific flares. - Non-Drug Support : Breathing, relaxation, and coping strategies taught by
palliative-care counsellors. - Education & Monitoring : Patient and caregiver training to recognise and
respond to attacks safely.
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FAQs
Can cancer pain be controlled?
Yes. Most cancer-related pain can be effectively managed with medicines, nerve blocks, and supportive care.
When should a patient see a pain specialist?
When pain affects daily life, sleep, or is not relieved by regular treatment, a pain specialist should be consulted.
Are nerve blocks safe for cancer pain?
Yes. Nerve blocks are safe, commonly used, and can provide strong pain relief while reducing the need for high-dose medicines.