Cancer Pain Treatment in Las Vegas and Henderson

The pain associated with cancer can be a difficult and unpleasant experience. However, pain management can help, so you do not have to suffer with pain while you receive treatment. With appropriate care, cancer pain can be controlled or eliminated completely.

How does the doctor measure pain?

There is no available test used to measure pain. The doctor uses special scales, visual aids, and detailed questioning techniques to assess and rate your cancer pain. A person’s pain tolerance varies from person to person, and the type and site of cancer determines the severity of pain.

How common is cancer pain?

According to many studies, around 90 percent of persons with advanced cancer report severe cancer pain. At least one-third of all cancer patients have some type of pain. The most common cause of cancer pain occurs with metastasis (spread) to the bones.

What causes pain related to cancer?

The type of cancer determines the source of the pain. If a tumor presses on organs or nerves, a person will experience pain. Cancer treatment also can be painful. Chemotherapy and radiation can produce serious side effects and discomfort. In addition, the stage of the cancer and extent of severity influences cancer pain. Common causes of cancer pain include:

  • Poor blood circulation
  • Tumor pressing on nerves, bone, or organ
  • Side effects to therapies
  • Stiffness due to inactivity
  • Infection or inflammation
  • Psychological responses due to tension, depression, and/or anxiety

What pain symptoms are associated with cancer?

Pain related to cancer can be dull (slow and mild), sharp (knife-like and intense), throbbing (pounding), intermittent (come and go), or continuous (all the time). In addition, if a tumor presses on nerves, neuropathic pain can be burning, stinging, tingling, and the patient can experience weakness and numbness of an extremity.

Which medicines are used to treat cancer pain?

The pain management specialist will often use a combination of medications to treat pain. The medication prescribed depends on the type of cancer, the severity of the pain, and the patient’s tolerance to the medications. Options include:

  • Anticonvulsants – For nerve-related pain, the doctor can prescribe gabapentin or carbamazepine.
  • Antidepressants – Drugs like nortriptyline and amitriptyline are used for nerve-related pain.
  • Topical agents – These items include Lidoderm (pain patch), capsaicin (topical cream), menthol, and camphor.
  • Narcotic analgesics – For severe pain, the doctor may prescribe oxycodone, hydrocodone, codeine, fentanyl, or hydromorphone.

How is cancer pain treated?

Other than medications, the pain specialist can use interventional pain techniques to control the patient’s pain. Treatment options include:

  • Celiac plexus block – This procedure is used to treat pain related to pelvic and abdominal cancer. The celiac plexus nerves supply the abdomen, and the doctor inserts a small needle near the nerves using x-ray guidance. A long-acting anesthetic is instilled onto the nerves. Based on a recent clinical study, this block has a 90% efficacy rate.

 

  • Superior hypogastric plexus block – The superior hypogastric plexus is a mass of nerves that supply the lower abdominal region. As with other nerve blocks, a needle is positioned near the nerves and an anesthetic is applied. According to a recent research report, the success rate of this block is 72%, with many patients reporting pain relief that lasted for up to six months.

 

  • Neurolysis – To destroy a portion of the nerves affected by the cancer, the doctor can inject a neurolytic agent onto the nerves. Phenol and alcohol are commonly used agents.

 

  • Radiofrequency ablation (RFA) – Radiofrequency energy can be applied to the painful nerves to destroy a portion of the nerve root and block pain. This treatment is used for long-term pain relief.

 

  • Patient-controlled analgesia (PCA) – Medication can be administered intravenously via a PCA pump. This device allows the patient to administer his/her own dose, controlling the frequency and amount of medication.

Resources

Kaufman M, Singh G, Das S, Concha-Parra R, Erber J, Micames C, & Gress F. (2010). Efficacy of endoscopic ultrasound-guided celiac plexus block and celiac plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer. J Clin Gastrology, 44:127–134.

McGreevy K, Hurley RW, Erdek MA, Aner MM, Li S, & Cohen SP (2013).The effectiveness of repeat celiac plexus neurolysis for pancreatic cancer: a pilot study. Pain Practice,13, 89–95.

Plancarte R, de Leon-Casasola OA, El-Helealy M, et al.(1997). Neurolytic superior hypogastric plexus block for chronic pelvic pain associated with cancer. Reg Anesthesia, 22:562-568.