FSB Author Article
Excerpt
The following is an excerpt from the book When It's Cancer: The 10 Essential Steps to Follow After Your
Diagnosis
By Toni
Bernay, Ph.D., and Saar Porrath, M.D.
Published
by Rodale; March
2006;$15.95US/$22.95CAN; 1-57954-823-7
Copyright © 2006 Toni Bernay, Ph.D.
Once your pain management team is in place, you can work together to
create a plan that anticipates every level of pain and institutes
measures for alleviating it. Remember, the key to effective pain
management is early intervention -- and that starts with you. You need
to inform your team when you're hurting, where, and how much. This is
why being able to talk with them comfortably and candidly is so
important. (We've provided tools ahead that might help with this
conversation.)
As you meet with your team members, you might want to share with
them the following pain management model. It establishes a continuum of
care to track with pain that ranges from mild to severe.
1. Complementary
and alternative therapies: We recommend CAM therapies as a
starting point because they are the least toxic. Your body will be
exposed to plenty of toxins during cancer treatment; it doesn't need
more. Also, with CAM therapies, you spare your body from the side
effects of yet another medication. Acupuncture, chiropractic, hypnosis,
massage, and meditation are among the options that have proven
successful in controlling pain.
2. Psychotropic drugs:
Mediated via neurotransmitters, these medications help
manage emotional distresses like depression and anxiety, both of which
aggravate pain. Since scientists have determined that neurotransmitters
inhabit the entire body, not just the brain, psychotropics have become
some of the most frequently prescribed drugs for pain management.
3. Over-the-counter
medications: Among the most common OTC pain relievers are
acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as
aspirin and ibuprofen. They may be enough to alleviate mild pain.
4. Low-dose
opioids: Seventy to 90 percent of cancer patients control
moderate pain with oral opioids such as Darvon, Percodan, and Percocet.
The long-term use of these medications has not been shown to worsen
pain. If that should happen in individual cases, the patients may be
advised to switch to an opioid other than the one they have been using.
5. Slow-or
fast-release opioids: Perhaps the best known of the opioids is
morphine, which is sold under several brand names. It's the most
commonly prescribed medication for severe pain and is available in
slow-or fast-release forms. Other slow-release opioids, which tend to
have longer-lasting effects, include Fentanyl, Levorphanol, methadone,
MS Contin, and Oramorph. In the fast-release category are codeine,
hydromorphone, and oxycodone. When taken as prescribed, opioids --
though quite potent -- rarely lead to addiction.
6. Invasive
procedures: For acute pain and some chronic pain, a nerve block
can provide temporary relief. In this procedure, the physician injects
a local anesthetic into or around nerves or below the skin at the site
of pain. The anesthetic interrupts the transmission of pain signals to
the brain, providing relief for up to several hours. In some
instances where drug therapy is ineffective, the pain pathways may be
redirected or severed through surgery or controlled with implanted
devices.
Reprinted from: When It's Cancer: The 10 Essential Steps to Follow After Your Diagnosis by Toni Bernay, PhD, and Saar Porrath, MD © 2006 Toni Bernay, PhD Permission granted by Rodale, Inc., Emmaus, PA 18098. Available wherever books are sold or directly from the publisher by calling (800) 848-4735 or visit their website at www.rodalestore.com.