Treating Pain Associated With Cancer

Chronic pain is a tremendous public health problem, and a costly one. As health care advances and the need for palliative care rises, patients and health care providers are constantly investigating alternative methods of pain treatment and management. Questioning and challenging traditional health policies and practices has created a curiosity in the use of cannabis as an alternative option to standard opioids, for the management of chronic pain. Cannabis, is a leafy green plant consisting of buds and leaves of the cannabis sativa forma indica plants. Marijuana has been used in holistic solutions for hundreds of years; it has also been especially prevalent among terminally ill patients, who have been reported using it to alleviate symptoms like chronic pain, nausea and depression.

When managing the childs pain during cancer treatment the nurse must work with an interdisciplinary team involving many different experts to come up with the best possible pain management plan for the child. The nurse would be the one to carry this plan out in the child’s care. Knowing what opioid’s, nonopioids, NSAIDS, acetaminophen with codeine, oxycodone, and morphine to give during different times is crucial. The nurse must also know the side effects of these medication and monitor the child closely.

Narcotic analgesics, especially morphine are underused for pain control with in the medical field. This underuse is because medical professionals, including doctors, fear patient addiction, side effects and possible lose of their licenses. These fears deny adequate healing and a better quality of life to those who would benefit from a more effective use of these drugs, as done in hospice care.

The patients who are in pain requires pain relief, but many of them with chronic pain have trouble with prescribed opioids either due to psychosocial problems

The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety

Pain is one of the most common and feared complications of cancer. It is exacerbated by stress, anxiety, fatigue, and malaise which accompany advanced cancer. Pain is generally absent in the early stages of cancer, but it is a significant factor as the illness progresses to advanced stages. Cancer-associated pain can arise from a variety of direct and indirect mechanisms including direct pressure, obstruction, and invasion of a sensitive structure, stretching of visceral surfaces, tissue destruction, infection, and inflammation (McCance 2010). Pain is generally accepted as whatever the patient says it is, wherever the patient says it is. Treatment of pain and its associated symptoms is a primary responsibility of the healthcare team. Treatment modalities for pain include the use of opioid analgesics, patient-controlled analgesia, psychological interventions, and preventing recurrence of pain. Reinforcing the reporting of pain by the patient is important, as is a respect for the social and cultural differences with respect to pain perception.

Traditionally, doctors prescribed opioid treatments for pain-related medical conditions. Chronic pain in particular is difficult to treat. While the search for a cure is underway, the best most patients can hope for is effective management of their condition.

In the United States, opioids have become a major component in healthcare because they are an exceptional method of relieving pain. For those who are recovering from a recent inpatient surgery or those with cancer who are in a great deal of pain, it is a necessity. A known problem with opioids is that they are addictive, which leads to overuse of the medication by the patient. Opioids are also highly sought after as a street drug, this leads to patients exaggerating their pain level in order to receive more pills and selling their excess medication to others. Doctors will often prescribe opioids to patients who do not need such an aggressive form of pain relief, for example, people with arthritis or who have gone through a minor outpatient surgery. This can lead to a long-term use of these pain relieving drugs and possible addiction, which goes against the original purpose of opioids. In order to solve America’s dependence on opioids, medical professionals must go back to the original method of prescribing them, that is, only short-term use for people recovering from surgeries or in pain due to cancer, instead of a long-term solution for acute pain.

This has a capability of administering a constant delivery of a drug into the body. Sudden pain can be ceased instantly by the patients PCA.

Prior to 2000, nurses would routinely monitor a patient’s blood pressure, pulse, respirations and temperature: the four vital signs. After 2000, the Joint Commission on Accreditation of Healthcare Organizations added pain as the fifth vital sign and nurses were required to evaluate a patient’s pain level using a numeric scale of 0 to 10 (Florida Office of the Attorney General, 2012). This led to a flood of opioid based pain relievers hitting the market and an increase in physicians writing prescriptions for these medications. Previously opioids had been used for treatment of cancer related pain, but broadened to include management of chronic non cancer pain (Edlund, et al., 2014). Research by Edlund

Chronic pain is a tremendous public health problem, and a costly one. As health care advances and the need for palliative care rises, patients and health care providers are constantly investigating alternative methods of pain treatment and management. Questioning and challenging traditional health policies and practices has created an interest in the use of cannabis as an alternative option to standard opioids, for the management of chronic pain. Cannabis, or marijuana, is a leafy green plant consisting of buds and leaves of the cannabis sativa forma indica plants. Marijuana has been used in holistic solutions for hundreds of years; it has also been especially prevalent among terminally ill cancer patients, who have been reported using it to alleviate symptoms like chronic pain, nausea and depression.

The main ar-gument of the article is that neuropathic pain is challenging to manage and is a signifi-cant burden on society. The authors highlight how intrathecal drug delivery can be an alternate intervention for neuropathic pain when other methods of treatment fail to re-lieve symptoms. The topics covered in the article are the various medications used to manage neuropathic pain such as opioids, alpha-2 adrenergic agonists, calcium channel blockers, gamma-aminobutyric acid agonists, local anaesthetics, and corticosteroids. Ev-idence shows that intrathecal opioids may provide long term benefits for neuropathic pain, with other medications such as baclofen, ziconotide, bupivacaine, clonidine also showing moderate evidence of effective management of neuropathic

Drug therapy is described by Fitzgibbon and Loeser (2010, p.190) as the cornerstone of treating cancer pain. There is currently no specific NICE guidance on pain management on cancer. However, opioids

The perfect effect and management of persistent discomfort within malignancy depends on awareness of the fundamental pathophysiology structures as well as molecular systems, good examples of such instances include:

A 52-year-old male with metastatic renal cell carcinoma presents for assessment of chronic pain. His pain has been treated with a combination of oxycodone plus acetaminophen taken orally. Despite increasing doses of the analgesic combination, the pain is getting worse.