Common Misconceptions about Cancer Pain Treatment

Misconception 1: My pain is caused by cancer, so I don't need any special treatment. Once the tumor is cured, the pain will naturally subside.

While cancer treatment is an important aspect of pain management, relying solely on cancer treatment to control pain has a very low effectiveness rate, possibly less than 10%. This is because, on the one hand, cancer treatment has limited effectiveness, and on the other hand, many patients experience pain because the tumor has damaged nerves or bone marrow. Damaged nerves and bone marrow are very difficult to repair and will continue to cause pain due to constant stimulation. Therefore, if cancer pain is accompanied by chronic pain, they must be treated as two separate conditions: the cancer and the pain. Simultaneous treatment yields better results.

Misconception 2: Cancer treatment is the most important; I'll treat the cancer first, and only treat the pain if all else fails.

In reality, many patients experience loss of appetite and sleep, leading to a severe decline in quality of life and a rapid decrease in immune function. This significantly impacts cancer treatment, reducing its effectiveness. The earlier pain is controlled, the better it is for cancer treatment. Therefore, our treatment principle should be "treating cancer pain simultaneously, with pain relief as a priority."

Misconception 3: I'll endure the pain first, and only use painkillers when it becomes unbearable.

In fact, timely and regular use of painkillers is safer and more effective, and requires a lower dosage. Using medication only when the pain is severe not only results in poor relief but also, due to the torment of pain, easily leads to anxiety, depression, insomnia, and loss of appetite, affecting the patient's quality of life. The resulting malnutrition and weakened immune system can also make the patient unable to tolerate cancer treatment.

Misconception 4: Morp hine is addictive; eventually, more and more are used, and it's impossible to stop. It should be avoided if possible.

Experimental studies and clinical practice have confirmed that the risk of addiction is very low for cancer pain patients taking oral morp hine or using transdermal patches. The reason why medications are used in increasing quantities is twofold: firstly, these drugs develop tolerance (the body gradually adapts), and secondly, as the tumor progresses and the pain worsens, more painkillers are needed for control. In reality, if the patient's tumor is controlled and the pain disappears, painkillers can be gradually reduced until they are completely discontinued.

Myth 5: If the pain is unbearable, the only option is to take pethi dine.

In reality, pethi dine is no longer recommended for cancer pain treatment due to its high toxicity and poor analgesic effect. Many medications, such as morp hine, oxy codone, and hydromo rphone, are now more effective and have fewer side effects than pethi dine. Even if these medications are ineffective, minimally invasive analgesia can be used to control cancer pain.

Myth 6: Minimally invasive analgesia is only used when medication is ineffective.

Many minimally invasive treatments (such as visceral nerve ablation and intrathecal analgesia) offer better pain relief and fewer side effects, allowing patients to control pain with less or even no painkillers, thus improving their quality of life. Furthermore, even with minimally invasive analgesia, the timing of treatment is crucial (for example, intrathecal analgesia requires the patient to be awake and lying on their side for about an hour to complete). Delaying treatment may lead to a worsening of the condition and loss of the optimal treatment window. Therefore, if a patient has indications for minimally invasive analgesia, the earlier it is used, the better the analgesic effect, the higher the quality of life, and the longer the survival time.

Misconception Seven: Postoperative pain is normal; just endure it.

Ancient tales of Guan Yu undergoing bone-scraping surgery and modern stories of Liu Bocheng undergoing surgery without anesthesia have given many people the misconception that enduring pain is a sign of fortitude. However, this is not the case. With in-depth research into pain, it has become clear that pain can induce various adverse physical and psychological reactions, leading to other damages. For example, simply enduring pain can cause anxiety in patients, increasing the incidence of cardiovascular disease during surgery; it increases the risk of atelectasis and lung infection; it prevents patients from getting out of bed early, increasing the risk of lower limb thrombosis; it lowers the patient's immune function, potentially leading to postoperative infections; and postoperative pain can cause anxiety, fear, irritability, helplessness, depression, and sleep disorders. Therefore, we must also say "no" to postoperative pain. For postoperative pain, early intervention and treatment are essential for achieving better quality of life and a better prognosis.