There is more than one way to treat cancer pain. Your doctor prescribes medicine based on the kind of pain you have and how severe it is.
In studies, these medicines have been shown to help control cancer pain. Doctors use three main groups of drugs for pain, which are: nonopioids, opioids, and other types. You may also hear the term analgesics used for these pain relievers. Some are stronger than others. It helps to know the different kinds of medicines, why and how they’re used, how you take them, and what side effects you might expect.
Here are the different kinds of cancer pain medicines:
1. Nonopioids – for mild to moderate pain
2. Opioids – for moderate to severe pain
3. Other types of pain medicine
1. Nonopioids – for mild to moderate pain
Nonopioids are drugs used to treat mild to moderate pain, fever, and swelling. On a scale of 0 to 10, a nonopioid may be used if you rate your pain from 1 to 4. These medicines are stronger than most people realize. In many cases, they are all you’ll need to relieve your pain. You just need to be sure to take them regularly.
You can buy most nonopioids without a prescription. But you still need to talk with your doctor before taking them. Some of them may have things added to them that you need to know about. Keep in mind that they do have side effects. Common ones, such as nausea, itching, or drowsiness, usually go away after a few days. Do not take more than the label says unless your doctor tells you to do so.
Nonopioids include:
A. Acetaminophen, which you may know as Tylenol®
Acetaminophen reduces pain. It is not helpful with inflammation. Most of the time, people don’t have side effects from a normal dose of acetaminophen. But taking large doses of this medicine every day for a long time can damage your liver. Drinking alcohol with the typical dose can also damage the liver.
Make sure you tell the doctor that you’re taking acetaminophen. Sometimes it is used in other pain medicines, so you may not realize that you’re taking more than you should. Also, your doctor may not want you to take acetaminophen too often if you’re getting chemotherapy. The medicine can cover up a fever, hiding the fact that you might have an infection.
B. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (which you may know as Advil® or Motrin®) and aspirin
NSAIDs help control pain and inflammation. With NSAIDs, the most common side effect is stomach upset or indigestion, especially in older people. Eating food or drinking milk when you take these drugs may stop this from happening.
NSAIDs may also keep blood from clotting the way it should. This means that it’s harder to stop bleeding after you’ve hurt yourself. NSAIDs can also sometimes cause bleeding in the stomach.
Tell your doctor if:
Some people have conditions that NSAIDs can make worse. In general, you should avoid these drugs if you:
2. Opioids – for moderate to severe pain
If you’re having moderate to severe pain, your doctor may recommend that you take stronger drugs called opioids. Opioids are also known as narcotics. You must have a doctor’s prescription to take them. They are often taken with aspirin, ibuprofen, and acetaminophen.
Common opioids include:
Getting relief with opioids
Over time, people who take opioids for pain sometimes find that they need to take larger doses to get relief. This is caused by more pain, the cancer getting worse, or medicine tolerance (see Medicine Tolerance and Addiction). When a medicine doesn’t give you enough pain relief, your doctor may increase the dose and how often you take it. He or she can also prescribe a stronger drug. Both methods are safe and effective under your doctor’s care. Do not increase the dose of medicine on your own.
Managing and preventing side effects
Some pain medicines may cause:
Other less common side effects include:
Almost everyone taking opioids has some constipation. This happens because opioids cause the stool to move more slowly through your system, so your body takes more time to absorb water from the stool. The stool then becomes hard.
You can control or prevent constipation by taking these steps:
If your pain has kept you from sleeping, you may sleep more at first when you begin taking opioids. The drowsiness usually goes away after a few days.
If you are tired or drowsy:
Nausea and vomiting usually go away after a few days of taking opioids.
These tips may help:
Usually these side effects last only a few days. But if they last longer, your doctors can change the medicine or dose you’re taking. Or they may also add another medicine to your pain control plan to control the side effects. Keep in mind that constipation will only go away if it’s treated. Your health care team can talk with you about other ways to relieve side effects. Don’t let side effects stop you from getting your pain under control.
3. Other types of pain medicine
Doctors also prescribe other types of medicine to relieve cancer pain. They can be used along with nonopioids and opioids. Some include:
A. Antidepressants. Some drugs can be used for more than one purpose. For example, antidepressants are used to treat depression, but they may also help relieve tingling and burning pain. Nerve damage from radiation, surgery, or chemotherapy can cause this type of pain.
B. Antiseizure medicines (anticonvulsants). Like antidepressants, anticonvulsants or antiseizure drugs can also be used to help control tingling or burning from nerve injury.
C. Steroids. Steroids are mainly used to treat pain caused by swelling.
Read Complementary and Alternative Medicines for Cancer if you are interested to learn more about alternative treament options for cancer.
Source: National Cancer Institute
Catharine “Kate” is a Certified Administrator for Residential Care Facilities for the Elderly (RCFE) and an Expert Senior Care Advisor. Kate’s grandmother battled Alzheimer’s Disease and Kate personally understands what millions of families are going through. Kate and her team are very passionate in empowering Seniors and their families by providing them with the Best Available Senior Care Options based on Senior’s care needs, preferred location and family’s budget.
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