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Myths About Cancer Pain

By Arlene F. Harder, MA, MFT

Many people fear pain from cancer more than they fear death, although there is much that can be done to relieve even severe pain. Part of this fear arises from the fact that many doctors do not treat pain as aggressively as they could. Perhaps the Supreme Court decision throwing the question of a "right to die" back to the states will force all of us to openly discuss the real issue, which is pain relief.

However, another cause for the fear of pain is the prevalence of myths concerning pain, such as:

Cancer is always painful.

Cancer and treatment for cancer if usually much less painful than people fear it will be.

If your doctor says nothing more can be done for your pain, you will have to live with it.

Unfortunately, most doctors are not as well trained to deal will pain as they should be. It is estimated that at least 95% of the time pain can be adequately controlled without sedation IF the physician knows what to prescribe. Pain specialists, as well as the nurses and doctors that work with hospice, can give you advice on what can relieve your pain. The good news is that you don't have to call hospice and get their advice.

Narcotics shouldn't be given until the very end of life because it causes addiction.

It is true that drugs like morphine need to be administered with caution to patients with a history of alcohol or drug abuse Addiction is rarely an important clinical problem for cancer patients, however, because the body metabolizes opiate medications differently when the patient is in pain than when they are used as a recreational drug.

When your doctor suggests morphine, that means he's "given up" on you.

Today, morphine is not reserved for terminal care. Yet, the use of strong opioid analgesics is still occasionally delayed because of the out-dated idea that such treatment signifies a hopeless prognosis. The earlier use of morphine -- when the patient is relatively well, but troubled by pain -- supports ample anecdotal evidence that patients whose pain is relieved do better than those who are disturbed by continued pain.

It is best to have patients take pain medication on an "as needed" basis.

This approach, too frequently prescribed, means that you get pain medication only when pain becomes more intense or when a pain that had gone away comes back. To get optimal pain control, pain medication should be given "by the clock." Since it usually takes about 30 minutes for any pain medication to work, taking medication by the clock, rather than when you feel pain, will give you much better pain control. Some medications can be taken every three to four hours and some long-acting medications can even be taken every 8 to 12 hours.

Pain has to be tolerated so that you won't feel sleepy and "out of it."

The correct use of pain medication helps a patient maintain autonomy, cognitive capacity and dignity and allows mobility for home care and travel. In fact, life is enhanced because pain is reduced to a tolerable level and the patient is better able to rest, sleep and eat, as well as to be generally more active. Patients can be exhausted by weeks or months of insomnia and poor nutrition associated with intolerable pain, without the relief proper pain medication provides.

You may need to be persistent to get the pain relief to which you are entitled. There IS a way to manage pain.

© Copyright 1993, Revised 2002, Arlene F. Harder, MA, MFT