"People are suffering unnecessarily."
(EDUARDO BRUERA)
Q: What can go wrong when patients don't tell doctors about their cancer pain?
A: The main problem of not reporting cancer pain is that it might be a serious problem that goes untreated. They might have a new cancer site that needs a change in the cancer treatment. A lump may be starting to pinch on nerves or the spinal cord and might need immediate treatment. By not talking about it, the patient might not take advantage of changes in treatment that might be extremely useful.
Q: What about the impact on them emotionally?
A: The other big problem is for quality of life. People are suffering unnecessarily, which leads to less activity, being very depressed, and being more uncomfortable with the cancer.
Q: How often do people keep silent about it?
A: Most of the data suggest it's frequent that patients and their families will not mention that they have pain. There are reasons why patients might not. They might think that it may not be related to the cancer. They might think it could be some other condition like arthritis or a cold. The patient may not want to distract or confuse their doctor, whose time is limited, and want them to focus on the treatment. In other cases, patients might be a little bit worried and not willing to accept the fact that it might be a sign cancer is there.
Q: What are the main causes of cancer pain?
A: The main cause is actually the presence of the tumor in a particular area of the body. Either the primary cancer grows and starts pinching on the nerves or the primary cancer gives a little seed that travels with the blood to another part of the body and leads to another lump, or metastasis, and that starts growing and pinching on the nerves. That's about 75% of the cases. About 15% of patients have pain that is due to some of the treatments, some of the chemotherapy or surgery treatments hurt little nerves and patients get peripheral neuropathy (pain in the hands and the feet). Another 5% to 10% of patients have pain that has nothing to do with the cancer, such as rheumatic issues, or issues with the bowel or the heart.
