Controlling Cancer Pain

Monday September 8, 2008

As a nurse, I thoroughly enjoying patient teaching. I think this is one of many things that draws me to hospice and palliative care. There are so many opportunities to teach patients and families ways to improve comfort and quality of life. But, there are also many opportunities for patients and families to teach me.

This past week, I admitted a retired pediatrician to hospice. He was a wonderful man with a remarkable health history. He had been initially diagnosed with lung cancer over 20 years ago and was lucky enough to beat it. His cancer remained in remission until last year when it came back with a vengeance. Hungry to make up for lost time, the cancer spread quickly - to his spine, liver, and brain.

I initially assumed that this doctor knew everything he could possible know about his disease and treatment, including the principles of pain control. I was hesitant to begin the standard patient teaching for fear he would think I was belittling his medical expertise. It quickly became obvious, however, that he was just like any other patient - eager for any knowledge I could impart that might make him feel better.

He wanted to remain in control of his medication regimen despite the fact that he was increasingly drowsy and forgetful. He also wanted to experiment with his medications, "just to see what each one would do". This meant that he wasn't taking his pain medication as scheduled. His erratic use of pain medication lead to uneven pain control and his pain lead to insomnia, fatigue, and over-all poor quality of life.

So, I had the pleasure of teaching this doctor the principles of pain control, including the importance of taking his pain medication as scheduled and keeping an accurate record of all medications taken, and I had the pleasure of learning an important lesson: never assume a patient knows something. Such assumptions may deprive them of a valuable opportunity to increase their quality of life.

What is Pain?

How Often Should I Take/Give Pain Medications?

Tips for Assessing Pain

Tips for Safe Use of Medications