Cancer pain is the most common symptom when cancer is diagnosed and its frequency is increasing regardless of cancer treatment. Between 33-40% of cancer patients who have completed curative treatment complain of chronic pain, while 5-10% have their daily activities limited by chronic pain. In contrast, it has been reported that out of 1.7 million European cancer patients, at least 66% died of cancer with pain before death and 55% were exposed to moderate to severe pain. It is not possible to know the numbers in our country even now.
Since 1996, many methods and guidelines for cancer pain management have been published by the World Health Organization. Despite the guidelines published even in European countries, there are obstacles to good and complete control of cancer-related pain. It is known that at least 1/3 of patients do not receive adequate attention to pain during regular cancer treatment, that patients with cancer pain do not have access to necessary analgesic treatment due to lack of attention, and that cancer patients are exposed to pain for longer due to delayed access to red prescription drugs. Uncontrolled or inadequately treated pain leads to physical and emotional impairment, reduced quality of life and increased number and variety of complaints. The elicitation of pain in cancer patients can be achieved by using questions routinely asked in patient assessments. For example; “Have you ever experienced pain that interferes with your daily activities?” or “Does this pain interfere with your daily activities, for example, can you go to the toilet?” can be asked to obtain information about the level and degree of pain. In addition, the severity, etiology, character and underlying mechanisms of pain can be determined by bedside assessment and a strategy for the treatment of pain can be determined. In patients with cancer pain, the presence of metastasis, that is, the spread of cancer to other tissues and organs, increases the severity of pain. The severity of pain makes it difficult to treat pain in cancer patients.
In the treatment of cancer pain, there are many different treatments for patients whose pain does not go away with red prescription and other drugs. Some of these are;
Spinal-Epidural catheters (Pain Catheter)
Spinal/epidural port (pain pump) placement
Blockade of certain nerves, radiofrequency treatment depending on the location of the cancer pain
Vertebroplasty/Kyphoplasty (filling for tumours in the bones of the spine)
Percutaneous cordotomy (blocking pain pathways to the brain with radiofrequency)