Why you should take
SHARING ADVICE
pain control seriously Pain can be a significant part of the cancer experience for many patients, some of whom are reluctant to take prescription opioids. Some patients fear becoming addicted to medications such as morphine or are concerned about common side effects, such as sedation, itching, constipation and even hormonal imbalances. Brendan McGinn, MD, an assistant professor of anesthesiology specializing in pain management at Upstate, said side effects are easily treated, and cancer patients, especially, can obtain pain relief with appropriate opioid prescribing. “In actuality one of the few indications for chronic usage of these medications is in the treatment of cancer pain,” he said. People with cancer may feel pain from a tumor that physically compresses internal organs, nerves or bones, from surgical trauma or from the effects of chemotherapy or radiation. McGinn said psychological stress can also be a major factor contributing to pain.
McGinn emphasized that pain should be treated aggressively as soon as it become an issue and that staying ahead of pain is essential in helping to reduce its severity. He said studies have shown that having good control of pain can help cancer patients live longer. Standard nonsteroidal anti-inflammatories such as Tylenol and ibuprofen are effective for joint and muscle pain related to cancer, while nerve pain that is more of a burning or tingling sensation may be treated with some antiseizure or antidepressant medication, McGinn said. However, severe pain, no matter what the cause, may require morphine or other types of opioids. In addition to medications, interventions such as nerve blocks and various injections can be utilized to treat cancer pain. Meditation, acupuncture or comprehensive psychological support can also help. “These are all crucial therapies, and they’re often underutilized,” McGinn said. Pain management is one of the Upstate Cancer Center’s support services. Reach the Division of Pain Medicine by calling 315-464-4259 or visiting the support services at upstate.edu/cancer/cancer-care. ●
ways a dietitian can help
Registered dietitians play an important role in cancer care. The Upstate Cancer Center’s Registered Dietitian Nutritionist Maria Erdman gives six examples: l
Patients in treatment for cancer do better when they are well nourished. Erdman said, “a well-nourished patient will have more lean body mass and may be more tolerant of sometimes difficult treatments.” Good nutrition can also help reduce the number of hospital visits and, if someone does have to be hospitalized, the amount of time he or she stays may be reduced.
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Patients who may need the most nutritional intervention include those with head and neck cancers, esophageal cancer and lung cancer. That’s because they may develop difficulty swallowing during treatment and require alternative ways of eating. Some cancer patients experience nausea and vomiting and/or diarrhea. Many cancer treatments target fast-growing cancer cells, and the cells lining the gastrointestinal tract are often affected too, since they are among the body’s fastest-dividing cells.
CANCER CARE
fall 2015
Medications can be useful, but how, what and how much a patient eats can also impact symptoms. l
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Some patients who lose weight during treatment also have trouble eating large quantities of food. A dietitian can provide recipes and ideas for foods that are nutritionally dense with good amounts of protein and calories. A patient who must be fed through a tube may require the assistance of a dietitian to help optimize the volume and type of feedings. A dietitian can sometimes help obtain health insurance coverage for these products. People wanting to reduce their cancer risk can also learn from oncology dietitians about the value of good nutrition. One factor in cancer prevention, Erdman said, is to maintain a healthy body weight, remain physically active and eat a wide variety of plant-based foods, including fruits, vegetables, whole grains, nuts, seeds and beans. “Following these guidelines doesn’t mean you won’t get cancer,” she said, “but making healthy lifestyle choices can reduce your risk, no matter what other risk factors you may have.” ●
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