Palliative Care in India

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Pain and palliative care

Having cancer does not always mean that there will be pain. But if there is pain, there are different types of pain which can be relieved by different methods either medicinal or non medicinal.

Pain can affect day-to -day activities if not taken care of appropriately. It can easily affect your activities of daily living such as eating, sleeping, mobility etc. This could also lead into behavioural changes of agitation, irritability and sadness. However, pain should never be considered as normal with cancer. It must be addressed and controlled to enable better quality of life.

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Types of pain are:

  • Acute pain: severe pain which lasts for a short duration of time
  • Chronic pain: also known as persisting pain which is usually dull but present for more than 3 months. Chronic pain will not go away but it can be controlled with medicines.
  • Breakthrough pain: this a sudden burst of pain even though regular medication is being taken, Breakthrough pain medication may  be different from the usual pain medication as it will have greater intensity and could be worse.

Pain from the cancer are:

  • Spinal cord compression: when the cancer spreads to the spinal cord it can cause compression which is mostly manifested by pain in the neck.
  • Bone Pain: this type of pain may occur when cancer spreads to the bones. Treatment may either be aimed towards the cancer or towards strengthening the bone. External beam radiation therapy may be used or biphosphonates are used to strengthen bones and keep them from breaking.

Pain from treatment for cancer:

  • Procedures and testing: Some tests required to determine the efficacy of treatment are painful. The pain associated with these procedures are treated with regular medicines to reduce the pain felt after.
  • Surgical Pain: Depending on the type of surgery, pain after a surgery is expected. Pain after a surgery may last from a few days to weeks.
  • Phantom pain: is a long lasting effect of surgery. This pain goes beyond the surgical pain and is usually difficult to treat. In the case where a body part is removed such as an arm, leg or breast, there may still be a feeling that there is pain or unpleasant feeling from the absent part. This is most difficult to treat and requires various methods of pain management.
  • Pain from chemotherapy or radiation: Pain may be due to the side effects of chemotherapy and radiation such as peripheral neuropathy and mouth sores.

As pain can affect the daily activities, it can cause a hindrance to the overall quality of life.

Palliative care is specialized medical care for people who are suffering from terminal illnesses like cancer. It is the total care including physical, psychological, social and spiritual care aimed towards improvement of quality of life and dying peacefully. The care is focused around symptomatic management such as pain.  Palliative care is provided by a team of specially trained doctors, nurses and social workers who work together to support the patient in all his/her needs. It is however not only limited to the patient, but is extended even to the family, to help cope with imminent death of loved ones. 

Authored By : Dr. Shiva Kumar Uppala

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