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Tuesday, 24 April 2012

Treating Pain In Cancer Patients

Posted on 03:00 by Unknown
Tanya Uritsky, Pharm D, is a clinical pharmacy specialist in pain management and palliative care at Penn Medicine. In this blog, she discusses the role of pain management in cancer care. 

I wear a button on my lab coat that has the word “pain” encircled with a red line through it. I wear it because I am affectionately known as the “No Pain Girl.”

Patients I meet almost always comment on this button and request one of their own. Although these buttons only come in large batches, which tend to be pricey, I know that these patients consider the thought of “no pain” to be priceless.

But another common response to my button is, “No pain, no gain.” I am aware that most of the time this statement is made in casual conversation on an elevator or in a stairwell, but over the past year and a half at Penn, I have found it means so much more than a casual interaction. 

Treating pain in patients with cancer is, for me, associated with providing relief when pain prevails despite great effort.  I’ve created relationships filled with hugs, tears, and unbelievable gratitude and affection in the face of such affliction and uncertainty.

Pain is often a symptom that opens a door for me. The presence of pain is frequently associated with other consequences that can be physically apparent, like nausea or vomiting. Sometimes it may not be so obvious, like depression or anxiety. In treating pain, adverse effects of the drugs can create other symptoms that need to be addressed. Patients may question the meaning of the pain, leading to very real fears such as “Is my disease worse? Will I ever work again?”

I recently made a friend. She is my patient, but our relationship over the past few months makes her seem more like my friend.  When I recently saw she was returning for a potentially curative treatment, I couldn’t resist the opportunity to stop by her room.

When I did, she immediately started to cry. I thought, “What did I do?” Before I could complete that thought, she jumped up and hugged me. She said: “Tanya, you were able to do what no one has been able to do in 10 years. With your help, I was able to live again. Thank you.” 

This is the reward for treating pain in patients with cancer – restoring quality of life and functionality.  It is so much more than medications.  It is a therapeutic relationship.  It is a bond of trust.  It is listening when patients do not feel that they are being heard. 

With all of the medications, the adverse effects, and the treatments, it can be easy to get wrapped up in it all.  But with pain, like the button I wear, there is so much more than meets the eye. What I have come to realize is that what can be gained from the interaction with these patients, is what is truly priceless.

Learn more about Penn’s Symptom Management and Palliative Care Program.
Learn more about cancer pain management on OncoLink.
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