What does modern Pain Management look like?

Paramount in modern pain management is that pain is reduced sufficiently. In more than 90% of all cases, this is possible by using medication. Additional infusions, injections, catheters, operations or other invasive measures are rarely necessary. Analgesic therapy can take place over many years and even when opioids are being used - you do not need to fear drug addiction, dependency or side effects as long the pain management regimen is tailored to your individual requirements.    

In order to achieve an optimal effect on the pain mechanism, and depending on the cause of pain,  different types of medication will be used. To achieve an effective and side-effect free therapy, the combination of different drugs is the preferred option.

The following rules, however, should be observed:

1. Your therapy should be kept as simple as possible. Therefore, pain relieving medications (analgesics) should be administered whenever possible as tablets or as drops (oral administration).
2. Most analgesics must be given according to a strict time table.Pain relieving medications must also be taken when no pain is present to ensure continued freedom from pain.
3. The choice of pain killers is mainly based on the recommendation of the WHO Analgesia Scale.
4. Treatment and dosage must be individualised according to your requirements. During the period when the appropriate dosage for your situation is being ascertained, you will  need to see your doctor more often, and where appropriate your doctor will change your drug regimen.
5. During break-through pain you will receive quick acting medication which you can use as often as you like and in addition to your regular pain medication schedule. Care will be taken to ensure drugs for break-through pain are scheduled in such a dosage to avoid tiredness. 

The choice of analgesics is based on the underlying cause and intensity of the pain. To achieve a lower dose of a specific chemical compound, e.g. opioid, a combination of drugs is often used. However, it may be necessary to increase the dosage of analgesics during your treatment and you should not be frightened if your doctor suggests such action in order to reduce your pain.  In contrast to other pain relieving medication, there is no  maximum dose in the treatment with opioids (e.g. morphine).  Moreover, an increase in your analgesic dose does not mean that your illness has progressed and you should not refrain from using pain killers when you experience pain.

Pain, experienced over time, is draining on physical resources. This in turn weakens your body and the mental  resilience required for you to cope with your cancer therapy and to remain as independent and self-sufficient as you can be. Morphine, as an analgesic in the right dosage, can be taken over years and you need not be fearful of drug dependency and addiction.  Ask your doctor to write up an individual medication plan, and do not hesitate to telephone should you have questions. To assist you with this, you will be handed a business card with relevant information at the beginning of your  CIO treatment.