It’s fantastic news when patients are declared free of cancer. Unfortunately, this doesn’t necessarily mean they’re free of pain. An De Groef (Faculty of Medicine and Health Sciences) provides more insight into persistent pain complaints after cancer treatment and offers solutions for effective pain management.
IN SHORT
- Quite some patients who are declared free of cancer experience persistent pain.
- These complaints are insufficiently reported and treated.
- Caregivers, patients and those around them should be better informed about these issues. More insight and openness contribute to effective pain management.
Pain after cancer treatment
‘Having cancer doesn’t always come with pain. There are several common types, such as breast and prostate cancer, that are hardly ever detected through pain complaints,’ says An De Groef, professor of Rehabilitation Sciences and Physiotherapy at UAntwerp. ‘Cancer treatments, like surgery, chemotherapy and radiotherapy, do regularly cause pain. This pain has a clear function: our body gives a signal to take it easy for a while, in order to recover properly.’ Prolonged pain after a treatment can also be normal, while there’s still an injury. As the injury heals, the pain should decrease. But that doesn’t always happen: many completely recovered cancer patients experience persistent pain. It’s a problem that receives too little attention, says De Groef: ‘Caregivers pay much more attention to pain complaints during cancer treatment than when they follow up on cured patients, when the focus is on the cancer staying away. And the patients themselves post-treatment? They tend to keep quiet about their complaints. They don’t want to be ungrateful, and think the pain is just part of the deal. But there are solutions!’
This is why pain education– learning more about pain – is crucial. What are pain stimuli and what is their function? When is pain normal (and when isn’t it)? What factors come into play? ‘We encourage caregivers to keep asking about complaints,’ says De Groef. ‘And we empower patients to take the initiative themselves and don’t just put up with their pain. We use videos and brochures to reach out to them and invite them to come talk to us. They’re always asked to bring someone along so those around them are also informed.’
The right type of pain
In those conversations, patients get an explanation of how pain arises. It can be caused by tissue damage, damage to the nervous system, or an imbalance in the pain system itself. ‘Recognising the right type of pain is crucial,’ says De Groef, ‘as this determines which approach is the best one. For one thing, we have different types of medication for different types of pain. And there are all kinds of treatment options too, including physiotherapy and talk therapy.’
Influencing pain
Patients are also made aware of how they can influence their own pain experience. For example, says De Groef, exercise can boost physical and mental health: ‘It doesn’t have to be high-intensity. It’s also good if you walk or cycle instead of taking the car! And for certain pain complaints, it’s best to do exercises under the guidance of a physiotherapist.’
Not only biological factors play a part in pain sensitivity. The psychosocial aspect is just as important! Stress, for example, increases pain sensitivity.
In addition to exercise, there are other factors that influence pain. ‘These may be biological, such as the healing of an injury. But the psychosocial aspect is just as important! Stress, for example, increases pain sensitivity, so it can be helpful to do relaxation exercises.’ Finally, the people around a patient also play an important role. ‘We have to get rid of the myth that free of cancer means free of complaints. Pain is often invisible, so ask patients how they’re really doing, and what you can do to help.’ De Groef calls for more openness about these problems: ‘By talking about pain, patients, those around them and caregivers can make a difference together!’