The main challenge for cancer patients is beating the disease entirely. However, enduring the agony that cancer causes is an added major challenge. There are different kinds of pain that cancer patients have to endure.
Physical Pain: Physical pain can result from tumor growth, tissue invasion, or compression of nerves caused by cancer. In addition to causing physical discomfort, treatments including radiation therapy, chemotherapy, and surgery can also have adverse effects like exhaustion, nausea, and neuropathy.
Mental Pain: Significant emotional anguish, such as worry, sadness, fear of the future, and uncertainty about one’s health, can be brought on by cancer. Having to deal with a diagnosis, going through treatment, and accepting that you might not live long can cause mental suffering.
Social Pain: A patient’s relationships and social life may be affected by cancer. They might go through changes in their social duties and obligations, feel alone or misunderstood by friends and family, or struggle with financial constraints associated with treatment expenditures. Disruptions in social ties might exacerbate a patient’s distress because social support is essential for coping with cancer.
Spiritual Pain: Cancer tests the spiritual beliefs and ideals of many patients and poses existential problems. They could struggle with issues related to the purpose of pain, death, and life. A great spiritual journey can be experienced when one finds purpose, hope, and peace among the turbulence of disease.
Addressing each dimension of pain requires a comprehensive approach that considers not only physical symptoms but also the psychological, social, and spiritual well-being of the patient. This often involves a multidisciplinary team of healthcare professionals, including doctors, nurses, psychologists, social workers, and spiritual counselors, working together to provide holistic care and support. Additionally, peer support groups, counseling services, and complementary therapies can also help alleviate the various forms of pain experienced by cancer patients.
The Golden Drug
Administering morphine to cancer patients is a common practice for managing pain, especially when other pain management strategies are insufficient. Morphine is a potent opioid analgesic that works by binding to opioid receptors in the brain and spinal cord, thereby reducing the perception of pain. Morphine, a powerful analgesic, swiftly alleviates moderate to severe pain, offering patients relief within mere minutes.
Although morphine can relieve pain and help to enjoy a better quality of life, it is often misunderstood. Some believe that morphine hastens death. Yet a controlled use of morphine keeps the patient as comfortable as they want to be. It is introduced gradually and is tailored to the patient’s symptoms and reactions. Often, patients come on hospice service much too late, so by the time morphine is started, the disease process is already nearing the end. The timing of the patient death is because of the illness, not morphine.
Some others think morphine is used only at end of life. Managing a patient’s pain and symptoms to their liking is of utmost importance. As pain increases, the morphine dose can be adjusted to relieve it. There is not a maximum dose; it is tailored to each patient for their symptomatic relief.
There is a myth that morphine is addictive for hospice patients. Yet, if morphine is prescribed, it will be for the purpose of relieving pain, and will not cause the patient to crave the drug or become addicted. It is also believed that at morphine stops breathing but it not so. When a hospice patient has difficulty breathing, morphine can calm the patient, but does not stop breathing.
Cancer patients who experience severe pain due to the disease itself or as a side effect of treatments such as surgery, chemotherapy, or radiation therapy can be given morphine to effectively manage both acute and chronic pain.
Morphine can be administered through various routes, including oral, intravenous (IV), subcutaneous (under the skin), and transdermal (skin patches). The choice of route depends on factors such as the patient’s condition, the urgency of pain relief, and their ability to tolerate oral medications.
However, morphine can cause side effects such as drowsiness, constipation, nausea, vomiting, itching, and respiratory depression. Patients should be closely monitored for these side effects, and appropriate measures should be taken to manage them, such as administering laxatives for constipation or antiemetics for nausea.
Risk of Dependency and Tolerance: Prolonged use of morphine can lead to physical dependence and tolerance, where higher doses are required to achieve the same level of pain relief. However, in the context of cancer pain management, the focus is on improving the patient’s quality of life, and concerns about dependency are secondary to the need for effective pain control.
Morphine is often used as part of a multimodal approach to pain management in cancer patients, which may include other medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), adjuvant analgesics (e.g., antidepressants, anticonvulsants), physical therapy, psychological support, and interventional procedures like nerve blocks or radiotherapy.
In palliative care or end-of-life situations, morphine is commonly used to alleviate pain and provide comfort to terminally ill cancer patients. The focus shifts from curing the disease to maximizing the patient’s quality of life.
