CHAPTER 3
Talking About Your Pain
Pain control is part of treatment. Talking openly is key.
Controlling pain is a key part of your overall cancer treatment. The most important member of the team is you. You’re the only one who knows what your pain feels like. Talking about pain is important. It gives your health care team the feedback they need to help you feel better.
Some people with cancer don’t want to talk about their pain. They think that they’ll distract their doctors from working on ways to help treat their cancer. Or they worry that they won’t be seen as “good” patients. They also worry that they won’t be able to afford pain medicine. As a result, people sometimes get so used to living with their pain that they forget what it’s like to live without it.
But your health care team needs to know details about your pain and whether it’s getting worse. This helps them understand how the cancer and its treatment are affecting your body. And it helps them figure out how to best control the pain. Try to talk openly about any other medical problems and fears you have. And if money worries are stopping you, be sure to read the Financial Issues section starting on page 30 of this booklet. There may be ways to help you get the medicine you need.
Tell your health care team if you’re:
This information could affect the pain control plan your doctor suggests for you. If you feel uneasy talking about your pain, bring a family member or friend to speak for you. Or let your loved one take notes and ask questions. Remember, open communication between you, your loved ones, and your health care team will lead to better pain control.
Talking about your pain.
The first step in getting your pain under control is talking honestly about it. Try to talk with your health care team and your loved ones about what you are feeling. This means telling them:
Describe and rate your pain.
You will be asked to describe and rate your pain. This provides a way to assess your pain threshold and measure how well your pain control plan is working. Your doctor may ask you to describe your pain in a number of ways. A pain scale is the most common way. The scale uses the numbers 0 to 10, where 0 is no pain, and 10 is the worst. You can also use words to describe pain, like pinching, stinging, or aching. Some doctors show their patients a series of faces and ask them to point to the face that best describes how they feel.
No matter how you or your doctor keep track of your pain, make sure that you do it the same way each time. You also need to talk about any new pain you feel. It may help to keep a record of your pain. See the chart on page 37 for an example. Some people use a pain diary or journal. Others create a list or a computer spreadsheet. Choose the way that works best for you.
Your record could list:
Share your record with your health care team. It can help them figure out how helpful your pain medicines are, or if they need to change your pain control plan.
Here are some ways your health care team may ask you to describe or rate your pain:
0–10 Numeric Pain Intensity Scale, Simple Descriptive Pain Intensity Scale, and Visual Analog Scale (VAS): Acute Pain Management Guideline Panel. Acute Pain Management in Adults: Operative Procedures. Quick Reference Guide for Clinicians AHCPR Pub. No. 92-0019. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services.
“Faces” Pain Scale adapted with permission from Hockenberry MJ, Wilson D, Winkelstein ML: Wong’s Essentials of Pediatric Nursing, ed. 7, St. Louis, 2005, p. 1259. Used with permission. Copyright, Mosby.