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The goal of the ASCENT program is to help rural and/or Hispanic cancer patients better manage their pain. This website includes educational information and other resources on different pain management techniques. We encourage all patients to explore the resources on this page to maximize the pain relief gained from participation in this study.
Public blog
Introduction
Pain is one of the most common symptoms associated with cancer and cancer treatments. Cancer pain--like chronic pain--can be debilitating. While this pain can be frustrating disruption, it is highly treatable.
The Achieving Equity through Sociocuturally-informed Digitally-Enabled Cancer Pain Management (ASCENT) study leverages multiple strategies to help patients manage their cancer pain. Primary treatments have significant scientific support showing that they are effective at managing pain. Additional treatments have less scientific support but have made a significant difference for individual patients.
Read more about the treatment strategies below.
Primary Treatments
These methods have the strongest scientific evidence for effectively treating cancer pain.
There are three first line strategies that we recommend for ASCENT patients.
1. Medications
Acetaminophen (i.e. Tylenol) may ease mild pain. The daily dose should not be more than 3000 mg, and you should not use acetaminophen if your liver is not working well.
Non-steroidal anti-inflammatory medications, also called NSAIDs, such as ibuprofen or naproxen sodium, may ease pain that is mild-to-moderate. Talk to you cancer care team before using NSAIDS. This is because NSAIDs can cause harm when combined with some chemotherapy and oral cancer medications.
Prescription pain medicines, such as gabapentin, duloxetine and steroids, may ease all types of cancer pain. They calm the nerves that carry pain signals. And they are effective for nerve pain.
Opioids, also called narcotics, are a special class of prescription pain medicine. They may ease cancer pain that is moderate-to-severe. Because of side effects and risk of addiction, these medications are usually prescribed for a limited time.
Note: Prescription pain medications can cause side effects. These may include constipation, light-headedness, dizziness, and nausea. Laxatives and stool softeners can help with constipation. When used for a long time, opioids can lead to addiction. Use opioids only as long as needed to manage your pain.
Additional Resources:
2. Physical Movement
Physical movements like walking, stretching, yoga, and therapeutic exercise increase your pain threshold, relieve joint stress, and allow you to move with less pain. There are many different types of physical activity that could help manage your pain.
Options include:
- Step count monitoring and goal setting;
- Gradual, progressive strength training with REST DVD;
- Explore local resources if group fitness classes are preferred;
- Explore options to resume exercises that were successful in the past
- Yoga (more resources below)
Additional Resources:
Yoga involves gently moving through a series of positions which you briefly hold, while paying special attention to your breathing. Learn how yoga can help with pain management.
Mindful Movements: Gentle Yoga
3. Cognitive Behavioral Therapy Skills
Cognitive behavioral therapy, also called CBT, can help you recognize negative thoughts that can make your pain worse. CBT sessions are guided by a trained provider and tailored to individual patients.
Relaxation, imagery and distraction can lessen stress that makes pain worse or more difficult to control. Listen to relaxing music or a favorite television program to help distract you from pain.
Staying Grounded
Explains techniques for bringing oneself back to the present moment to get control over overwhelming emotions and thoughts.
- Rest as you need to. Let painful areas relax.
- Use pillows to keep pressure off your area of pain and to help support your body in comfortable positions.
Additional Resources:
Cognitive Coping Skills: Changing Your Thoughts About Chronic Pain and Illness
Using Relaxation Skills to Relieve Your Symptoms
What is Cognitive Behavioral Therapy (CBT)?
Anxiety and Chronic Pain or Illness
Ways to Manage Your Feelings and Thoughts
Information for Family and Friends of Those Living with Chronic Symptoms
Breathing: An introduction
Breathing from the belly is a very effective way of lowering stress. Learn how practicing relaxed breathing can help with pain management.
Meditation: An introduction
Meditation is a way of focusing your attention on the present moment to manage thoughts and feelings. Learn how practicing meditation can help with pain management.
Additional treatments
Integrative therapies
Integrative therapies, such as acupuncture/acupressure, progressive muscle relaxation, and music listening/therapy, can help to relieve your pain. These treatments also relieve other symptoms like anxiety and insomnia. The following integrative therapies may help ease your pain.
Acupuncture/Acupressure
Acupuncture is a form of traditional Chinese medicine that aims to restore a balanced energy flow in the body to treat pain and illness. Click the links below to learn more.
What You Need to Know About Acupuncture
Acupressure involves applying pressure at certain points on the body to relieve discomfort. Acupressure does not puncture the skin, but targets specific areas of the body, similar to acupuncture.
Progressive Muscle Relaxation
In progressive muscle relaxation, you slowly tense and then relax each muscle group.
This can help you focus on the difference between muscle tension and relaxation. You can become more aware of physical sensations.
Click this link to learn more.
Music Listening/Therapy
Music therapy is the use of music by a board-certified music therapist (MT-BC) to support the patient and caregivers. Music (live or recorded) is combined with therapeutic techniques to support the needs of patients of all ages.
Music therapy can help:
- Decrease anxiety
- Decrease blood pressure
- Decrease pain symptoms
- Elevate mood
- Improve quality of life
- Slow heart rate
Read more: Music Therapy
Procedures
Surgical and non-surgical procedures can help ease pain to treat pain by interrupting pain signals or reducing inflammation in the painful area.
- Nerve blocks can be used to prevent pain signals from reaching your brain. These can be temporary, such as when the dentist gives you Novocain™, or they can last longer. Nerve blocks work best when pain is in a limited area.
- Steroid injections can relieve pain from inflamed joints, tendons and nerves. These injections are usually given with special guidance from ultra sound or other imaging techniques.
- Trigger point injections are used to relieve spastic, painful muscles. They work best when a few painful areas can be targeted.
- Spinal approaches deliver pain medications directly to the central nervous system, as when an epidural eases pain during childbirth. Spinal approaches can be used in special situations for severe pain when oral medications don’t work or cause bad side effects.
Additional Resources:
Click the links to learn more about the above procedures.
Spinal Injections: Epidural, Facet Joint, Sacroiliac Joint, and Nerve Root
Care After Your Steroid Injection
Palliative Medicine
Palliative care is a specialized area of medicine that focuses on preventing, managing, and relieving symptoms of cancer. In addition to treating physical issues, such as pain, nausea, and fatigue, Palliative care also focuses on improving quality of life for patients and their loved ones. You may hear "palliative care" and "hospice care" used in similar ways, but they are not the same. Palliative care is given at every step of the treatment process to provide an extra layer of support no matter what stage of cancer you have.
Read more here: Palliative Care.
Integrative therapy options with less scientific support
These options, while helpful to some patients, are lacking the scientific support that acupuncture/acupressure, progressive muscle relaxation, and music listening/therapy have. They may be helpful to you, but expectations should be managed.
Massage
Massage relaxes muscles, increases blood flow and stimulates the release of the body's pain-relieving chemicals.
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