tumor pain

jan9wils

Recently (about 4 months) I have been having pain from tumors growing and pressing on nerves, pulling on muscles, etc. Most of my tumors are in my abdomen. This has interfered with me be able to be as physically active as I would like to be sometimes.  I've been taking percocet which has helped with the stabbing burning pains and leaves me with a dull ache most of the time. But the percocet wears off before my next dose is due. The past month the pain is getting more intense. Now my treating doctor has recommended small dose of slow release morophine. She said I can take the percocet in between for break-through pain along with the morophine if needed. This is the study doctor, not my gyn/onc who has treated me for the past five years. Does anyone have experience with tumor pain? Is this typical? 

oldbeauty

Take the morphine...or get fentanyl patch

I had a total of three episodes of sudden onset of excruciating tumor pain from 2010 to 2012 before my first recurrence was diagnosed.  The first 2 times I wound up in the ER almost delirious with pain.  A morphine shot each time addressed it.  The underlying cause was not detected until the 3d time, when I ended up admitted to the hospital to get my cancer pain under control.  In my case, it was the growing tumor in a right para-aortic lymph node that was impinging on the psoas muscle/nerve complex.  I was placed on a number of meds for pain, including a fentanyl patch, while I began external radiation on the tumor.  As the tumor responded, I weaned myself off the drugs, with diminishing doses of fentanyl being the last to go.  On a scale of 0-10, that pain was 11, and I would not want to experience it again.  I would not hesitate to use the morphine or its latest synthetic, fentanyl.  Those opioids do cause constipation, which I would imagine you'd want addressed given the locus of your tumor pain.  So, if you use these drugs, your pain doctor ought to talk with you about the best method for preserving elimination while you work on easing your pain.  Best wishes.  Oldbeauty

jan9wils

oldbeauty said:

Take the morphine...or get fentanyl patch

I had a total of three episodes of sudden onset of excruciating tumor pain from 2010 to 2012 before my first recurrence was diagnosed.  The first 2 times I wound up in the ER almost delirious with pain.  A morphine shot each time addressed it.  The underlying cause was not detected until the 3d time, when I ended up admitted to the hospital to get my cancer pain under control.  In my case, it was the growing tumor in a right para-aortic lymph node that was impinging on the psoas muscle/nerve complex.  I was placed on a number of meds for pain, including a fentanyl patch, while I began external radiation on the tumor.  As the tumor responded, I weaned myself off the drugs, with diminishing doses of fentanyl being the last to go.  On a scale of 0-10, that pain was 11, and I would not want to experience it again.  I would not hesitate to use the morphine or its latest synthetic, fentanyl.  Those opioids do cause constipation, which I would imagine you'd want addressed given the locus of your tumor pain.  So, if you use these drugs, your pain doctor ought to talk with you about the best method for preserving elimination while you work on easing your pain.  Best wishes.  Oldbeauty

Yes, I have been counselled

Yes, I have been counselled about constipation and will be taking senecot.  With the percocet I would be fine for several hours or even days and then, BAM! Horrible pain. I don't want to be swimming or out in my kayak when that happens. But, I don't want to sit around not doing things I can still enjoy thinking that it might happen. So that is the reason for the slow-release morphine. I am not adverse to the morphine, I am wondering if I will experience break-through pain.

derMaus

jan9wils said:

Yes, I have been counselled

Yes, I have been counselled about constipation and will be taking senecot.  With the percocet I would be fine for several hours or even days and then, BAM! Horrible pain. I don't want to be swimming or out in my kayak when that happens. But, I don't want to sit around not doing things I can still enjoy thinking that it might happen. So that is the reason for the slow-release morphine. I am not adverse to the morphine, I am wondering if I will experience break-through pain.

Ditto what Oldbeauty said:

Ditto what Oldbeauty said: Fentanyl patches are the way to go. She and I had/have the same presentation/location and the patches have been my saving grace. I did a post on them on July 29, under Lulu's update https://csn.cancer.org/node/320156. The advantage of the patches is that they're time release and last for 72 hours. You can still have breakthrough pain, of course, but  it's less likely when your system is receiving a steady stream of medication vs. the up-and-down of taking individual doses. Also, I found the Fentanyl to leave me more clear-headed than the oral medications.

Kaleena

Have you tried the pain

Have you tried the pain clinic?   I’m not sure if they have one near you.   They can do a nerve block 

derMaus

Kaleena said:

Have you tried the pain

Have you tried the pain clinic?   I’m not sure if they have one near you.   They can do a nerve block 

Excellent point, I'll ask

Excellent point, I'll ask about it when I'm in next week. Thank you for the suggestion !!!

jan9wils

nerve block

What is a nerve block. Is this like an epidural?

Kaleena

jan9wils said:

nerve block

What is a nerve block. Is this like an epidural?

Before I had my surgery last

Before I had my surgery last April I was having pain daily.  They referred me to a pain clinic.  I was a bit apprehensive and I called to see what they would do.  One thing they mentioned was a nerve block.   However I never did go to the pain clinic as it was determined I needed surgery.  However they gave me a nerve block prior to my surgery.   It helps to reduce the need for pain meds.   I got it both times last year for my two surgeries .  Recently I fractured my humerus and needed surgery.   They also gave me a nerve block in my neck shoulder area.  It lasted two days.  By the time the pain from surgery hit I only took one oxy and then only needed Tylenol or Motrin

 

Nerve Block

 A nerve block is an anesthetic and/or anti-inflammatory injection targeted toward a certain nerve or group of nerves to treat pain. The purpose of the injection is to "turn off" a pain signal coming from a specific location in the body or to decrease inflammation in that area.

Imaging guidance, such as fluoroscopy or computed tomography (CT or "CAT" scan), may be used to help the doctor place the needle in the most appropriate location so that the patient can receive maximum benefit from the injection.

 

jan9wils

Kaleena said:

Before I had my surgery last

Before I had my surgery last April I was having pain daily.  They referred me to a pain clinic.  I was a bit apprehensive and I called to see what they would do.  One thing they mentioned was a nerve block.   However I never did go to the pain clinic as it was determined I needed surgery.  However they gave me a nerve block prior to my surgery.   It helps to reduce the need for pain meds.   I got it both times last year for my two surgeries .  Recently I fractured my humerus and needed surgery.   They also gave me a nerve block in my neck shoulder area.  It lasted two days.  By the time the pain from surgery hit I only took one oxy and then only needed Tylenol or Motrin

 

Nerve Block

 A nerve block is an anesthetic and/or anti-inflammatory injection targeted toward a certain nerve or group of nerves to treat pain. The purpose of the injection is to "turn off" a pain signal coming from a specific location in the body or to decrease inflammation in that area.

Imaging guidance, such as fluoroscopy or computed tomography (CT or "CAT" scan), may be used to help the doctor place the needle in the most appropriate location so that the patient can receive maximum benefit from the injection.

 

Thank you for sharing your

Thank you for sharing your information. I'm going to ask about this.