Pain medication for Stage IV NCP SCC, HPV neg, mets/ lymph nodes & lungs

BlessingsFairy

My husband was recently diagnosed with Stage IV Nasopharyngeal cancer with mets to the lymph nodes and lungs. He has his first chemo treatment two weeks ago and goes back on the 27th. Last week he asked me to call his oncologist to see if he could get any medication for pain.

He has a tumor at the upper left back of his throat, kind of behind his nose. He's been having horrible headaches, sore throat and what he thinks is bone pain. The nurse called back to say the doctor didn't think pain medication would help with his headaches, to take baths in Epsom salt for the body pain and is scheduling him an appt with their Palliative Care Center.

I was a little surprised they wouldn't try anything for the headaches, bit maybe he needs to go to the Palliative Care Treatment appointment and see if they can offer anything to help, and if that doesn't, maybe they will prescribe him something. I'm interested in what you guys have experienced in getting help for pain. Appreciate any feedback. Thank you.

wbcgaruss

Dear BlessingsFairy anytime I was in cancer treatment they didn't hold back at all on pain medication and made sure I had plenty of pain medication and that it was working for me. I have had cancer treatment 3 times and my care team always provided sufficient pain meds. The time my ENT removed a cancerous spot from my tongue I was given plenty of pain meds. I even asked for Lortab 10 (Liquid Hydrocodone) and was given it for pain along with an Oxycodone and acetaminophen combination of pills. Not recent but an example of pain meds I was provided. Right now in our country there is a big addiction crisis and they are being lets say not as freely giving meds. I don't know if that is what is happening in your situation. But in my opinion and I believe most cancer centers agree the patients are going through a very severe situation and pain should not be something they have to endure. My opinion-They should give your husband all the pain meds he needs to get through this situation and through this period in his life. They could surely give him something to help relieve his pain till he gets to his Palliative Care appointment and after that Palliative Care may have their own plan for pain management. No one should suffer with pain going through cancer treatment, he should be on a pain management plan. I can't imagine pain medication wouldn't help with his headaches related to cancer. I would get back to the office and ask them to explain it more thoroughly maybe I am wrong. But I think pain meds would help any pain. I am assuming you have tried Over The Counter pain meds such as Ibuprofin, Aleve, etc. If your husband has pain beyond the threshold of OTC medications I would insist to the doctor that you need something stronger. If he won't yield go to another doctor on his care team or get a second opinion.

Wishing You the Best

Take Care God Bless-Russ

LORTAB 10--

This combination medication is used to relieve moderate to severe pain. It contains an opioid pain reliever (hydrocodone) and a non-opioid pain reliever (acetaminophen). Hydrocodone works in the brain to change how your body feels and responds to pain. Acetaminophen can also reduce a fever.

Oxycodone and Acetaminophen Combination--

Oxycodone and acetaminophen combination is used to relieve pain severe enough to require opioid treatment and when other pain medicines did not work well enough or cannot be tolerated.

Acetaminophen is used to relieve pain and reduce fever in patients. It does not become habit-forming when taken for a long time. But acetaminophen may cause other unwanted effects when taken in large doses, including liver damage.

wbcgaruss

BlessingsFairy

https://csn.cancer.org/discussion/comment/1702480#Comment_1702480

Thank you for that information, Russ. I, too, was surprised at the answer when I called about pain medication. We have not been contacted with an appointment yet with the Palliative Care Center so I am going to call tomorrow and push for better answers. I have been on daily oppose since my 3rd back surgery in 2009. Since I stopped working in 2013, I am now down to 4 10mg oxycodone/325mh acetaminophen daily.

The nurse did ask is we had tried numerous OTC meds and was he taking his allergy script and I told her yes. She asked if he had tried anything else, and being honest, I told her he had tried a couple of mine and they provided a little relief. I cannot imagine that this answer would have affected the doctors decision. As I live it everyday,

I do know the hoops we jump through for pain medication and I'm still surprised and angry that the government controls/limits what my doctor gives me. Whose MY doctor here?? BUT I am hoping maybe the Palliative Care Center is where they start everyone before giving pain medication, but I didn't get that feeling of her asking the doctor about a possible script and getting back with me. I also cannot imagine having a tumor at the back of your mouth and nose NOT being painful and there not being a medication they can try. You'd fall over if I told you the daily opiates I was prescribed 7 or so years ago so I know what's out there. HOWEVER , what the doctor is limited to by the DEA, I have no idea but I'm going to see if I can find out. And truly, if your time is limited, making the patient comfortable should take precedent over any limits except black box warnings on some combinations of drugs due to obvious dangers like combining benzodiazepines and opiates since they both suppress ones respiratory system.Those are logical, other limits are not, for people truly in pain. Thank you again for your reply.

wbcgaruss

Sometimes you really have to push and advocate for yourself or a loved one. If he is in really unbearable pain there is no excuse for them to hold back from their patient and their duty.

Also, you might want to mention Fentynol Pain Patches to your doctor they used them a lot when I was in the hospital the last time for an extended period of time back in 2019 and I assume they still do

Fentanyl skin patch is used to treat severe pain, including acute pain following surgery. Ionsys® is applied by your healthcare provider in a hospital setting after surgery for the short-term management of acute pain.

Do this search on the internet "arent doctors supposed to keep their patients pain free" and there are many articles about patient rights and guidelines, more than I can post here. Also, I would list the search link but since the site upgrade on here it won't work.

Here are a couple examples though--

https://www.npr.org/sections/health-shots/2022/11/03/1133908157/new-opioid-prescribing-guidelines-give-doctors-more-leeway-to-treat-pain

Access to pain treatment as a human right

https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-8-8

Words Matter When Talking About Pain With Your Doctor

https://www.npr.org/sections/health-shots/2018/07/23/626202281/words-matter-when-talking-about-pain-with-your-doctor

Why Must Pain Patients Be Found Deserving of Treatment?

https://journalofethics.ama-assn.org/article/why-must-pain-patients-be-found-deserving-treatment/2008-01

Talk to Your Doctor About Managing Your Pain

https://www.cdc.gov/injury/features/manage-your-pain/index.html

Wishing You the Best

Take Care God Bless-Russ

steven59

Hi Blessingefairy, I really had to fight with my radiologist yesterday for pain meds. He insisted I wait for palliative care, which was the same story I got last week. Yesterday I came prepared with my post surgery regimen and my wife and while it was clear pain management isn't something he's comfortable with we were able to show him how my pain was managed by the hospital and get (hopefully)enough meds to last until a slot opens up in palliative care. Being the holidays also I think is slowing things down. Work hard and don't take no for an answer.