What are the Causes and Types of Pain in Lung Cancer
An estimated 75% of all cancer patients live with chronic pain. In lung cancer patients, acute pain is often felt in the chest and lumbar (lower back) regions of the body. Approximately 20% of patients with lung cancer present with chest pain at diagnosis, and pain increases in severity as lung cancer advances, with patients at later stages of the disease experiencing more pain.
Types of pain in lung cancer
Pain is generally considered the most common symptom of lung cancer. It is often caused by multiple factors and its management needs to be multi-disciplinary to address all these aspects. In cancer, pain can be characterized into two areas: acute pain and chronic pain.
Acute pain is usually due to a definable injury or illness. It may be a secondary cause of cancer, such as a severe bleeding into a tumor, bone pain caused by a metastasis(spread of cancer), or abdominal pain caused by a metastasis that obstructs the bowel. Acute pain is usually experienced for a limited duration and is predictable. It is usually associated with clinical signs such as increased heart rate, high blood pressure, sweating, and pale skin.
Chronic cancer pain may be a result of the same causes as acute pain but it is experienced for a much longer duration. Chronic pain can persist for more than 12 hours a day and often has a gradual or poorly defined onset. Approximately 75% of cancer patients live with chronic pain.
Many cancer patients experience flares of pain despite using medications. These flares are called breakthrough cancer pain. Breakthrough pain greatly impairs a patient’s quality of life and can cause additional psychological burden.
Causes of pain in lung cancer
The three most common causes of lung cancer are:
- Metastasis of lung cancer to the bones, which accounts for approximately 34% of lung cancer pain
- Presence of a Pancoast tumour, located at the top of the lung close to the brachial plexus nerves and cervical sympathetic nerves, which accounts for approximately 31% of lung cancer pain
- Spread of the cancer into the chest wall, accounting for approximately 21% of lung cancer pain
Managing pain in lung cancer
Palliative care is a specialized field that aims to alleviate symptoms and maximize the patient’s quality of life. It does not focus on curing the disease or prolonging life, which is the goal of other cancer treatments, such as chemotherapy. However, it is an important part of the patient’s treatment plan and encompasses physical symptoms, psychosocial distress and caregiver distress.
The management of pain due to lung cancer may include a combination of medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, opioids (pain medications), and antidepressants. For metastases to the bone, radiation therapy and the use of bisphosphonates (drugs to help prevent bone breakdown) can alleviate pain. In addition, (stopping smoking) is recommended, as surveys have revealed that lung cancer patients who continue to smoke after diagnosis have a higher incidence of pain and other lung cancer complications than non-smokers and those who quit smoking.
Pain has an enormous effect on your quality of life, so if you are experiencing pain related to your lung cancer, alert your family and doctors. They can recommend strategies to help alleviate your pain so that it doesn’t become a controlling factor in your life.
