Detailed description of cancer pain: There is a kind of pain that makes you feel like you are being stabbed with a needle even when you are wearing clothes 

Cancer pain is one of the common symptoms in tumor patients. Its sensation varies from person to person and is affected by the tumor type, its location, the extent of invasion, the nature of the pain (such as nociception or neuropathology), and the patient. Characteristics of pain along with significantly different tolerance to pain are among these differences.

Cancer pain at its core features are “complexity” and “extensive influence”, which can be very concretely grasped through understanding the properties, location, the way of manifestation and accompanying feelings of the pain:

The mechanisms of cancer pain are multiple, and hence cancer pain is not a single one. Typical types and associated sensations are as follows:

I. Nociceptive pain (most common)

Direct tumor invasion, compression of surrounding tissue (such as bone, internal organs, muscles, skin), or tissue damage by treatment (surgery, radiotherapy, puncture) are the causes of the most typical type of cancer pain and the sensations will have characteristics of “local” and “physiological pain” with clear indications:

(A).Bone invasion pain :The tumor metastasis to the bones (such as spine, ribs, pelvis) is the source of the pain that is most of the time manifested as persistent dull pain, soreness, or distending pain**. The pain becomes abruptly more serious when moving (such as turning over, walking, pressing) (such as “tingling ”“stretching”), it may be more prominent at rest during the night and in the worst cases, it will interfere with sleep.

(B). Visceral pain : The pain is mainly deep dull pain, distending pain, or colic**, and the positioning is difficult (such as “a dull pain in the stomach ”“chest tightness”), may be accompanied by nausea, abdominal distension, fatigue and other discomforts; if the visceral capsule is stretched (such as liver cancer enlargement stretching the liver capsule) Will appear “persistent swelling and pain + episodic exacerbation”. There is tumor invasion in internal organs (such as liver, lungs, gastrointestinal tract, pancreas) in which the pain is manifested.

(C).Soft-tissue pain : Tumors in the skin, muscles, and fascia that have penetrated normally manifest as tingling, burning, or tenderness of the local area. The pain will be aggravated when it is touched or slightly rubbed (such as clothing contact).

2. Neuropathic pain (susceptible, harder to relieve)

Only nerves that are compressed by tumors and have cancer cells invaded, or treatment (such as chemotherapy drugs causing peripheral neuropathy and radiotherapy damaging nerves) are the sources of the pain which is felt more “abnormal”, often accompanied by abnormal neurological function:

Typical sensations: **shock-like pain, pinprick-like pain, jumping pain, numbness pain**, or “burning sensation”“ ant crawling sensation ”“tightening sensation” and even spontaneous pain (“spontaneous pain”) when there isn’t any external stimulation;

Special manifestations: It may also be accompanied by hyperalgesia (severe pain with slight touch, such as rubbing a sheet against the skin) or allodynia (normal temperature and pressure all turn into pain), and the pain often radiates along the nerve distribution area (such as lung cancer invading the brachial plexus, and the pain radiates from the chest to the arm).

3. Mixed pain (most common clinically)

In fact, cancer pain most of the time are not of a single type but are a mixture of “nociceptive + neuropathic”, for instance: the patient of pancreatic cancer not only has the visceral distension and pain caused by the tumor invasion of the pancreatic capsule but also low back radiation-like electroshock pain due to the invasion of the abdominal plexus and the muscle strain pain caused by the long-term bed rest. The superposition of multiple pains will form “persistent dull pain + paroxysmal severe pain” and thus be hard to be generalized by only one description.

2. Other key feelings of cancer pain: Besides “pain”, cancer pain is also “painful”

Along with pain sensation, cancer pain, is also a double discomfort “psycho-physiological” which deepens the patient’s suffering:

Paroxysmal pattern :Most cancer pain is “persistent basic pain + paroxysmal burst pain”——. For instance, patients normally have 3-4 points of persistent dull pain (10-point scale), however, the pain may suddenly escalate to 7-10 points during activity, coughing, or at night thus becoming severe quickly, and the suddenness of burst pain and short duration (several seconds to dozens of minutes) are main characteristics but the frequency is high Seriously disrupting the pace of life.

Psycho-accompaniment : Besides, cancer pain for long periods can make the patient anxious, depressed, fearful, and other such feelings. Emotions may increase the pain sensation (“the more afraid the pain, the more painful it becomes”), thus the patient gets into a loop of “pain-bad mood-more pain”; a few patients may feel the pain condition getting worse; hence the psychological load increases.

Functional impact : The painful feeling will restrict the patient’s activities (for example not daring to turn over or walk), which will then make the time of lying in bed longer and muscles get weaker, then eating and sleeping (“so painful that I can’t sleep”) will be affected, leading to a decrease in the overall quality of life and the person’s treatment tolerance may also be influenced. for instance the performance of chemotherapy and radiotherapy cannot be stably maintained due to the pain condition (such as being unable to cooperate with chemotherapy or radiotherapy due to pain).

3. Important reminder: Cancer pain can be stopped and gradually, do not be a victim of “hard carrying”

Many patients are misled to the wrong conclusion that cancer pain is an unavoidable consequence of growing tumors, and that the only way is to wait for it to disappear by enduring it. On the contrary, through the proper pain relief regimen (drug treatment, nerve block, psychological intervention, etc.), more than 80% of cancer pain can be greatly alleviated. If there is pain, the doctor must be given a detailed report of the pain (location, dull or tingling, frequency), the intensity of pain (10-point scale) and how it affects life so that the doctor can select the appropriate pain relief medication to prevent pain getting worse and reduce the quality of life caused by “hard carrying”.