Are There Drugs That Can Decrease Cancer Pain?

QUESTION: My husband has had cancer for a few months and has just begun to
suffer from the pain that can come with it. Although he's suffering, he
refuses to complain to his doctor because he's afraid of being put on
morphine. Are there any other drugs besides morphine that could help him?
He's just been taking aspirin, which has helped a little.
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ANSWER: Yes, there are many drugs other than morphine that could help
alleviate at least some of the pain. Your husband's doctor will have to do a
thorough evaluation before prescribing, and several different medications may
have to be tried before just the right one is found for your husband. There
is certainly no reason for him to suffer in silence.
If your husband is experiencing mild to moderate pain, a nonsteroidal
anti-inflammatory drug (NSAID) may be effective. Aspirin is itself an NSAID,
and it's possible that a higher than normal dosage would lessen the pain.
It's important not to try this without a doctor's examination, as this could
cause impaired platelet function and increase the risk of bleeding.
Aspirin can be highly effective for the cancer patient with a normal
platelet count and no history of ulcers or gastrointestinal bleeding. Aside
from aspirin, there are more than a dozen other NSAIDs which are useful.
Anti-inflammatory agents are recommended by the World Health Organization's
Cancer Program for Pain due to mechanical compression of tendons, muscles,
periosteum, pleura, or peritoneum without nerve involvement.
The NSAIDs can also relieve pain in muscles or joints caused by trauma
during surgery or radiologic treatment, and visceral pain unassociated with
obstruction. Once the anti-inflammatory agents no longer work (or if they
don't work to begin with), your doctor may consider trying corticosteroids.
This class includes drugs such as prednisone or dexamethasone (Decadron,
Hexadrol). The corticosteroids can be efficient when significant pain is
caused by bony metastases or tumor infiltration of the nerve plexus. Both the
NSAIDs and corticosteroids have potential side effects and your husband will
have to take blood tests on a regular basis to make sure the medications are
not taking their toll on the various organs of the body.
If these treatments fail to give appropriate pain suppression, it may be
necessary to prescribe an opiate.
A compound of codeine with aspirin is frequently used if an analgesic
alone is not enough.
Morphine should only be considered as a final alternative for patients in
severe pain, but it is not to be feared. The proper use of this potent
analgesic allows many sufferers to enjoy life, and participate in the
recreation and family activities that are the real reason for all these
efforts in the first place.