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Adjuvant Medications
Some medications originally developed
to treat medical conditions other than cancer have been found to have pain-relieving
qualities. These medications -- called "adjuvant", meaning something
that helps or assists -- may be prescribed for you along with first-line cancer
medications, like opioids and NSAIDs, to treat particular types
of pain that sometimes occur in cancer especially bone pain and nerve pain.
They may also be prescribed in combinations together.
Some of the more frequently-used adjuvant
medications include:
- Antidepressants:
These are not taken to relieve depression, but because they
may help relieve nerve pain that sometimes develops from cancer treatment.
Some commonly-prescribed antidepressants in this category include
Elavil®, Pamelor®
and Norpramin®. It's important to understand that antidepressants take time
to become effective, sometimes several weeks. Side effects may include dizziness
and gastrointestinal problems. Antidepressants may also help people cope with
insomnia, and are often recommended to be taken at bedtime.
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Anticonvulsants:
These drugs, originally developed to help manage seizures, are helpful in relieving
cancer-related neuropathic (nerve) pain. Some anticonvulsant medications used
for cancer pain management include Neurontin®, Tegretol® and
Klonopin®, among
others. Side effects can include lowered blood counts, dizziness, blurred vision,
and nausea. Anticonvulsants may take some time to reach peak effectiveness.
Another medication, baclofen (Lioresol®), which is not an anticonvulsant, is
also effective for some people experiencing shooting, stabbing and knife-like
neuropathic pain.
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Corticosteroids:
Corticosteroid medications, such as dexamethasone and prednisone,
work effectively to reduce inflammation, thereby helping to ease some forms
of cancer pain. Short-term used of these medications may cause increased appetite
and fluid retention. Long-term use can result in weight gain, "moon face,"
osteoporosis, and other side effects.
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Bisphosphonates
: These medications help relieve the pain of cancer that has spread
to the bones. Bisphosphonates like Aredia® and Clodronate® are most commonly used
for this purpose.
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Calcitonin:
This medication, Miacalcin®, helps some people in obtaining relief for bone pain.
It is usually administered by nasal spray.
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Radiopharmaceuticals
: These medications also work to help reduce the pain of cancer that
has spread to the bones. The drugs have few side effects and act on the cancer
while sparing soft tissue throughout the body. The onset of effect is slow
(2 or more weeks) but pain relief from radiopharmaceuticals
is usually relatively long-term ( 3-6 months). Be aware that in some patients,
radiopharmaceuticals may cause a temporary pain increase before it decreases.
Strontium-89 (Metastron®) is a radiopharmaceutical used for pain relief.
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Octreotide (Sandostatin®):
This medication is used to treat the pain of bowel obstruction, which can occur
in the course of some cancers. The medication helps control severe diarrhea. 
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