Radiation, which is also used to treat cancer, can be very helpful in alleviating cancer pain in some circumstances.  It can be used to reduce the size of some tumors which, in turn, takes pressure off organs and nerves that the tumor touches.  It can also be used to treat the pain of cancer that has spread to the bones, the brain, blood vessels, nerves and spine.

     Treatment with radiation is done by specialists called radiation oncologists, who will determine the dosage of radiation needed and oversee the treatment itself.  In some instances, radiation is performed by implantation, when radioactive material is placed inside the body for a period of time, during which it kills cancer cells.

     Side effects of radiation may include skin irritation and redness. Speak with your radiation oncologist regarding appropriate skin creams to ease the irritation; do not use conventional skin lotions, as they may make the condition worse. Additional possible side effects vary, depending on the area of the body receiving the radiation, and the form in which it is administered.

     Radiation can also be the cause of pain for cancer patients, as a result of side effects from these treatments. 

     Chemotherapy

     Chemotherapy, which you know is used primarily to treat cancer, can also sometimes be helpful in reducing the size of or stabilizing tumors and thereby easing pain, even if a cure may not be possible. Some drugs in use for chemotherapeutic reduction of pain include:

·      leuprolide (Lupron®) - for palliative treatment of pancreatic cancer

·      gemcitabine (Gemzar®) - treatment of pain in advanced pancreatic cancer

·      goserelin acetate implant (Zoladex®) - for the treatment of advanced prostate cancer

·      mitoxantrone (Novantrone®) - combined with corticosteroids for treatment of pain related to prostate cancer

·      Samarium sm 153 - a radioactive agent for cancer that has spread to the bone pamidronate (Aredia®)  - like other bisphosponates on the market, pamidronate treats hypercalcemia associated with cancer and bone metastases.

     Chemotherapy can also be the cause of pain for cancer patients, as a result of side effects from taking these medications.  Some of the more common side effects that cause pain include:

·      mouth sores - In some cases, mouth sores can be prevented by keeping the mouth very clean, using non-irritating toothpaste, and, if time permits, having all dental problems resolved before beginning chemotherapy. Once mouth sores occur, treatments may include the avoidance of very hot foods, carbonated beverages, eating soft foods till the sores heal, and using special medications, such as viscous lidocaine and other special mouth washes, designed to numb the mouth.  There are several effective mouthwashes that can be prepared for mouth sore treatment by pharmacists; ask your health care provider to help you with this.

·      neuropathy - Neuropathy is nerve discomfort and sometimes pain   tingling, numbness, "pins and needles" in feet and hands. Some chemotherapy medications can cause damage to the peripheral nerves, those in the fingers and toes, and in some cases, the damage can spread into the feet and legs and arms. While there are medications to treat this disorder that help some people (antidepressant medications like Elavil®, anticonvulsant medications like Neurotonin®; for more information, see Adjuvant Medications), there is also a medication that can prevent the onset of severe neuropathy in some patients, called Ethyol(Amifostine®). If you are taking a chemotherapeutic medication likely to cause neuropathy, you may want to discuss using this medication before chemotherapy.

·      nausea and vomiting There are now excellent medications available for controlling nausea, such as Zofran® and Kytril®, that are taken before chemotherapy is given. These drugs have made chemo- related nausea a thing of the past for many cancer patients.  If these medications aren't effective, there are many others to try, and this should be discussed with your health care provider.  The important thing is not to give up and assume that nausea is a necessary part of taking chemotherapy.  Most people can avoid it.

·      diarrhea Diarrhea can be triggered by some chemotherapy medications that kill the cells lining the intestine.  Resting the bowel is important (this means a restricted diet of soft food and liquids for several days in some cases) and if necessary, specific medications to help resolve the problem. It is important not to take over-the-counter products for diarrhea induced by chemotherapy. Instead, discuss treatment with your physician and/or chemotherapy nurse.

·      constipation Some chemo medications cause constipation, and the most important thing to remember is to not let this go on for days and days, but to seek relief promptly.  Constipation is almost always a certainty if you are taking opioid medications, as well, and a bowel regimen should be started at the same time as opioid medications are started.  Home remedies for constipation include drinking 8 full glasses of water a day and eating foods that are high in fiber   peeled fruits and vegetable, whole-grain cereals and breads, etc. If you are constipated for two days or more, seek assistance from your health care provider. Neglected constipation can be very serious.