Power Over Pain

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Power Over Pain

Q&A with Jay R. Thomas, M.D., Ph.D.

Despite modern medical advances, feeling pain remains one of the hallmarks of being human.

For cancer patients especially, pain can interfere with treatment and challenge recovery. But treating the physical discomfort is only part of the answer. Pain usually runs deeper than we think.

Prominent palliative care specialist Jay R. Thomas, M.D., Ph.D., the Arthur M. Coppola Family Chair in Supportive Care Medicine and chair of City of Hope’s Department of Supportive Care Medicine, sheds some light on pain and how best to manage it.

Q: What is pain?

Nociceptive pain is the “normal” pain we feel when, for instance, we stub our toe. A pain nerve in our toe picks up the signal and sends it to the spinal cord, then the brain, and we feel and experience that hurt.

Neuropathic pain, on the other hand, usually results from physical nerve damage. For example, a cancer surgeon might cut through a nerve while removing a tumor, and if the nerve grows back abnormally, this can result in pain signals being sent to the brain long after any physical damage.

But pain and its associated suffering is more than just physical. This leads us to the concept of “total pain.” 

Q: Will you explain total pain?

Total pain takes into account the fact that the suffering we experience from physical pain can be profoundly affected by our psychological, interpersonal and spiritual concerns.

Experiments show us that people perceive not just physical pain, but suffering, too. Our emotional state plays a big part in this. So our relationships with other people, our psychological health and our spiritual concerns are very important to how we perceive pain.

As health-care providers, we must address pain at each level. Even with the right medicines, we can’t optimally control pain without addressing total pain.

Q: What can patients or their loved ones do to alleviate pain?

The best thing is to report pain accurately to your doctor.

I recommend keeping a log and answering some basic questions: Where is the pain? How would you describe the pain—sharp, dull, burning, radiating? When did it start? How long does it last—continuous or comes and goes? What makes it better or worse? If patients can come armed with these answers, it really helps physicians understand and intervene appropriately.

Q: How do doctors manage cancer-related pain?

Each person is unique, so their experience with pain will be unique. To effectively address a patient’s pain, you must treat total pain. At City of Hope, we’ve brought together a comprehensive, interdisciplinary group of psychologists, psychiatrists, social workers and spiritual-care providers who work closely with each other as well as with the patient, family and caregivers. Together, we effectively address the total pain experience for the best outcome.

This team approach is vital. No matter how enlightened or skilled a physician, you need a team like this to address patients’ needs.

We Support You and Your Caregivers

For more information about supportive care services, visit the Sheri & Les Biller Patient and Family Resource Center online at cityofhope.org/billercenter.

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