Jimenez, Cheenee Carla R.

Hospice Rotator: May 1-31, 2016

REACTION PAPER ON CANCER PAIN by Eduardo Bruera, MD and Hak Nan Kim, MD

Ninety three percent of the patients referred that I have seen are cancer patients and 80 percent of
these patients have cancer pain. These patients have been given pain medications, as needed, usually
opioids, by the primary service. However, most of the times, their pain is not controlled. As a hospice
rotator, it is a must to ask the details of the patient’s pain, especially the pain scale, for us to be guided
on what pain medications we can give for pain control. The control of pain somehow improves the
quality of life of the patient.According to Dr. Bruera and Dr. Kim, “pain intensity reported by a patient
represents the expression of pain that should be used for monitoring and adjusting treatment.”This
becomes a continuing care for the patient.One patient of mine, was diagnosed with cervical cancer, she
was complaining of thigh pain. During our first meeting, she was taking Tramadol 50 mg/ tab prn for
pain that time, I can not talk to the patient because of her pain. She was very uncomfortable but was
apologetic because she can not talk to me properly. I adjusted her tramadol to every 6 hours round the
clock and it was able to control her pain and the day after, I was able to establish rapport and she
trusted me with the information I was asking her.

Another patient of mine, a 62 y/o male was diagnosed to have gastric cancer. He was quiet and
cooperative, however, even though he was cooperative in sharing information and how he felt, I was
not able to see him smile. Upon interviewing, he experienced epigastric pain, about 4/10 in pain scale.
So I decided to adjust his pain reliever, round the clock. During the next meeting, he was able to smile at
me, thanking me that I somehow relieved his pain. He was also thankful everytime I visit him, maybe
because someone talks to him, from the heart. I think, being an SHPM physician heals people with pain
not only with medications but also with their kind,empathic and listening heart.

“ Physicians can further enhance the well being of patients with cancer pain if they conduct a careful
assessment of the pain syndrome, frequently monitor adverse effects of drugs and maintain excellent
communication with the patient and family.” When the family sees that the patient’s pain is controlled,
we also create an air of trust. This also calms not only the patient but also the family as most of the
time,family members are also worried whenever the patient is uncomfortable.

According to Revelations 21:4: “He will wipe every tear from their eyes. There will be no more death or
mourning or crying or pain, for the old order of things has passed away” Pain, may it be from cancer, or
emotional pain, will eventually be gone with Jesus’s hands. In hospice, we do not cure diseases to
prolong the life of patients who are about to be with God, but we make sure that their remaining stay
here on earth will be worthwhile.They say pain is for the weak. I agree because I know that the people
who experience pain were once strong but are already tired and I think, they should be given time to
rest and to enjoy their remaining days with their loved ones.