Pain, Neuropathy & Lymphedema

Pain

Pain has been commonly associated with cancer survivorship. Many survivors express that pain lasts well after their treatments are over. Some experience pain in their surgery site or other places of the body. JAMA Oncology found that cancer survivors experience pain at almost double what the general population experiences. These findings mean that cancer survivors need a specific approach to managing pain as this is currently a major issue for the cancer survivorship community.

What is Pain:

There are different types of pain. Below, we will focus on acute pain and chronic pain.

Acute pain is pain that may come from inflammation, tissue damage, injury, illness, or recent surgery. It usually lasts less than a week or two. The pain usually ends after the underlying cause is treated or has been resolved.

Chronic pain is long-standing pain that persists beyond the usual recovery period or occurs along with a chronic health condition, such as arthritis. Chronic pain may be "on" and "off" or continuous. It may affect people to the point that they can't work, eat properly, take part in physical activity, or enjoy life.

How Should Pain Be Treated?

Pain can be managed for most people, however, it is possible that pain may not be completely relieved. There are therapies that can lessen pain and its effects on the body. Some of those are listed below.

• Removal or Reduction of the Cancer
• Palliative Surgery or Radiation Therapy
• Pain Relieving Medications
• Nerve Blocks
• Neurosurgical Approaches
• Psychological approaches such as counseling
• Complementary therapies such as
  • Relaxation techniques
  • Meditation
  • Movement therapy
  • Acupuncture
  • Oncology Massages

In all cases, speak to your healthcare provider and care team about what is the most suitable approach for you.

(Peripheral) Neuropathy

Peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system (the vast communication network that sends signals between the central nervous system (the brain and spinal cord) and all other parts of the body.) There are many different types of neuropathies that have their own symptoms and prognosis. Neuropathy often starts in the hands but can affect other body parts.

Symptoms

The symptoms of neuropathy may include but are not limited to:

• Numbness
• Tingling
• Weakness in the affected area
• Sharp, burning, throbbing or stabbing pain
• Falling
• Sexual function problems
• Excessive sweating that isn't related to temperature or the body's exertion of effort at that time

Testing and Treatment

If you feel as though you may be experiencing neuropathy. Speak to your healthcare provider to explore this concern more thoroughly. Your provide may conduct a physical exam on you to review symptoms and may recommend you for additional testing to confirm the diagnosis.

After testing and diagnosis, you may explore treatment for neuropathy. Treatment options may consist of:

• Medications that may be used to control pain
• Physical therapy and rehab
• Occupational therapy
• Surgery
• Mechanical assistance aids
• Oncology massage
• Nutrition plans
• Suitable exercise regimens
• Acupuncture

In Georgia, there are many healthcare centers that have a department focused on the treatment and care of neuropathy. Your healthcare team should be able to refer you to a suitable specialist within your area.

Lymphedema

Lymphedema is swelling due to the build-up of lymph fluid in the body. Cancer or treatments related to cancer can cause lymphedema. Lymphedema occurs when the lymph system is damaged or blocked. Fluid builds up in soft body tissues and causes swelling. Lymphedema usually affects arms or legs, but it can also affect other parts of the body. Lymphedema can cause long-term physical, psychological, and social problems for patients.

Symptoms:

These symptoms may occur in your arms or legs:

• Swelling of part or all of your arm or leg, including fingers or toes
• A feeling of heaviness or tightness
• Restricted range of motion
• Aching or discomfort
• Recurring infections
• Hardening and thickening of the skin (fibrosis)

Survivors can take preventative steps that may keep lymphedema from developing. These steps can be taught by your healthcare team.

Some of the preventative steps are:

• Inform healthcare provider if you notice symptoms of lymphedema
• Keep skin and nails clean and cared for, to prevent infection
• Avoid blocking the flow of fluids through the body
  • Do not cross legs while sitting.
  • Change sitting position at least every 30 minutes.
  • Wear only loose jewelry and clothes without tight bands or elastic.
  • Do not carry handbags on the arm with lymphedema.
  • Do not use a blood pressure cuff on the arm with lymphedema.
  • Do not use elastic bandages or stockings with tight bands.
• Keep blood from pooling in the affected limb.
  • Keep the limb with lymphedema raised higher than the heart when possible.
  • Do not swing the limb quickly in circles or let the limb hang down. This makes blood and fluid collect in the lower part of the arm or leg.
  • Do not apply heat to the limb.
• Exercise within the limits that have been approved by your provider.

Treatment of Lymphedema

Below are a few ways that lymphedema may be treated. Discuss the options with your care team to see which may be the best fit for you.

• Pressure garments
• Exercise
• Bandages
• Skin care
• Combined therapy
• Compression device
• Weight loss
• Laser therapy
• Drug therapy
• Surgery
• Massage therapy

References:

https://jamanetwork.com/journals/jamaoncology/article-abstract/2736363

https://www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-pain

https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/palliative-care/pain-management/treating-pain 

https://www.cdc.gov/cancer/survivors/patients/lymphedema.htm

https://www.cancer.gov/about-cancer/treatment/side-effects/lymphedema/lymphedema-pdq

https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Peripheral-Neuropathy-Fact-Sheet

Last Updated: 10/30/2020 9:57:41 AM

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