The Prostate Net Pain management for patients and

The Prostate Net Pain management for patients and caregivers Biren Saraiya MD The Cancer Institute of New Jersey

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Key Points • Pain control is desirable and achievable • There are many choices for pain therapy – Oral medications – Intravenous medications – Patches – Radiation/surgery • Pain control requires frequent reassessment, adapting to needs and management of side effects

Goals of Care • In Cancer treatment, there are two goals: – Cure the cancer – Palliate the symptoms (prolong quality of life) • In either setting, optimal pain control is desired

Pain • • • S U C K S

Pain Subjective Underreported Compromises function Control requires Knowledgeable patient and clinician • Side effects need to be addressed • •

Pain Therapeutics • Non pharmacological – Heat/Cold – Exercise – Radiation, Surgery • Pharmacological – Delivered differently • • Oral Intravenously Nerve block Patches (lidocaine, fentanyl)

Pain Therapeutics • Pharmacological – NSAIDS (ibuprofen) – Acetaminophen (tylenol) – Opioids • Short acting (Oxycodone, hydromorphone) • Long acting (oxycontin, MS Contin, Methadone) – Antidepressants – Anti-seizure medications

Understanding Opioids • Works well for different types of pain • Concern for addiction low • Most side effects (nausea, vomiting, drowsiness etc. ) last only few hours to days • Exception is constipation • When need to increase medication dose, increase in PERCENTAGES, not absolute numbers • Dosing should be based on desired and achieved pain control • Changes should be in percentages, not absolute numbers

Being advocate for yourself • Establish a goal with your treatment team for pain control • Ensure the treatment team meets the goal • If goals not met, ask for help – Pain Management Specialists • Anesthesiologists • Medical Doctors – Palliative Care Specialists • Medical Doctors who also specialize in symptom management