Physical, Integrative, Behavioral, and Psychosocial Interventions
Noninvasive physical, integrative, thinking and behavioral, and psychological methods can be used along with drugs and other treatments to manage pain during all phases of cancer treatment. These interventions may help with pain control both directly and indirectly, by making patients feel they have more control over events. The effectiveness of the pain interventions depends on the patient's participation in treatment and his or her ability to tell the health care provider which methods work best to relieve pain.
Incidence and mortality
Lung cancer has a tremendous impact on the health of the American public, with an estimated 221,130 new cases and 156,940 deaths predicted in 2011 in men and women combined. Lung cancer causes more deaths per year in the United States than the next four leading causes of cancer death combined. Lung cancer incidence and mortality rates increased markedly throughout most of the last century, first in men and then in women. The trends in lung cancer...
Weakness, muscle wasting, and muscle/bone pain may be treated with heat (a hot pack or heating pad); cold (flexible ice packs); pressure and vibration (to improve relaxation); exercise (to strengthen weak muscles, loosen stiff joints, help restore coordination and balance, and strengthen the heart); changing the position of the patient; restricting the movement of painful areas or broken bones; stimulation; controlled low-voltage electrical stimulation; or acupuncture. See the PDQ summary on Acupuncture for more information.
Massage therapy may also help improve relaxation, manage pain, and benefit mood. The following precautions should be taken with massage therapy during cancer treatment:
Avoid massaging any open wounds, bruises, or areas with skin breakdown.
Avoid massaging tumors on the surface of the skin.
Avoid massaging areas with deep vein thrombosis (blood clot in a vein). Symptoms may include pain, swelling, warmth, and redness in the affected area.
Avoid massaging soft tissue when the skin is sensitive following radiation therapy.
(For more information on massage, see Exercise 2 in the following section.)
Thinking, Behavioral, and Psychosocial Interventions
Thinking, behavioral, and psychosocial interventions are also important in treating pain. These interventions help give patients a sense of control and help them develop coping skills to deal with the disease and its symptoms. Beginning these interventions early in the course of the disease is useful so that patients can learn and practice the skills while they have enough strength and energy. Several methods should be tried, and one or more should be used regularly.
Relaxation and imagery: Simple relaxation techniques may be used for episodes of brief pain (for example, during cancer treatment procedures). Brief, simple techniques are suitable for periods when the patient's ability to concentrate is limited by severe pain, high anxiety, or fatigue. (See Relaxation exercises below.)
Hypnosis: Hypnotic techniques may be used to encourage relaxation and may be combined with other thinking/behavior methods. Hypnosis is effective in relieving pain in people who are able to concentrate and use imagery and who are willing to practice the technique.
Redirecting thinking: Focusing attention on triggers other than pain or negative emotions that come with pain may involve distractions that are internal (for example, counting, praying, or saying things like "I can cope") or external (for example, music, television, talking, listening to someone read, or looking at something specific). Patients can also learn to monitor and evaluate negative thoughts and replace them with more positive thoughts and images.
Patient education: Health care providers can give patients and their families information and instructions about pain and pain management and assure them that most pain can be controlled effectively. Health care providers should also discuss the major barriers that interfere with effective pain management.
Psychological support: Short-term psychological therapy helps some patients. Patients who develop clinicaldepression or adjustment disorder may see a psychiatrist for diagnosis.
Support groups and religious counseling: Support groups help many patients. Religious counseling may also help by providing spiritual care and social support.