The Prostate Net Pain Management for Patients and Caregivers

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The Prostate NetPain Management for Patients and
Caregivers
Biren Saraiya MD The Cancer Institute of New
Jersey
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Question for audience

• What concerns do you have about pain control?
• 1. My doctor does not think pain is important
• 2. My doctor is too busy to talk about symptoms
  including pain
• 3. If I talk about my pain, my doctors will not
  treat my cancer
• 4. Doctors will not be able to control pain
• 5. Pain medications will make me an addict
• 6. Pain medications will make me loopy
• 7. Pain is inevitable

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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

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Goals of Care

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

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Pain Therapeutics

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

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Pain Therapeutics

• Pharmacological (different delivery systems)
• Pain pumps
• Patches (lidocaine, fentanyl)
• Non pharmacological
• Radiation, Surgery
• Exercise, Heat/Cold
• Quadramet

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Understanding Opioids

• Works well for different types of pain
• Not concerned about addiction
• 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 (mild, moderate, severe)
• Changes should be in percentages, not absolute
  numbers

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Professional Help

• Pain Management Specialists
• Anesthesiologists
• Medical Doctors
• Palliative Care Specialists
• Medical Doctors who also specialize in symptom
  management