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Cancer Pain

"How It Hurts More than You Know"
By: Stef dela Cruz, MDCancer Pain

Cancer pain per se is attributed to physical and physiologic changes – it is as tangible as a cut, pinch, or fracture. However, the pain of cancer goes beyond that experienced by the tissues of the body.

The moment to explore the many aspects of cancer pain has come. Everyone whose lives have sadly been touched by the Big C deserves to understand this pain in its entirety.

Physical Pain

Although pain is often due to cancer itself, it is sometimes caused by diagnostic tests or the treatment used to help fight the disease, according to the American Cancer Society. Physical pain may also exist for no apparent reason – there can be muscle aches, headaches, and many other types of pain, the cause of which cannot be isolated with certainty.

“It hurt when I had my first mammography,” shares Dr. Gia Baquiran-Sison, Chief Medical Officer of Global Telehealth, Inc. She was diagnosed with invasive intraductal carcinoma, a type of breast cancer, two years ago. “It was painful because the mass in my breast was already three centimeters big.”

Otherwise, the actual tumor in her breast did not cause her any discomfort. She did, however, experience pain again during chemotherapy.

“There are chemotherapy drugs that cause pain. One of the drugs I was given was [docetaxel], supposedly known to cause bone pain. The mere splash of water on my face whenever I showered was enough to trigger pain.”

Managing pain for people with cancer cannot be overemphasized. As a doctor and a cancer patient, Dr. Sison believes that treatment can be as uneventful as possible with the help of the health professionals who want you to feel better.

“Work with your doctor by communicating with him. You need to speak your mind and say how you feel.”

The pain of uncertainty

“Once you have cancer, you can't deny the fact that it can come back later or metastasize. That pain of knowing that it can come back anytime is always there.”

To Dr. Sison, this is the worst type of pain she had to endure. She still fears to have to undergo bone scans, which are supposed to detect if cancer has spread. Called scanxiety, it is something experienced by many other people with cancer.

Dr. Sison recalls, “When it’s time for my yearly bone scan, it kills me all the time. I don't want to do it because I don't want to find out.”

The pain of judgment

Cancer patients get judged often. It can come in the form of ignorant or insensitive opinions: “She has breast cancer because she refuses to get married – doesn’t she know that having children protects from breast cancer?” It can come in the form of indignant righteousness: “How come she didn’t go to the doctor as soon as she experienced those symptoms? That’s really dumb of her.”

All of a sudden, a cancer patient’s decisions take center stage. Perhaps she deserved it. She didn’t do everything she could do to save herself.

She didn’t make the right choices in life.

Dr. Sison knows this pain. “After this article gets published, maybe some of your readers will judge me for refusing my bone scans. They will probably say I’m a doctor who doesn't walk the talk.

“But this is me being transparent. I am no longer scared of being judged. This is my reality and this is how I feel.”

Monetary pain

Many Filipinos struggle with their finances each day. Throw cancer into the mix and all bets are off.

Cancer therapy is, therefore, something not everyone can afford. “I spent PHP 85,000 for each chemotherapy cycle and I had to finish four cycles. I maxed out my health card. It was a concern because, at the time, my husband was the only one who was working.”

Dr. Sison voices her frustration about organizations that promise to lend a hand. “Many television networks have foundations that supposedly help those in need. If you had cancer and you approached them, what are the chances that you will receive financial help?”

She also feels that the government could do so much more. “I fought for a friend who needed financial help. I asked myself, where was the government in all of it? The lines for the [Philippine Charity Sweepstakes Office] are always fantastically impossible – that is unless you know someone inside.”

The pain of losing a body part

How would you feel if you were told you had to lose one breast, maybe both? What if it was a leg that had to be cut off? What if losing an organ would save your life but would make having a child no longer a possibility?

Losing a body part is painful – not just physically, but also emotionally. People who have limbs and body parts surgically removed undergo the same stages of grief as those who lose a loved one.

The pain of sharing

Because of the many unpleasant consequences of telling others that one has cancer, many choose to keep it a secret. The pity, the inappropriate comments, and the stigma – it can all be a little too much.

Dr. Sison believes, however, that sharing can be therapeutic, both for the sharer and the listener. “I once drew strength from the blog of a breast cancer patient. I realized there was someone out there who was on my side, someone who understood me.

“I always encourage my friends to share. [Sharing] is something I do, too. If I can touch the lives of one woman and urge her to get a mammography or undergo chemotherapy for breast cancer, to me, it’s like getting a trophy in heaven.”

The pain of losing work

Many cancer patients miss out on wonderful opportunities, not because they are too ill to take them, but because others have had misgivings about keeping the doors open.

“I was offered a job by a multinational company. During my interview, I was still wearing a turban because I had lost my hair from the chemotherapy. I knew they were thinking, ‘Hey, this is a cancer patient.’ My condition was stigmatized and I felt it.”

To Dr. Sison, the way she was treated was unfathomable and unfair. “I cannot understand the stigma. To put a stop to it, employers should start giving assistance. Pulling out cancer patients from work is not the solution.

“I hope that cancer patients like me help fight the stigma. We must be loud and proud because we are fighting cancer. It is the most difficult journey. We live even as we fear death.”

Pain relief can come in many forms: a pill, a comforting word, or even a quiet, heartfelt hug.

“Nothing beats personal presence,” Dr. Sison says, emphasizing the role that loved ones play in helping to ease the pain of someone with cancer. Her advice: when in doubt, lend an ear.

“We all have problems, not just sickness. I wouldn’t know the pain of being a battered wife, the same way people without cancer wouldn’t know [the pain of having it]. We just need to respect each other. We need to be there to listen, not to judge.”

Dr. Sison encourages people fighting cancer to be kind to themselves. “Take it one day at a time. Focus on getting better, not just on getting well.”

Lastly, she wants people with cancer to remember that sadness isn’t something that should be avoided at all costs. “Sometimes, you have to experience and embrace sadness to appreciate the simple joys of life.” Put simply, one way out of emotional pain is right through it.

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