- Question from Blue Hat: I'm worried that if I complain about pain, my family will just worry about me even more, and that'll just make it harder for me. What can I do?
This is actually not an uncommon problem. Usually, one of the barriers to treatment is that patients don't tell their doctors they have pain. I think one of the reasons they don't tell is exactly what you are saying, which is that it will alarm the family. You have the sense that if you complain about it, the fear is it's probably the cancer, and you don't want to deal with that. There's also a sense that you don't want to interfere with your doctor taking care of your cancer, and if you tell about these ancillary problems, he won't be concentrating on treating the cancer.
It is important to communicate to your physician or nurse about pain. It is important that it is known. First of all, it's important to find out if it's the cancer or not. Everybody needs to have his or her pain treated. You do not need to live with pain. As a pain and palliative care physician, I see it as a failure to cure breast cancer but have somebody in chronic pain. The important thing is to have somebody that is having quality of life and is totally cured, and not just have the cancer cured or put into remission.
- Marisa Weiss, M.D. I agree completely. I have some patients who just throw up their hands and say, "I guess I should just be grateful that I'm alive." And what Dr. Berger is saying is that we need to shoot for a higher goal than just that.
- Ann Berger This is also normal, because many women think their doctors won't listen, and they don't. In my experience, when I had my episode of neuropathic pain, I was about a week to two after the operation, and I couldn't sleep at night, which is a normal problem. It wasn't pain; I just couldn't sleep. And then a few nights, I'd wake up with nerve pain down my arm, and it was like my arm felt blown out, my hand was blown up, and I knew I was dealing with a potentially long-term problem. The first thing my husband said at three o'clock a.m. after a few nights was, "What's going on?" I answered that this was nerve pain. His comment was that maybe I need to tell the surgeon or plastic surgeon involved, and my comment was, "I'm not calling those dummies. They're going to blow me off." The person I did call was a physician who did acupuncture. At my next visit, I did say something to my plastic surgeon, who was an excellent plastic surgeon, but the first thing she said was, "I don't know why you'd be having pain. It doesn't make sense."
- Marisa Weiss, M.D. Whom do you think the best physician or nurse is to bring your pain concerns to as a first step?
- Ann Berger I think you need to take it to your surgeon or oncologist, depending on your physician at that time in your treatment. If that person does not listen, then look further. Go back to your primary care physician, if you have one, or demand that somebody who may be able to help your pain, like a pain management person, see you. In terms of not telling family, families are more concerned when they don't know what's going on. Particularly if you're in pain, family members who care about you are going to know you're in pain even if you don't say something. They'll be more concerned if you don't say something. Sometimes the not knowing can be more concerning than knowing something.
- Marisa Weiss, M.D. Take care of your pain! Don't let these concerns stand in your way!
The Ask-the-Expert Online Conference called Breast Cancer Pain featured Ann Berger, R.N., M.S.N., M.D. and Marisa Weiss, M.D. answering your questions about managing pain caused by breast cancer and breast cancer treatments.
Editor's Note: This conference took place in April 2002.
The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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