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• • Antidepressants - This class of drugs is used primarily to treat depression. Examples of antidepressants that may be also be used to treat cancer pain include: amitriptylene (e.g., Elavil); desipramine (e.g., Norpramin); doxepin (e.g., Sinequon); and impipramine (e.g., Tofranil).

  • Bisphosphonates - This class of drugs is used primarily for the treatment of osteoporosis. Studies have also demonstrated that bisphosphonates may relieve bone pain in cancer patients. Examples include: alendronate (e.g., Fosamax); pamidronate (Aredia); and etidronate (e.g., Didronel).

  • Corticosteroids - This class of drugs is used primarily to treat inflammatory conditions such as rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. By reducing inflammation, corticosteroids also reduce pain. A common type of corticosteroid drug used for the management of cancer pain is dexamethasone (e.g., Dexmethsone).

• Breakthrough Cancer Pain - Despite the regular use of pain medications on a fixed schedule, many cancer patients (estimates range from 50% to 65%) experience a type of pain known as breakthrough cancer pain. This type of pain is characterized by a sudden onset, may last from minutes to hours, and is usually severe in nature. Breakthrough cancer pain occurs most often in patients who are experiencing persistent or chronic cancer pain who notice a sudden, periodic "flare-up" of severe pain even though they are taking pain medication on a regular schedule.

Breakthrough cancer pain is most often treated with opioid medications that act quickly, such as immediate release morphine tablets or capsules, but are rapidly eliminated from the body so that they cause less side-effects. The U.S. Food and Drug Administration (FDA) has also approved a drug called ACTIQ (Oral Transmucosal Fentanyl Citrate) in the form of a lozenge on a stick that dissolves slowly in the mouth for the treatment of breakthrough cancer pain. Be sure to notify your doctor if you think you may be experiencing breakthrough pain that is not controlled with your regular fixed-schedule pain medications so that he/she may determine the best course of treatment to alleviate your pain.

For more information about cancer-related pain and the treatment options, please click on the following link: http://www.cancer-pain.org

The Role of Complementary and Alternative Medicine Therapies in Cancer-Related Pain

As a general rule, complementary and alternative medicine (CAM) therapies are usually not considered as a viable treatment option for the management of acute cancer-related pain. Acute cancer-related pain usually responds best to conventional drug therapy (e.g., NSAIDs; narcotic analgesics; adjuvant pain medications). Surgery may also be necessary for the treatment of some types of acute cancer pain such as when a tumor compresses a nearby nerve or the spinal cord or if the tumor is causing abdominal or intestinal obstruction. Once the acute pain has been brought under control by conventional treatment modalities, CAM therapies may be considered in the management of chronic (persistent) cancer-related pain. A potential benefit of using CAM therapies in conjunction with conventional treatments for the management of chronic cancer-related pain is that they may reduce the dosage of conventional pain medications that may be required to achieve chronic pain control and, therefore, also potentially reduce the side-effects that may be associated with conventional pain medications.