When Cancer Returns : Legal Papers, Pain Control

by National Cancer Institute

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Advance directives

A living will lets people know what kind of medical care you want if you are unable to speak for yourself.

A durable power of attorney for health care names a person to make medical decisions for you if you can't make them yourself. This person is called a health care proxy.

Other legal papers that are not part of the advance directives

A will tells how you want to divide your money and property among your heirs. (Heirs are usually the family members who survive you. You may also name other people as heirs in your will.)

A trust appoints a person you choose to manage your money for you.

Power of attorney appoints a person to make financial decisions for you when you can't make them yourself.

Note: You do not always need a lawyer present to fill out these papers. But you may need a notary public. Each state has its own laws about advance directives. Check with your lawyer or social worker about the laws in your state.

Managing the Side Effects of Your Treatment

You probably already know about ways to manage the side effects of cancer treatment. If so, parts of this section will be a review for you. It outlines some of the support therapies cancer patients have found helpful.

Comfort Care

You have a right to comfort care both during and after treatment. This kind of care is often called palliative (PAL-ee-yuh-tiv) care. It includes treating or preventing cancer symptoms and the side effects caused by treatment. Comfort care can also mean getting help with emotional and spiritual problems during and after cancer treatment.

People once thought of palliative care as a way to comfort those dying of cancer. Doctors now offer this care to all cancer patients, beginning when the cancer is diagnosed. You should receive palliative care through treatment, survival, and advanced disease. Your oncologist may be able to help you. But a palliative care specialist may be the best person to treat some problems. Ask your doctor or nurse if there is a specialist you can go to.

Pain Control

Having cancer doesn't always mean that you'll have pain. But if you do, you shouldn't accept pain as normal. Your doctor can control pain with medicines and other treatments. Managing your pain helps you sleep and eat better. It makes it easier to enjoy your family and friends, and to focus on the things you enjoy.

Have regular talks with your health care team about your pain. Let them know what kind of pain it is, where it is, and how bad it is. These talks are important because pain can change throughout your illness. And your pain may show where cancer has returned after remission. Many hospitals have doctors who are experts in treating pain. Tell your doctor if you would like to talk to a pain specialist.

Your medicine, and how you take it, will depend on the type of pain and its cause. For example, for constant pain you may need a steady dose of medicine over a long period of time. You might use a patch placed on the skin or a slow-release pill.

Controlling Pain: What To Tell Your Doctor

When describing pain to your doctor, give as much detail as you can. Your doctor may want to know:

• Where exactly is your pain? Does it move from one spot to another?
• How does the pain feel - dull, sharp, burning?
• How often do you have pain?
• How long does it last?
• Does it occur at a certain time of day - morning, afternoon, night?
• What makes the pain better? What makes it worse?

Using Strong Drugs To Control Pain

People with cancer often need strong medicine to help control their pain. Don't be afraid to ask for pain medicine or for larger doses if you need them. And the drugs will help you stay as comfortable as possible.

People with cancer hardly ever get addicted to these drugs. Sadly, fears of addiction sometimes prevent people from taking medicine for pain. The same fears also prompt family members to encourage loved ones to "hold off" between doses. But people in pain get the most relief when they take their medicines and treatments on a regular schedule.

Other Ways To Treat Pain

Cancer pain is usually treated with medicine and other therapies. But there are also some nondrug treatments. They are types of complementary and alternative medicine (CAM). Many people have found the methods listed below helpful. But talk with your health care team before trying any of them. Make sure they are safe and won't interfere with your cancer treatment.

Acupuncture is a form of Chinese medicine that stimulates certain points on the body using small needles. It may help treat nausea and control pain. Before using acupuncture, ask your health care team if it is safe for your type of cancer.

Imagery is imagining scenes, pictures, or experiences to feel calmer or perhaps to help the body to heal.

Relaxation techniques include deep breathing and exercises to relax your muscles.

Hypnosis is a state of relaxed and focused attention. One focuses on a certain feeling, idea, or suggestion.

Biofeedback is the use of a special machine to help the patient learn how to control certain body functions. These are things that we are normally not aware of (such as heart rate).

Massage therapy brings relaxation and a sense of well-being by the gentle rubbing of different body parts or muscles. Before you try this, you need to check with your doctor. Massage is not recommended for some kinds of cancer.

These methods may also help manage stress. Again, talk to your health care team before using anything new, no matter how safe it may seem. Ask your health care team for more information about where to get these treatments.

About the Author

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