Pain in late-stage cancer can stem from various factors, according to Dr. Luu Thao Ngoc, an oncologist at Tam Anh General Hospital in Hanoi. Tumor growth can compress surrounding tissues and organs, spread to the spinal cord, or damage bones. Pain can also arise during treatment, as a side effect of chemotherapy or radiation therapy, or post-surgery. Generally, pain in cancer patients is categorized into two main types: nociceptive pain and neuropathic pain.

Nociceptive pain occurs when nociceptors, the sensory nerve endings that detect pain, are stimulated by harmful stimuli without direct nerve damage. These nerve endings transmit signals to the central nervous system. Nociceptive pain is further divided into two forms. Somatic pain, originating from tissues like skin, muscles, bones, and joints, is characterized by sharp, localized pain, often intensified by movement or touch. Visceral pain, on the other hand, stems from internal organs. This pain is typically dull, diffuse, and difficult to locate precisely.

Dr. Thao explains that organs like the lungs, liver, and kidneys do not contain nociceptors within their parenchyma. Therefore, pain is felt only when the tumor invades or compresses adjacent structures containing nociceptors, such as the liver capsule, pleura, or renal capsule. This explains why many patients only experience pain when cancer has progressed to an advanced stage.

Neuropathic pain results from physical damage to nerve tissues, whether peripheral nerves or the central nervous system. This type of pain is described as burning, tingling, numbness, electric shock sensations, or sudden, sharp pain. It is often caused by tumors compressing or destroying nerves, or as a side effect of chemotherapy or radiation therapy on the nervous system.

A nurse cares for a cancer patient. Photo: Tam Anh General Hospital

A nurse cares for a cancer patient. Photo: Tam Anh General Hospital

Understanding the nature of their pain (sharp, burning, dull, etc.) helps patients describe it accurately, facilitating quicker diagnosis and appropriate treatment, says Dr. Ngoc. The goal of pain management in late-stage cancer is not only to reduce pain intensity but also to improve the patient's quality of life through medication and interventional procedures (nerve blocks, pain-reducing radiation therapy, neurolysis, etc.). The support of counselors, nurses, doctors, and family members is also crucial in bolstering the patient's morale during cancer treatment.

Anh Kiet