Pain relief

Pain doesn’t affect all men with prostate cancer but there are various ways in which pain may be controlled if it occurs. If cancer has spread to the bones, radiotherapy can be given to relieve the pain. Treatment is given to the affected bone or area. Between one and ten treatments are given to the sites of bone pain. Symptoms will usually improve four to six weeks after treatment, but men may notice some pain relief within a few days. Pain may also be controlled with the use of various drugs, but it sometimes takes a while to find the best dose. For bone pain, non-steroidal anti-inflammatory drugs (NSAIDs) e.g. ibuprofen can help, but these can sometimes irritate the lining of the stomach. Bisphosphonates reduce pain if given to men with hormone-relapsed prostate cancer.

Considers that radiotherapy took away a lot of the pain he had been experiencing.

Age at interview 63

Gender Male

Age at diagnosis 54

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But the bone metastases it can move about it a bit you know so every now and again you have to get a check up. At first I had a lot of pain in my lower back and the pelvis area, my shoulders, and I got radiotherapy for that which took a lot of the pain away.

Could you explain what that was like to have some radiotherapy?

The radiotherapy was, it’s painless you know you just lie there and they give you the radiotherapy. You can feel a bit tired after you get it…

Did you just have the one treatment or more, how many times?

Well I had one in my right, the right side of my pelvis at the back and one in my left at the back and both shoulders and it did ease it up a lot.

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Describes how a patch with the right dose of painkiller was found.

Age at interview 65

Gender Male

Age at diagnosis 59

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Then they put me onto pain patches, 50mg pain patches of Fentanyl.

I stayed in the hospital for 8 days on these pain patches occasionally being sick but I was on anti sickness tablets as well in the hospital. I had, I didn’t realise until I was finally discharged and sent home, still on the patches that there was a pattern to it and that it was immediately after a new patch was applied which they’re applied every 3 days, it was immediately after a new patch was applied that I felt sick again.

Yes you put a new patch on and you immediately get a high dose of the painkiller and it was that high dose that was making me feel sick again so I was being sick immediately a new patch was put on and then it was gradually getting into my body and I wasn’t sick any more. So realised that it was the new patch that was making me sick so I was going away to have a holiday with my daughters, went to see my GP and said ‘What shall I do because I’m being sick you know every time I put a new patch on?’ So he said ‘Well I suggest you don’t stop the pain patches whilst you’re away on holiday because we don’t want you to have a lot of pain while you’re away, see how you go. But I said ‘Well what about reducing the pain patches to 25 mg?’ which is the smallest dose you can have?’ So he agreed with that and in fact I started having 25mg pain patches just before I went away for the holiday. I found that they didn’t make me sick so I was okay while I was away on holiday. When I came back I thought well I don’t want to be on these pain patches permanently.

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Radioactive material (isotope) called Strontium 89 may also be used to control pain. The isotope is given as an injection into a vein in the arm, usually in the hospital outpatient department. When injected, Strontium is taken up by the affected bones, and gives pain relief. Specialist pain control is available in special pain clinics attached to hospitals and also in hospices.

Describes the strontium injection and its use as pain control.

Age at interview 65

Gender Male

Age at diagnosis 59

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Just to digress slightly in the meantime I’d been back to see the oncologist because of the pain and he suggested that I have a strontium injection which is a radioactive injection. I had the strontium injection the week before I went away on holiday, when I came back from holiday I realised that that should’ve then started to work so I suggested to my GP that I perhaps should stop having the pain patches altogether which he agreed.

How did the strontium injection work do you know?

Yes it basically releases radioactivity through your blood stream so that it hits wherever the pain is throughout your body so if you’re getting it in more than one place which I was it stops the pain wherever it’s occurring. I was told that the length of time that the strontium injection work vary between patients, it can be as little as 3 months and as much as 15 months before you need another one. At the moment it’s about coming up to the, getting on to the 3 month stage and it’s still working with me, there are no problems, at this stage I’m completely pain free, I’m feeling a lot better than I did.

Does it have any side-effects the strontium injections?

I haven’t had any, there can be side-effects with them but I haven’t had any so far.

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Describes his experience of the Pain Relief Centre.

Age at interview 69

Gender Male

Age at diagnosis 63

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I went to the Pain Relief Centre at the hospital and then I started on pills. Pills are things that Ive hated all the way through my life but unfortunately I now have to take them. I take 2 in the morning, 2 midday and 6 in the evening. Those are mainly of morphine, and other ones which you will come across in time.

At the Pain Clinic also I, with the pain specialist, worked out the medicines or the pills that I should have. This takes some time because you can take too much morphine or too little and it doesnt work and of course with this you do become ill and sick. But once youve balanced the number of pills and the correct amount of pills then it seems to work extremely well.

Do you suffer any pain at all at the moment?

Unfortunately yes it still comes usually at night when you get into bed and you sort of lie down and then it comes and you just have to get up and hope it goes as quick as possible. I suppose it lasts about quarter of an hour, 20 minutes. Not every night.

In which areas do you suffer pain, which parts of the body?

It’s the area where all the nerve ends go to on a man.

So do you take some pills to help that?

Ive got the pills, quick reacting pills the thing is that you just put up with it, but there we go.

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Complementary approaches for prostate cancer

The men we interviewed had used various complementary approaches - changing their diet, taking vitamin and mineral supplements, massage and relaxation therapies, and using herbal...

Catheters

During surgery a small tube or catheter is put into the bladder through the penis so that urine can be drained into a collecting bag....