Treatments

Medical Treatments for Pain Relief

There are many types of pain relief and many methods for providing pain relievers, including by mouth, through suppositories, via patches, or through a tube inserted in a blood vessel or injected under the skin. You may be given a pump that allows you to control the amount of pain medicine you receive. Some of the medical options, which may be provided alone or in combination with others, include

Opioids

Such as morphine, oxycodone, hydromorphone, methadone, fentanyl, meperidine, codeine, hydrocodone, and propoxyphene

Other pain medicines

Such as nonsteroidal anti-inflammatories (including naproxen, celecoxib, and ibuprofen), tricyclic antidepressants, anticonvulsants, N-methyl D-aspartate receptor antagonists, anesthetics, alpha-2 agonists, and anticholinergics

Other pain relievers

Such as nerve blocks, spinal infusions, surgery, and radiation therapy.

Treatments for Other Symptoms

Pain is not the only symptom of a serious illness. You may be suffering from shortness of breath, constipation, anxiety, loss of appetite, or other symptoms. As with pain, there are many ways to find relief. The following are some of the most common symptoms of serious illness and the remedies that you may be able to try or that a palliative doctor can discuss with you.

Shortness of breath

Change to a more upright position; open windows; use a fan, humidifier, or air conditioning; avoid strong odors; and identify triggers that cause the problem and eliminate them.

Nausea and vomiting

Avoid disagreeable foods and odors; avoid fatty and fried foods; take most medications after eating; suck on a mint or hard candy; eat small, frequent meals; and use relaxation techniques.

Constipation

Certain foods and beverages, such as prune juice, can help, but medical treatment is likely the best option.

Disorientation or delirium

This very common symptom can be prompted by medications, infection, or organ failure at the end of life and is best treated by a doctor. To help, loved ones can use soft, reassuring voices, keep noise to a minimum, and avoid night disruptions.

Loss of appetite

Reasons for loss of appetite are many and the doctor can suggest best options for treatment. Loss of appetite is normal at the end of life and does not mean the person is starving. People can live comfortably for a long time on very little food, and placement of an artificial feeding tube sometimes can shorten life. Things that sometimes increase the appetite include being involved in menu planning; having dietary restrictions (such as low-salt or cholesterol) lifted; eating small portions of a favorite food; avoiding food with strong orders; and eating easy-to-swallow foods, such as pudding or pureed food.

Depression and anxiety

Some depression and anxiety are normal in serious illness. Family members can help by providing updates on treatments and outlook; communicating openly and honestly; helping you renew your sense of self-worth and meaning; helping you establish short-term goals and focus on strengths; encouraging you to keep a journal, exercise, and use relaxation techniques; and doing other activities that can distract from depression and anxiety. Excessive depression and anxiety can be treated through medication and counseling.

Again, combinations of medications and other treatments may be used. Your palliative doctor has received special training and therefore has the expertise to devise a safe and effective pain and symptom treatment plan.