Causes of Cancer Pain
The main causes of cancer-related pain are the cancer itself, the cancer treatment or a complication of the cancer.
Pain, in general, is either ACUTE or CHRONIC. In the simplest of terms, ACUTE pain lasts for only a short-time. It goes away. And, CHRONIC pain lasts for a prolonged period of time. It typically doesn’t go away.
I’m going to focus on chronic cancer-related pain. In general, I’ve found that medical marijuana serves as a better treatment option for CHRONIC pain than it does for ACUTE pain.
The main causes of chronic cancer-related pain are due to the cancer in some way affecting either bone, soft tissue, or another organ. Some tumors invade and damage the organ or tissue. Other times, tumors can compress nerves in organs or tissues. Then, there are also incidents of tumors obstructing hollow organs or tissues. Then, there’s also nerve related pain (also known as neuropathy). Most of the time the damage to the nerve is caused by the cancer treatment itself.
Results I’ve Seen in my Patients with the use of Medical Marijuana
Levels of Pain
You may have seen this tool hanging on the wall at the hospital or at your doctor’s office. It’s used to very ineffectively assess pain. I say ineffectively because every time I ask a patient the question, on a scale of 1 to 10, what’s your level of pain their response is “oh, it’s off the charts.” 🙂
Joking aside, chronic pain is on the most common conditions that I treat in my practice. I’d have to say that I’ve seen some pretty impressive results. I’ve seen severe pain come down to a level of mild pain and I’ve seen mild pain be eliminated. Now, it’s important to note that the reduction of pain is relative to the amount of pain the patient is in to start with.
Use of Prescription Medications
The other aspect of pain management that medical marijuana impacts is the use of prescription pain medications. I generally see 1 of 3 scenarios play out,
- In the best case scenario, patients are able to completely eliminate the use of prescription medications with the use of medical marijuana. Even better, is that they don’t have to use the medical marijuana on an everyday basis.
- Another scenario is that patient do still have to continue using their prescription medications, but they’re able to either
- reduce the number of prescription medications that they’re taking or
- reduce the dosages of the prescription medications that they’re taking.
- In the worse case scenario, patients have to continue use the same number and dosages of their prescription pain medications along with the medical marijuana for better pain relief.
When I’m referring to prescription pain medications, I’m talking about,
- Hydrocodone (Vicodin)
- Oxycodone (Percocet, Oxycontin )
- Hydromorphone (Dilaudid)
- TRICYCLIC ANTIDEPRESSANTS
- SEROTONIN-NOREPINEPHRINE REUPTAKE INHIBITORS (SNRIs)
- Duloxetine (Cymbalta)
- Venlafaxine (Effexor)
- Gabapentin (Neurontin)
- Pregabalin (Lyrica)
Quality of Life
Chronic Pain has a way of seeping into every aspect of a patient’s life. I’ve seen it affect patients not just physically, but also affect them profoundly both mentally and emotionally. They’re not able to engage in the activities that bring them joy. It affects the quality of their sleep. It affects their performance at work. For many patients, enduring pain for what seems like an eternity often leads to anxiety. But, with the use of medical marijuana, I have seen an overall improvement in the quality of my patients’ lives. It doesn’t just reduce pain, it also impacts the physical, mental, and emotional aspects of patient’s lives. Patients are able to go back to golfing and gardening. They able to perform everyday tasks, like opening jars – something that many of us that don’t have joint pain take for granted. They’re able to carry their grandchildren. When it comes to sleep, I’ve had patients report that with use of medical marijuana, they’re able to fall asleep easily and stay asleep. And, even if they do end up waking up in the middle of the night, they’re able to fall back asleep without difficulty. Unlike with prescription and over-the-counter sleeping aids, patients report waking up feeling refreshed, not groggy. Patients find that using medical marijuana helps to get their mind off the of the pain. And, in turn, they’re able to concentrate better, which helps them to be more productive improving their performance at work. Finally, the use of medical marijuana helps to reduce anxiety. It helps to patients to escape racing thoughts. It helps to reduce and even eliminate panic attacks.
Why Does Medical Marijuana Reduce Pain?
MODULATES PAIN ALONG THE PAIN PATHWAYS
Just like life, pain is complicated. There are a lot of different components involved, but I’m going to try to boil it down to the basics for you. Let’s think of this whole system as an army. You have some troops that have specifically been assigned the task of detecting pain. Once they’ve detected pain, they send a signal to the command center, the brain. The brain then decides how it wants to react to the pain, physically, emotionally, etc. So, it sends signals to another set of troops that know how to carry out that specific command. So, let’s take the example of the body detecting temperature. If the detecting troops sense that a certain part of the body is near something that’s really, really hot, they send off signals to the brain. The brain decides that it needs that part of the body moved away from the source of heat. So, it sends a command over to the to troops that know how to move that part of the body away from the heat. The role of marijuana in these pain pathways is that it modulates the levels of pain. Research has shown that animals in states of pain have a greater number of cannabinoid receptors along these pain pathways. Activating these receptors overall makes the nerve (or the detecting troops I spoke of previously) less likely to fire off signals to the brain. As I was going through the research, I realized just how important the endocannabinoid system is. It’s especially important because otherwise what happens is that prolonged pain can actually make the nerve (or the detecting troops) even more sensitive to pain. In doctor speak, this is known as HYPERALGESIA. Or the nerve (or detecting troops) start to mistake even non-painful stimuli as painful. This is known as ALLODYNIA.
ALTERS PERCEPTION OF PAIN
I’ve had many patients tell me that marijuana takes their mind off of the pain or that the pain doesn’t bother them as much with the use of medical marijuana. And, it’s really interesting they say this because the research actually shows that marijuana alters the perception of pain. Back in 2012, researchers at the University of Oxford, took 12 healthy volunteers, applied capsaicin to their legs (to induce pain), gave them marijuana, and then took MRI scans of their brain. The scans showed that marijuana impacted activity in the parts of the brain known as the anterior mid-cingulate cortex and the amygdala. These are both parts of the brain that plays a role in emotionally interpreting pain.
source: Sean Mackey, Stanford. Plos One, Journal Neuroscience: Archives of Internal Medicine
Have you seen the movie Project X? It’s basically about 2 high schoolers who on a quest to become popular throw a house party. The scene from the morning after shows that the entire neighborhood has burned down. This is inflammation. There’s a reason why the root word inflame is in the word inflammation. So imagine that marijuana is a cop that happens to be passing by this party. He sees that the situation is completely out of control. So, he calls in the T-regs (T-regulatory cells) as back-up. They’re there for damage control – to make sure to prevent the body from attacking itself even further. In the meanwhile, marijuana goes after the high schoolers that are causing a ruckus. These would the be immune cells that are causing inflammation. Marijuana also confiscates the high schoolers cell phones. These would be the cytokines, which are chemicals produced by the immune cells, to signal the start and stop of inflammation. In summary, marijuana,
1. Causes apoptosis (cell death) of immune cells that are causing an autoimmune attack
2. Suppresses the production of cytokines
- What are cytokines? Chemicals made by immune cells that start and stop inflammation
3. Activates T-regulatory cells
- What are T-regulatory cells? A type of immune cell that helps to make sure that the body doesn’t respond to to self-antigens and prevents autoimmune disease
Would you like my help? Head on over to the GET HELP page, I’ll step-by-step walk you through how to safely use medical marijuana to help relieve your Cancer pain.
- Cancer Pain
- A survey of pain in patients with advanced cancer.
- Overview of cancer pain syndromes
- Upregulation of spinal cannabinoid-1-receptors following nerve injury enhances the effects of Win 55,212-2 on neuropathic pain behaviors in rats.
- Walker JM, Hohmann AG. Cannabinoid mechanisms of pain suppression. In: Pertwee RG, ed. Cannabinoids (Handbook of Experimental Pharmacology). Berlin, Germany: Springer-Verlag; 2005:509-554.
- Amygdala activity contributes to the dissociative effect of cannabis on pain perception
- Cannabinoids as novel anti-inflammatory drugs