Psychological approach to cancer pain

Pain and fear tend to go hand in hand. But it is the fear of potential pain that often causes more problems than necessary. As per Quartana et al. (2009), this fear of potential pain is referred to as pain catastrophizing. This form of catastrophizing has been associated with negative repetitive thinking that may lead to avoidance as a coping strategy to keep away from the aversive situation or stimuli (Flink et al., 2013). 

With these feelings of aversion, there is a possibility that individuals may choose not to undergo care as it may be ‘painful’, which may ultimately lead to them being unable to heal considerably. This is one of the many reasons why pain management is important when it comes to care provision in both the medical and psychological fields. 

Though pain as a concept exists, it is important to note that not all pain is equal. One way to understand this is to look at acute and chronic pain. Acute pain is commonly associated with short-term pain that has a sudden onset and tends to have a known cause, chronic pain on the other hand is associated with long-term pain (usually longer than three months) that re-occurs and oftentimes has an unknown cause (Bonezzi et al., 2020). 

As such, the care and medication provided for individuals with these types of pain are different. In most cases, once the cause of pain is found, medication, rest or therapy is advised for treatment, but in cases where the cause of the pain remains a mystery, it becomes difficult to cure the pain an individual feels due to the potential backlash the symptoms that ineffective medication may cause. One example of a disease that presents the case of both acute and chronic pain is cancer. 

As per the National Cancer Institute (2021), cancer is a disease wherein there is an uncontrollable growth of abnormal or damaged cells in the body. The disease can be caused due to environmental factors or genetics and tends to be localised to one area or metastasis to multiple parts of the body (National Cancer Institute, 2021). Kumar (2011) also mentions that one of the most common symptoms of cancer is pain and that it can be caused by the disease itself as well as the treatment of the disease. 

Additionally, Filipponi et al. (2022) mentions that cancer-related pain can be found from diagnosis to survival. Moreover, chronic pain in regard to cancer has been associated with a

lower life quality, survival and treatment adherence rate (Filipponi et al., 2022). One way to aid individuals undergoing such a situation is to provide them with access to non-medication-based services that they can apply for reduced pain. 

With cognitive therapies such as REBT and CBT, associated with improved mental states of individuals, applying these techniques to cancer patients is likely to help them cope with difficulties. Moreover, these therapy techniques can be used to equip patients with pain management techniques such as deep breathing, muscle relaxation, meditation and autogenic training (Vambheim et al., 2021). 

Furthermore, the latest research around cancer pain management has found that CBT aids in improving symptoms of insomnia and fatigue of a survivor while simultaneously improving their functional health (Blumenstein et al., 2022). In addition to this, such techniques may prove beneficial for those choosing to not treat their cancer. In cases of individuals who choose not to use medication for treatment, therapy will likely be able to provide them with resources that they can use to manage and reduce their pain. 

Therefore, therapy as a mode of pain management acts as a technique that would aid patients with most if not all forms of cancer pain by helping them be more in charge of their treatment plan. All in all, this is a form of care that needs to be further applied in hospitals and institutions that care for patients with cancer.

With the risk of cancer increasing with each generation, psycho-oncology as a field gains more importance. Most treatment in terms of cancer remains medical and therefore physician based wherein the patient remains a passive recipient of care. With the potential introduction of therapy as a form of additional treatment for cancer related pain, patients will likely be able to play an active role - instead of a passive one - in their treatment plan. 

(George is a graduate from FLAME University, and Das is an assistant professor of psychology at FLAME University, Pune)