ASK THE EXPERT MANAGING PERSISTENT PAIN AFTER AN EARLY BREAST CANCER DIAGNOSIS
Professor Paul Glare
T he Beacon spoke with Professor Paul Glare, Chair of Pain Medicine in the Northern Clinical School of the University of Sydney, to discuss what persistent pain is, when to seek help, and where to find support. WHAT IS A PAIN MEDICINE SPECIALIST? Pain medicine specialists are doctors who assess and treat pain. Most have completed fellowship training by the Faculty of Pain Medicine of the ANZ College of Anaesthetists and have the letters FFPMANZCA after their name. Multidisciplinary pain clinics include physiotherapists, psychologists, occupational therapists, and doctors. They tend to approach a patient’s pain holistically, rather than relying on drugs and injections to manage pain and offer psychosocial assessments and a range of pain management treatments. WHEN MIGHT A PERSON EXPERIENCING PERSISTENT PAIN AFTER TREATMENT FOR EARLY BREAST CANCER BE REFERRED TO A PAIN MEDICINE SPECIALIST? Having treatment for early breast cancer can be painful, for example, recovering after surgery or chemotherapy. This pain is normal and generally managed by your surgeon, oncologist or GP. Remember that breast cancer and pain aren’t always related. However,
WHERE ARE PAIN MANAGEMENT CLINICS AVAILABLE IN AUSTRALIA?
there’s no obvious cause, such as another tumour or an infection, it’s considered persistent pain. Many people who get breast cancer may already have other kinds of pain, such as a bad back or arthritis. Feeling sick from cancer or its treatment also means they can get deconditioned and this can make their original pain worse. When the usual treatments to reduce someone’s pain haven’t worked, their GP, breast surgeon, or medical oncologist can provide a referral to a pain specialist. WHAT DOES A PAIN MEDICINE CLINIC PROVIDE? Unlike measuring your temperature or blood pressure, pain is subjective. Pain specialists rely on your assessment of it, which includes both its sensory and emotional components. If you only address the sensory component (severity) and ignore the emotional component (the distress it causes), pain management will be less effective. A multidisciplinary team focuses on how the pain is impacting your functioning and level of distress and tries to reduce the intensity of the pain. Working with a multidisciplinary team teaches you to do things you may not think you can, and often helps to reduce the intensity of your pain. These strategies can help with different kinds of pain, including neuropathic pain.
Most of the large hospitals in metropolitan areas have pain
management clinics as well as some larger regional centres. In rural and remote areas, many psychologists and physiotherapists have expertise in pain management, so you don’t necessarily have to travel to a hospital clinic. Lack of access to specialised pain management support is an issue. I’m involved in a research project looking into how we could provide access to pain management via a digital intervention to help improve access for people living in rural and regional areas. WHAT ADVICE WOULD YOU GIVE TO SOMEONE WHO’S READING THIS ARTICLE AND THINKING IT RELATES TO THEM? Pain after cancer treatment is common. Believe that your pain is real. If the pain is not interfering too much with your life, then keep doing what you’re doing. However, if it’s causing you distress and disability, and you’re unable to function properly, then seek help because there’s likely to be an emotional component to your pain. A doctor, psychologist, or physiotherapist who understands persistent pain can teach you pain self-management techniques that offer you a good chance of returning to a more normal and enjoyable life.
if your pain continues beyond the usual recovery period and
To learn more about persistent pain after early breast cancer, watch BCNA’s webcast Persistent pain after breast cancer—addressing quality of life
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April 2024 | Issue 97
Breast Cancer Network Australia
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