Over 200,000 American women are expected to be diagnosed with breast cancer in 2010, according to estimates by the National Cancer Institute, and 38 percent of these diagnoses will be made after the cancer has spread outside the breast. The National Cancer Institute states that breast cancer most commonly metastasizes to the bones, lungs, liver or brain, and pain can occur in any of these sites. Assessing the pain that is experienced in metastatic breast cancer is the first step towards effective treatment and maintaining the maximum level of functionality.
Step 1
Decide why pain management is a worthy use of your time and energy. In your journal, write one reason why you want to control your experience of pain. Make it realistic, positive and very specific. For example, write "I will decrease my pain during waking hours to a level that does not interfere with my ability to go to work on 18 out of 20 work days in June." Then write a list of steps you will take to accomplish this goal. The first step is assessing when the pain occurs, where it is located and what makes it better or worse.
Step 2
Draw a picture of your pain experience over the course of a day so you can show it to your physician. Draw an outline of the front of your body on the top half of the page, and on the bottom half draw the back of your body. When you feel pain or discomfort, take a moment and make a mark on the drawing to show where the sensation is most intense. Then use arrows to show how it moves or radiates. Mark it with a red marker when pain occurs during the daytime, and use a blue marker to record pain that happens as you are falling asleep or if it wakes you up at night.
Step 3
Use words to describe the pain. At the side of your pictures, write a single word description of the pain and draw a line from the word to where you feel the pain. This may help your physician identify the source of the pain more effectively. For example, metastatic bone pain can come from pressure of a tumor inside the bone, a form called somatic pain that is commonly described as throbbing or aching. But the same metastasis can trap the nerves running near the bone surface and produce neuropathic pain, which is described as burning or tingling. Hepatic or liver metastasis produce visceral pain, causing a feeling of pressure or deep squeezing, as described in the August 2000 issue of "Cancer Control."
Step 4
Consider what other things things are adding to your pain. Depression, the deep feeling of hopelessness, helplessness and futility, is not uncommon in patients with metastatic cancer, and it adds to the experience of pain. Taking control of your pain by assessing it and integrating non-medical means of pain management in addition to using medication may help lessen your feeling of helplessness, and adding an antidepressant medication often makes the pain more manageable. Other things can also intensify your pain, including fear and fatigue. Treat your pain before it becomes out of control to lessen your fear of the pain itself, and ensure that you get a full night's sleep. Getting outdoors early in the morning each day lets you get the sunlight your body needs to break down melatonin, the brain chemical that makes you sleepy. This will help you stay alert during the day, which should decrease your experience of pain.
Things You'll Need
- Journal
- Pen
- Red and blue, narrow-tip markers
