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#39889 03-21-2006 03:17 AM
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My Dad is experiencing significant pain and we are trying to get that under control. He has been using Hydrocodone - 15 cc's every 4 hours but he is finding his pain getting worse. His Dr. prescribed Roxiset on Sunday and my Dad tried it, but it did nothing for his pain. Does anyone have any experiences with pain meds that they can share with me. This is all WELL beyond us, we have never taken anything more than the occasional Tylenol before

#39890 03-21-2006 09:16 AM
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Hydrocodone (AKA Vicodin) is a medium strength pain reliever. Great stuff if you stub your toe, have a bad headache or something. Roxicet (AKA Percocet) is basically the same stuff only a little stronger (both have acetomeniophen (AKA Tylenol) in them as well).

Here's a link to the NCCN guidelines for adult cancer pain. You may want to print this out and let the doctors know that you demand adequate pain relief.

http://www.nccn.org/professionals/physician_gls/PDF/pain.pdf

Pain management is a BASIC PATIENT RIGHT -DEMAND it!

You have to make sure he's not playing this down for some kind of pride issue. Pain is rated from 0-10 with 10 being the worst (it's all explained in the NCCN guidance document -see Pain A 1 of 2). He should given a questionnaire every time he's in to find out what his pain thresholds are. He will also need additional meds for "breakthrough pain".

Taking potent narcotics will also have other issues such as constipation (see Pain D, 1 of 2), etc. These will need to be managed as well. Make sure he sees a nutritionist weekly and also that someone manages his medications.

Personally they gave me Fentaynl patches for "long term" pain and morphine sulphate for "breakthrough pain".


Gary Allsebrook
***********************************
Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2
Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy)
________________________________________________________
"You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)
#39891 03-21-2006 09:48 AM
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Hi Jillian,

They gave me liquid morphine. It is important to keep the pain under control. The morphine helped, but I still had considerable pain. I also had Oxycontin and hydrocordon. I stopped the hydrocordone because I thought it was not effective. the morphine I took when needed.

Make sure you use perscription stool softeners or there can be problems with heavy pain meds.

Good luck.

Steve Daib


SCC, base of tongue, 2 lymph nodes, stage 3/4. 35 X's IMRT radiation, chemo: Cisplatin x 2, 5FU x2, & Taxol x2. Hooray, after 3 years I'm in still in remission.
#39892 03-21-2006 11:57 AM
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Remember that the "fast acting (short term)" painkillers, i.e. Morphine Sulfate still takes 1/2 hour for complete effectiveness if taken orally. It is the fastest acting. Injections are immediate.

Fentanyl patches take 24 hours before they reach their maximum effectiveness. They are a 72 hour, time release patch.

If you are medicating through a PEG tube ALWAYS get clearance from the doctor first. Crushing up time release pills can cause an overdose for example.


Gary Allsebrook
***********************************
Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2
Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy)
________________________________________________________
"You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)
#39893 03-21-2006 06:39 PM
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To control the pain we have been using a fentynal patch. The patch comes in different dosages from 25 microgram per hour to 500-1000 microgram per hour. The patch goes on directly on the skin and requires changing every three days. For breakthrough pain we use liquid morphine in 20 mg/ml strength.

We are also under the care of a pain management team at our cancer treatment center and we have monthly appointments with the team consisting of a pain management doctor and and RN.

Please consult with your treatment center about seeing a pain management team as their help and input can alleviate a lot of pain and suffering.


CG to wife;
Jan 2005 DX SCC Tongue T2N1MO; RND surgery Mar 2005; 35 XRT and 4 cisplatin completed Jul 2005.
Dec 2006 tongue surgery, Scar tissue no cancer.
Feb 2010 neck node FNA - negative.
2010 ORN right jaw plus fracture
2015 ORN left jaw plus fracture
Feb 2016 Lower jaw reconstruction by Fibula free flap+titanium plate - Permanent G-tube
June 2016 Difficulty breathing - Permanent Trachea tube
Dec 2019 DX Cervical cancer - Stage 1 - Surgery Jan 16 2020.
15-20 esophagus/larynx dilations

#39894 03-22-2006 03:15 AM
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They also make a 12 mcg Fentynal patch now; this is good for moving off of a stronger dose. Barry was on 25 mcg for a couple of months during & post-treatment , then went to 12 mcg for two weeks, then off everything.

Gail


CG to husband Barry, dx. 7/21/05, age 66, SCC rgt. tonsil, BOT, 2 nodes (stg. IV), HPV+, tonsillectomy, 7x carboplatin, 35x tomoTherapy IMRT w/ Ethyol @ Johns Hopkins, thru treatment 9/28/05, HPV vaccine trial 12/06-present. Looking good!

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