Wed, 04 May 2005

Morphine can 'kill cancer pain'

The Jakarta Post, Jakarta

Having to deal with cancer is one's worst nightmare, not to mention the chronic pain that often results.

"I have to put up with on and off pain all the time, especially when I am depressed," said Etty, a 48-year-old mother of two who found out that she had breast cancer a year ago.

Etty kept dealt with her pain in silence and refused to take pain-killers. "I am afraid of becoming addicted to those drugs," she said.

Cancer patients do not have to endure chronic pain because pain-killers, including morphine -- which are commonly feared as they are highly addictive, can release people from much of their suffering, a local oncologist claimed.

"A right dose of the correct type of medication will free patients from cancer pain and will have minimal side effects, thus allowing them to go on with their daily activities," Dharmais Cancer Hospital research and development head Asrul Hasral stated during a seminar on Tuesday.

While the Ministry of Health's data on the number of cancer patients reached 6 percent of the population recently, Asrul said that "one out of three patients with early stages of cancer complain about the pain they have to endure, while the figure increases to two out of three of those in the late stages."

Cancer pain, said Asrul, is assessed very subjectively, according to the patients' indidividual pain tolerance levels, measured by a standard assessment means called the Visual Analog Scale. A patient will identify points on scale ranging from 0 for not painful to 10 for intolerable.

The assessment will also be supported by imaging, or CT-scan data, to determine whether the pain is caused by broken tissues, damaged organs or nerves.

Medication can then be given accurately. Light cancer pain can be treated with standard over-the-counter pain relief medication such as aspirin or acetaminophen, while more severe pain is better treated by stronger medicine such as morphine.

"Morphine, whether given orally or through injection, will not cause addiction if taken in a proper dose, continuously and according to schedule," Asrul said, adding that it was sudden termination of the drug that would lead to symptoms of addiction.

"It is necessary to slowly taper off the use of it in order to prevent negative side effects," he explained.

Opiate-based medication should also be accompanied by other drugs such as antidepressants, anticonvulsants, bisphosphonates and radiation treatment, depending on the needs or symptoms of a patient, according to the doctor.

"Patients also need not worry about being 'mind-clouded' because of morphine, as it only causes drowsiness and constipation that can be taken care of by taking anti- constipation drugs.

For those reluctant to take chemical-based drugs, another option lies in the alternative herbal medicines.(003)