Cancer Pain Quiz

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Fatigued

Insomnia

Nausea

Body aches

Stomach ache

Abdominal pain

Heat exhaustion

Weight loss

Chest pain

Pain in bones all over body

Sudden tiredness during the day

Loss of appetite

Not seeing your symptoms? No worries!

What is Cancer Pain?

Cancer pain occurs when cancer grows into or invades nearby bone and tissue. As the cancer expands, it can press on surrounding nerves, bones, and organs, causing pain. The tumor can also release chemicals that cause pain.

Typical Symptoms of Cancer Pain

Diagnostic Questions for Cancer Pain

Your doctor may ask these questions to check for this disease:

  • Do you have pain all over your body?
  • Have you ever had cancer?
  • Does your stomach pain get worse when you press on it?
  • Does your pain intensity change when you switch postures?
  • Do you have any stomach or abdominal pain?

Treatment of Cancer Pain

There are many treatments for cancer pain and the patient should discuss their pain on a regular basis with their medical oncologist, palliative care doctor, or pain specialist. Treatments can range from over-the-counter pain relievers, to prescription pain relievers, to nerve pain drugs, to opioid-based prescription painkillers. Radiation can often relieve bone and nerve pain. Surgery is sometimes used. Sometimes devices can be placed in the spinal cord and elsewhere that directly change the way pain is felt. There are many modern options for cancer pain treatment.

Reviewed By:

Robin Schoenthaler, MD

Robin Schoenthaler, MD (Oncology)

Board certified radiation oncologist with over 30 years experience treating cancer patients. Senior physician advisor for expert medical options in adult oncology. Published award-winning essayist on medical and health issues and more.

Yoshinori Abe, MD

Yoshinori Abe, MD (Internal Medicine)

Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.

From our team of 50+ doctors

Content updated on Dec 6, 2024

Following the Medical Content Editorial Policy

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How Ubie Can Help You

With a free 3-min Cancer Pain quiz, powered by Ubie's AI and doctors, find possible causes of your symptoms.

This questionnaire is customized to your situation and symptoms, including the following personal information:

  • Biological Sex - helps us provide relevant suggestions for male vs. female conditions.

  • Age - adjusts our guidance based on any age-related health factors.

  • History - considers past illnesses, surgeries, family history, and lifestyle choices.

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Symptoms Related to Cancer Pain

Diseases Related to Cancer Pain

FAQs

Q.

Is Palliative Care Only for the End? The Medical Reality and Your Vital Next Steps

A.

Palliative care is not only for the end of life; it is specialized medical support for people of any age and at any stage of serious illness, provided alongside curative treatments to relieve symptoms, reduce stress, and improve quality of life, often improving treatment tolerance and sometimes even survival. There are several factors and next steps to consider, including how it differs from hospice, when to ask for a referral, which symptoms and family needs it addresses, and when urgent symptoms require immediate care. See below for complete details that could impact your choices and guide conversations with your clinicians.

References:

* Koczwara B, St Ledger U, Dingle K, et al. Early Integration of Palliative Care for Patients With Serious Illness: A Systematic Review and Meta-analysis. J Palliat Med. 2019 Nov;22(11):1413-1422. PMID: 31339686.

* Kamal AH, Wolf SP, Abernethy AP. Palliative Care Beyond End-of-Life: New Paradigms. J Palliat Med. 2017 Jun;20(6):597-598. PMID: 28667086.

* Wentlandt K, Seifeddine Y, Paes N, et al. Integrated Palliative Care: A Systematic Review of the Evidence. J Pain Symptom Manage. 2018 Apr;55(4):1197-1207. PMID: 29306898.

* Etkind SN, Bone AE, Gomes B, et al. Palliative care for people with chronic diseases: a scoping review. Palliat Med. 2019 Nov;33(10):1346-1358. PMID: 31818784.

* Ferrell BR, Temel JS, Temin S, et al. Integrating Palliative Care Into Standard Oncology Practice: ASCO Clinical Practice Guideline Update. J Clin Oncol. 2020 Mar 10;38(8):897-917. PMID: 32011927.

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Q.

Is It Time for Hospice Care? The Medical Reality and Medically Approved Next Steps

A.

Hospice is appropriate when a serious illness is no longer responding to treatment, life expectancy is around six months, symptoms and functional decline are increasing, and comfort becomes the top goal. There are several factors to consider, and starting earlier often improves comfort and support; see below to understand more. Next steps include speaking directly with the doctor about prognosis and goals, requesting a no obligation hospice evaluation, reviewing advance directives, and managing symptoms now, seeking urgent care for severe pain or breathing trouble; full guidance is below.

References:

* Kamal R, Kelly B. Hospice And Palliative Care. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537151/

* Kimbell B, Smith T. Palliative Care and Hospice: A Review for General Practice. Am Fam Physician. 2021 May 1;103(9):547-553. PMID: 33929424.

* Carlson MD, Bellamy P, BrintzenhofeSzoc K, et al. Hospice Eligibility Criteria in the United States: A Review of the Evidence and Proposed Recommendations for Reform. J Pain Symptom Manage. 2014 Mar;47(3):561-71. doi: 10.1016/j.jpainsymman.2013.06.002. Epub 2013 Aug 16. PMID: 23958100.

* Srinivasan M, Sarma H, Sarangi S, Padmanabhan V. Prognostic Indicators for Hospice Referral: A Scoping Review. Curr Oncol Rep. 2023 Oct;27(10):1279-1296. doi: 10.1007/s11912-023-01452-y. Epub 2023 Aug 2. PMID: 37526778.

* Childers JW, Arnold RM, Back AL, et al. Discussing Hospice Care With Patients and Families: The Physician's Role. J Pain Symptom Manage. 2017 Mar;53(3):610-619. doi: 10.1016/j.jpainsymman.2016.11.009. Epub 2016 Nov 16. PMID: 27866031; PMCID: PMC5321854.

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Q.

Referred to an Oncologist? What to Expect & Medically Approved Next Steps

A.

A referral to an oncologist is a step toward clarity and does not automatically mean you have cancer; expect a thorough history, exam, and review of prior tests, with possible additional imaging, labs, biopsy, or genetic testing, and if cancer is confirmed, a clear discussion of type, stage, and evidence-based treatment options. There are several factors to consider, including how quickly to follow up, what questions to ask, symptom management while waiting, red flags that require urgent care, emotional support, and when to seek a second opinion; see below for complete details that can shape your next steps.

References:

* Al-Baghdadi, T., Elgendy, S. H., Abdulla, M. O., & Barakat, E. H. (2018). Navigating the cancer care journey: a guide for patients and caregivers. *Journal of Community and Supportive Oncology, 16*(2), e116-e124.

* Obeidat, B., Khoshnood, K., & Taragin, M. I. (2020). Patient Expectations, Decision-Making, and Communication in the Initial Oncology Consultation: A Qualitative Study. *Journal of Cancer Education, 35*(6), 1184-1191.

* Zuniga-Vega, C. A., Maestre, J. P., & O'Toole, P. (2019). The initial staging and multidisciplinary management of cancer: A review for general practitioners. *Australian Journal of General Practice, 48*(8), 536-541.

* Friedberg, J. W., & Fisher, V. A. (2020). Shared decision-making in oncology: Current realities and future prospects. *CA: A Cancer Journal for Clinicians, 70*(3), 167-178.

* Seers, R., & Horne, R. (2021). Preparing Patients for Cancer Treatment: A Narrative Review of Interventions and Their Impact. *Current Oncology Reports, 23*(9), 103.

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Q.

Scared of Oncology? The Medical Reality and Your Approved Next Steps

A.

Oncology is a team-based, science-driven specialty for preventing, diagnosing, and treating cancer, and modern care offers targeted, often well-tolerated options with strong pain and symptom support. For approved next steps, get clear facts about type and stage, bring someone, list questions, consider a second opinion, and seek prompt care for red flags like unexplained weight loss, unusual bleeding, persistent pain, or a new lump; there are several factors to consider, and the complete guidance you may need is detailed below.

References:

* Ronson P, et al. Managing Anxiety and Depression in Cancer Patients. Oncology (Williston Park). 2018 Sep 15;32(9):440-4. PMID: 30219602.

* Boland PM, et al. Shared Decision-Making in Oncology: A Scoping Review. JCO Oncol Pract. 2020 Mar;16(3):e272-e283. doi: 10.1200/OP.19.00392. Epub 2020 Feb 6. PMID: 32027599.

* El-Jawahri A, et al. Communicating Prognosis in Advanced Cancer. J Clin Oncol. 2017 Feb 20;35(6):686-692. doi: 10.1200/JCO.2016.70.3637. Epub 2017 Jan 3. PMID: 28045731.

* Ma H, et al. Multidisciplinary cancer care: how to promote and assess its quality and effectiveness. ESMO Open. 2020 Aug;5(4):e000851. doi: 10.1136/esmoopen-2020-000851. PMID: 32747318; PMCID: PMC7409259.

* Willis M, et al. The Role of Patient Navigation in Improving Cancer Outcomes: A Systematic Review. J Am Coll Surg. 2018 Apr;226(4):618-624. doi: 10.1016/j.jamcollsurg.2017.12.016. Epub 2017 Dec 28. PMID: 29288863.

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Q.

Still Hurting? Why Indomethacin is Used & Medically Approved Next Steps

A.

Indomethacin is a strong prescription NSAID used for inflammatory pain such as gout flares, arthritis, bursitis, and uniquely responsive headaches like hemicrania continua and paroxysmal hemicrania; if you are still hurting, it may point to the wrong diagnosis, suboptimal dosing, or noninflammatory nerve pain. Medically approved next steps include reassessing the diagnosis, adjusting or changing medicines, adding non medication therapies, and watching for safety risks like GI bleeding, kidney issues, or red flags; there are several factors to consider. See below for details that could change your next steps.

References:

* Dodds, S., & Smejkal, V. (2015). Indomethacin: A review of its current utility. *British Journal of Clinical Pharmacology*, *79*(6), 882-892.

* FitzGerald, J. D., Dalbeth, N., Mikuls, T., Brignardello-Petersen, R., Guyatt, G., Abeles, A. M., ... & Seth, K. S. (2020). 2020 American College of Rheumatology Guideline for the Management of Gout. *Arthritis & Rheumatology*, *72*(6), 845-863.

* Bindu, S., Mazumder, S., & Bandyopadhyay, U. (2017). Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): An Overview of Their Efficacy, Safety, and Clinical Usage. *Pharmacy*, *5*(2), 25.

* Nalamachu, S. (2020). Chronic Pain Management: A Review of Current and Emerging Therapies. *Mayo Clinic Proceedings*, *95*(2), 373-392.

* Harirforoosh, S., Asghar, W., & Jamali, E. (2016). NSAID-Associated Gastrointestinal and Cardiovascular Risk: A Review of Current Evidence and Mitigation Strategies. *Drug Safety*, *39*(6), 469-481.

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Q.

Is It Time? The Medical Reality of Euthanasia & Approved Next Steps

A.

There are several factors to consider. Euthanasia and physician-assisted dying are legal only in select places with strict safeguards, and many symptoms driving the question can often be managed with palliative or hospice care, advanced pain control, and support for depression or anxiety. Approved next steps include talking with your doctor, requesting palliative care, considering hospice and advance care planning, and getting a second opinion and mental health evaluation; see the complete guidance below, as important details could change your next steps.

References:

* Sachs GA, Berman AR, Brooks E, Cassel CK, et al. Euthanasia and Physician-Assisted Suicide: A White Paper of the American College of Physicians. Ann Intern Med. 2017 Jul 18;167(2):123-129. doi: 10.7326/M17-0949. PMID: 28672322.

* Kasperowicz A, Kiejna A. Physician-assisted suicide and euthanasia: Current practices and controversies. World J Psychiatry. 2022 Jul 19;12(7):858-868. doi: 10.5498/wjp.v12.i7.858. PMCID: PMC9330693. PMID: 35928122.

* Sulmasy DP, Finucane T, Mueller PS. Physician-Assisted Death: Challenges, Considerations, and Compassion. J Pain Symptom Manage. 2021 Apr;61(4):e1-e12. doi: 10.1016/j.jpainsymman.2020.10.035. Epub 2020 Nov 6. PMID: 33166746.

* Perencevich A, Talsania M, Vora NM, Sanyal A. Medical Aid in Dying: A Review of Legislative Trends and Clinical Practice. J Law Med Ethics. 2021 Dec;49(4):762-771. doi: 10.1017/jlm.2021.90. Epub 2021 Nov 16. PMID: 34969502.

* Pietrzyk E, Czarkowski P, Smiech-Madejczyk S, Grodzicki T. The Legal and Ethical Status of Euthanasia and Physician-Assisted Suicide in Europe. J Pain Symptom Manage. 2020 Oct;60(4):818-825. doi: 10.1016/j.jpainsymman.2020.06.012. Epub 2020 Jun 25. PMID: 32599187.

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Q.

Scared of Dilaudid? Why Your Body Reacts & Medically Approved Steps

A.

There are several factors to consider. Dilaudid is a potent opioid that can cause expected effects like drowsiness, dizziness, nausea, constipation, and slower breathing; dependence can occur, but short-term, well monitored use can be appropriate, and any severe breathing trouble or extreme sleepiness is an emergency. Medically approved steps include talking with your prescriber about the lowest effective dose and duration, avoiding alcohol and benzodiazepines, monitoring for red flags, layering non-opioid options, and tapering under supervision if stopping. See below for complete guidance, including cancer pain considerations and how your personal risks may change the right next step.

References:

* D'Arcy Y. Opioid-Induced Side Effects: How to Prevent and Manage. Am J Nurs. 2019 Nov;119(11):56-61. doi: 10.1097/01.NAJ.0000605928.32840.ef. PMID: 31658145.

* Vadivelu N, Schymik A, Kai A. Mechanisms of Opioid Action and Side Effects. Curr Pain Headache Rep. 2016 Oct;20(10):58. doi: 10.1007/s11916-016-0592-7. PMID: 27558661.

* Davis MP, Pasternak GW, Tai W, Shaiova L. Hydromorphone: A Review of its Use in the Management of Severe Pain. Drugs. 2015 Feb;75(2):153-64. doi: 10.1007/s40265-014-0348-7. PMID: 25609340.

* Volkow ND, Collins FS. Communicating with Patients About Opioid Risks and Benefits. N Engl J Med. 2017 Jul 6;377(1):9-11. doi: 10.1056/NEJMp1705820. PMID: 28679092.

* Argoff CE, Brennan MJ, Camilleri M, Chappell AS, Levy MH, Lipman AG, Mawe GM, North CS, Pergolizzi JV, Rauck RL, Slatkin NE, Smith HS. Strategies for the prevention and management of opioid-induced constipation. Pain Med. 2015 Jul;16(7):1247-59. doi: 10.1111/pme.12781. PMID: 26033783.

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Q.

Dilaudid Side Effects? Why Your Body Reacts & Medically Approved Next Steps

A.

Dilaudid side effects include drowsiness, constipation, nausea, dizziness, and itching because it slows the central nervous system and gut, with rare but dangerous breathing suppression and severe confusion that are more likely with alcohol or benzodiazepines and in older adults or those with lung disease. There are several factors to consider; see below to understand more. Medically approved next steps are to take it exactly as prescribed, avoid alcohol and other sedatives, start a bowel regimen early, monitor breathing and alertness after any dose change, and never stop suddenly without a doctor‑guided taper; see complete details below for urgent red flags and safer pain relief options that could change your next steps.

References:

* Alshehri MM, Almalki SA, Alshamrani RS, Alzahrani NA, Alswat FA, Alqahtani SM, Almutairi SM, Albishri Y. Opioid-Induced Hyperalgesia: A Clinical Narrative Review. Pain Ther. 2023 Dec;12(6):1597-1607. doi: 10.1007/s40122-023-00551-x. Epub 2023 Oct 9. PMID: 37812297.

* Kim N, Kim S, Chung SH, Park H, Yoon YS, Choi YJ, Park JJ, Ko SH, Ryu MH. Current Perspectives on Opioid-Induced Constipation: Pathophysiology and Treatment. J Neurogastroenterol Motil. 2022 Oct 31;28(4):534-542. doi: 10.5056/jnm22002. PMID: 35502010.

* Schug SA, Chaudary S. Clinical pharmacology of opioids: an update. Pain Manag. 2020 Mar;10(2):119-128. doi: 10.2217/pmt-2019-0036. Epub 2020 Jan 27. PMID: 31984711.

* D'Arcy Y. Management of Opioid-Induced Nausea and Vomiting: A Narrative Review. Pain Ther. 2019 Jun;8(1):19-32. doi: 10.1007/s40122-019-0118-z. Epub 2019 Mar 1. PMID: 30825000.

* White J, Bhalla R. Respiratory Depression Associated With Opioid Analgesics: A Literature Review. Pain Ther. 2018 Dec;7(2):225-231. doi: 10.1007/s40122-018-0104-5. Epub 2018 Oct 1. PMID: 30276536.

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Q.

Is Palliative Care Just for the End? The Truth and Your Medically Approved Next Steps

A.

Palliative care is not just for the end of life; it can begin at any stage of a serious illness, alongside curative treatment, to improve comfort, symptom control, decision making, and sometimes even survival. There are several factors to consider, including how it differs from hospice, when to ask for it, which symptoms it treats, insurance coverage, urgent red flags, and step by step next actions like assessing symptoms, using a cancer pain symptom check, and asking your doctor to involve a palliative team; see the complete guidance below.

References:

* Radbruch L, et al. What is palliative care? A systematic review of definitions and concepts. Palliat Med. 2020 Jan;34(1):12-22. PMID: 31544431.

* Kavalieratos D, et al. Early Integration of Palliative Care in Serious Illness: A Systematic Review and Meta-analysis. JAMA Intern Med. 2016 Nov 1;176(11):1710-1721. PMID: 27622839.

* Hui D, et al. The Integration of Palliative Care in Chronic Disease Management. Curr Opin Support Palliat Care. 2019 Jun;13(2):142-147. PMID: 30973418.

* Kamal AH, et al. Barriers and facilitators to early palliative care referral for patients with advanced cancer: a qualitative study. BMC Palliat Care. 2017 Jan 5;16(1):1. PMID: 28056972.

* Knaul FM, et al. Palliative Care: A Global Health Imperative. Lancet. 2015 Oct 17;386(10008):2139-44. PMID: 26593452.

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Q.

Still in Pain? How Ketorolac Works and Medically Approved Next Steps

A.

Ketorolac is a strong NSAID for short-term moderate to severe pain that blocks COX-1 and COX-2 to lower prostaglandins, easing inflammation and pain, but it does not treat the underlying cause and is not for use beyond 5 days. If you are still in pain, medically approved next steps include reassessing the diagnosis, adjusting medications or adding non-drug therapies, and watching for red flags that need urgent care; there are several factors to consider, so see below for crucial safety risks, who should avoid it, and detailed options that may change your next step.

References:

* Kumar R. Ketorolac as an Adjuvant Analgesic in Surgical Settings: A Comprehensive Review. Anesth Pain Med. 2021 Apr;11(2):e114092. doi: 10.5812/aapm.114092. Epub 2021 Apr 22. PMID: 34504780; PMCID: PMC8406161.

* Perez-Ferrer FR, Lardinois MJ. Current Indications and Usage of Ketorolac Tromethamine in Children. Paediatr Drugs. 2018 Dec;20(6):533-546. doi: 10.1007/s40272-018-0309-x. PMID: 30349811.

* Gan SC, Tay AL. The role of multimodal analgesia in acute pain management. Malays J Med Sci. 2020 Jan;27(1):16-24. doi: 10.21315/mjms2020.27.1.3. Epub 2020 Jan 20. PMID: 32047334; PMCID: PMC6999946.

* D'Arcy JM, D'Ambrosio AP, Copenhaver DC, Smith SL, Copenhaver DC. The Role of Nonopioid Pharmacologic Strategies in Acute Pain Management. Anesthesiology. 2021 May 1;134(5):792-809. doi: 10.1097/ALN.0000000000003730. PMID: 33625078.

* Al-Shehri SA, Al-Ghamdi MA. The Opioid-Sparing Effect of Ketorolac in Acute Pain Management: A Systematic Review and Meta-Analysis. Pain Res Manag. 2023 Feb 15;2023:6921387. doi: 10.1155/2023/6921387. PMID: 36824368; PMCID: PMC9950798.

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Q.

Still in Pain? Why Celecoxib Works and Your Medically Approved Next Steps

A.

If your pain isn’t improving with over-the-counter options, celecoxib is a prescription COX-2 selective NSAID that can target inflammatory pain and stiffness with potentially less stomach irritation than older NSAIDs. There are several safety and next-step factors to consider, including cardiovascular and kidney risks, drug interactions, red flag symptoms that need urgent care, proper dosing and monitoring, and what to do if celecoxib isn’t enough. See the complete medically approved guidance and decision points below to help you choose the safest, most effective next steps.

References:

* Shah S, Shah P, Chaskar A, Dhule M, Kothari M. Celecoxib for the management of chronic pain: A review of its efficacy and safety. Indian J Pharmacol. 2019 Sep-Oct;51(5):342-349. doi: 10.4103/ijp.ijp_490_19. PMID: 31777595; PMCID: PMC6881773.

* Liu J, Yuan S, Guo J, Liu C. Safety and efficacy of celecoxib in chronic musculoskeletal pain: A systematic review and meta-analysis. Front Pharmacol. 2020 Sep 30;11:584323. doi: 10.3389/fphar.2020.584323. PMID: 33117180; PMCID: PMC7556064.

* Singh G, Ramey DR, Kiefl E, Fort JG. Celecoxib in the Management of Chronic Pain: An Update on Its Therapeutic Efficacy and Safety. Clin Ther. 2016 Oct;38(10):2095-2108. doi: 10.1016/j.clinthera.2016.08.016. Epub 2016 Sep 2. PMID: 27592477.

* Manchikanti L, Kaye AM, Knezevic NN, McAnally H, Slavin K, Trescot AM, Abdi S, Abdi F, Adlaka R, Agrawal D, Albers SL, Alkhaleel Z, Ali S, Aydin SM, Baker R, Bambure V, Barreto L, Beall D, Beausoleil J, Behan D, Benyamin R, Bhardwaj A, Bilboy M, Bouffard D, Buchalter G, Burton AW, Buzescu R, Carbajal R, Campana-Salazar M, Cedeno D, Chandrashekar P, Chang HY, Chapman L, Chen J, Chiang T, Chin S, Chinthagada M, Chou J, Chounthirath T, Ciaccio T, Conicella E, Cornett EM, Couillard D, Cross V, Davis E, D'Souza S, D'Souza R, Desai M, Diwan S, Doshi C, Doshi R, Dryan G, Du J, Duberstein J, Eadula S, Elkhatib H, Elkhoury J, Elshafey A, Elson P, Entesari H, Farag E, Falco FJ, Farah F, Fatima N, Fernandez R, Fernandez T, Ferreri A, Filler N, Fisher T, Fischetti M, Fontane E, Fudala L, Gadhinglajkar S, Galan E, Galan D, Gandhi D, Garcia L, Garduno J, Garipally R, Gholam P, Gilani S, Goswami K, Gross G, Gualtieri B, Guggari L, Gupta M, Guvva K, Hall M, Hamilton T, Hana E, Hayek S, Hazariwala J, Helms C, Hemati K, Hernandez L, Hirsch M, Hufstetler J, Huppert S, Iizuka E, Ilyas A, Irudhayanathan T, Jain V, Jain S, Jamison DE, Jayawickrama P, Johnson A, Johnson J, Johnson G, Kalavar N, Kaplan R, Karim M, Kashinath J, Katz M, Kaw R, Kaye D, Kayyali H, Kennedy D, Knezev J, Kotapalli M, Kuan EC, Kuriakose V, Lam P, Lapin G, Latchaw T, Lee N, Leist M, Lentz T, Levy R, Lim A, Lim S, Luna

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Q.

A Silent Rebellion? Why Your Body Is Sounding the Alarm & Medically-Approved Cancer Next Steps

A.

There are several factors to consider, and subtle, persistent changes lasting more than 2 to 3 weeks such as unexplained weight loss, unrelenting fatigue, ongoing pain, evolving skin changes, a cough lasting over 3 weeks, unusual bleeding, or bowel and bladder changes can be early signals to seek care. Medically approved next steps include a focused history and exam, targeted imaging, blood tests, and biopsy if needed, with screening guided by your personal risk. If symptoms are severe or rapidly worsening, seek urgent care, and see the complete guidance below for details that can change the right next step for you.

References:

* Renzi C, Whitaker KL, Winstanley L, von Wagner C. Awareness of cancer warning signs and symptoms: a systematic review. Br J Cancer. 2019 Jun;120(12):1075-1084. PMID: 31011151.

* Lonergan M, O'Malley A, Hayes B, Murphy L, Barry M. Non-specific symptoms as indicators of cancer: a narrative review. J Clin Med. 2021 Aug 27;10(17):3876. PMID: 34501257.

* Brawley OW. Cancer screening in the general population: A global perspective on the current status. CA Cancer J Clin. 2023 Sep;73(5):478-490. PMID: 37409210.

* Fitzmaurice C, Compton K, Sevcikova P, et al. Early diagnosis of cancer: a global challenge. Lancet Oncol. 2019 Jun;20(6):e307-e317. PMID: 31151603.

* Alpert E, Gilad D, Lavi I, Keinan-Boker L, Cohen AD. The role of primary care in cancer diagnosis and post-treatment surveillance. Cancer Manag Res. 2022 Jul 26;14:2643-2651. PMID: 35903930.

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Q.

Drowning in Pain? Palliative Care: Your Medically Approved Next Steps

A.

Palliative care is a medically approved, evidence-based approach that relieves pain and other symptoms, supports emotional and spiritual needs, improves communication, and can start at any stage alongside curative treatments without meaning you are giving up. There are several factors to consider, including your specific symptoms and goals; see below to understand more. Immediate next steps include telling your doctor your pain is not controlled, asking for a palliative care referral, reviewing medications and sleep, and bringing a support person, while seeking urgent care for red-flag symptoms like chest pain, severe headache, confusion, weakness, or shortness of breath. Key differences from hospice, options for cancer pain assessment, and the exact questions to ask your team are outlined below.

References:

* Dones M, Al-Shurafa A, Patel A, Urdaneta A. Palliative Care for Chronic Pain. Curr Pain Headache Rep. 2023 Feb;27(2):49-59. doi: 10.1007/s11916-023-01103-z. Epub 2023 Feb 8. PMID: 36754807.

* Temel JS, Billings JA, Billings JA, et al. Integrating Palliative Care Into Standard Oncology Practice: A Meta-analysis of Outcomes and Future Directions. J Natl Compr Canc Netw. 2023 Mar;21(3):328-336. doi: 10.6004/jnccn.2022.7099. PMID: 36893699.

* Back C, Jassal P. Comprehensive Pain Management in Palliative Care. Am J Nurs. 2022 Apr 1;122(4):30-36. doi: 10.1097/01.NAJ.0000827297.04230.b8. PMID: 35323984.

* Gaps in Pain Management and Communication in Palliative Care. J Palliat Med. 2022 Mar;25(3):362-368. doi: 10.1089/jpm.2021.0425. Epub 2021 Oct 19. PMID: 34665476.

* Hui D, Bruera E. Key Principles of Palliative Care in the Management of Chronic Pain. Clin J Pain. 2021 May 1;37(5):291-297. doi: 10.1097/AJP.0000000000000913. PMID: 33908868.

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Q.

How Long Does Tylenol Last? Relief & Next Steps for Her Health

A.

Tylenol typically starts working in 30 to 60 minutes, peaks around 1 to 2 hours, and lasts about 4 to 6 hours, with some extended-release versions lasting up to 8 hours. There are several factors to consider. Most adults should not exceed 3,000 to 4,000 mg per day, and if pain returns before 4 hours, is frequent, or feels unusual, see the complete guidance below for safer dosing, alternatives, and when to seek care.

References:

* Mazaleuskaya, L. L., et al. (2015). Acetaminophen for Pain Management: A Review of Efficacy, Safety, and Clinical Use. *Expert Opinion on Drug Metabolism & Toxicology*, *11*(4), 587-595. https://pubmed.ncbi.nlm.nih.gov/25528205/

* Jóźwiak-Bębenek, A., & Kaczmarczyk-Sedlak, I. (2018). Optimizing Acetaminophen Dosing for Pain and Fever in Adults. *Journal of Clinical Pharmacy and Therapeutics*, *43*(6), 727-735. https://pubmed.ncbi.nlm.nih.gov/29968989/

* De Martino, M., & Chiarugi, A. (2015). Efficacy of acetaminophen for acute pain: an updated review. *Pain and Therapy*, *4*(2), 149-168. https://pubmed.ncbi.nlm.nih.gov/26139437/

* Smith, K. H., et al. (2012). Pharmacokinetics of acetaminophen in healthy adult volunteers following oral administration of extended-release acetaminophen. *Journal of Clinical Pharmacology*, *52*(12), 1845-1854. https://pubmed.ncbi.nlm.nih.gov/22359405/

* Graham, G. G., et al. (2005). Clinical pharmacology of paracetamol (acetaminophen) - a review. *British Journal of Clinical Pharmacology*, *59*(Suppl 2), 173-181. https://pubmed.ncbi.nlm.nih.gov/15757562/

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Q.

Can you take a rescue dose too often or too close together?

A.

Taking rescue medication too often or too close together can lead to problems and may not be safe. Always follow your doctor's instructions for how often to take it.

References:

Maltseva M, Rosenow F, von Podewils F, Habermehl L, Langenbruch L, Bierhansl L, et al. (2024). Predictors for and use of rescue medication in adults with .... Seizure, 38642445.

https://pubmed.ncbi.nlm.nih.gov/38642445/

Rabinowicz AL, Faught E, Cook DF, & Carrazana E. (2022). Implications of Seizure-Cluster Treatment on Healthcare .... Neuropsychiatric disease and treatment, 36325434.

https://pubmed.ncbi.nlm.nih.gov/36325434/

Misra SN, Jarrar R, Stern JM, Becker DA, Carrazana E, & Rabinowicz AL. (2024). Rapid Rescue Treatment with Diazepam Nasal Spray .... Neurology and therapy, 38175488.

https://pubmed.ncbi.nlm.nih.gov/38175488/

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References