Varför ska vi förbättra smärtbehandling för patienter med öron-, näs- och hals cancer

Introduction
It is not unusual that patients with Head and Neck Cancer (HNC) often suffer from both tumors and treatment-related pain that is difficult to alleviate. Moreover, when a family member suffers from cancer, there is a risk that their family members’ quality of life will be negatively affected.‍

Method
Twenty-six patients and their relatives were invited to participate in an interview study: after radio-therapy had been completed.‍

Result
Patients in this study communicated different aspects of pain – not merely physical pain – impacted on their experienced well-being. Various pain dimensions - existential, physical, psychological and social - can influence the experience of pain and how it is treated.
The relatives described a challenging situation in supporting the patient because of the patient's experiences of pain. A dark picture of psychological distress, lack of participation of support and care from health care was also reported by relatives.‍

Conclusion
HNC patients demonstrated that they suffered from existential pain as early as in the treatment phase: fear of death, meaninglessness and guilt. Psychological, physical and social pain was also prominent. Caregivers require deeper knowledge in existential matters where sensitivity to and communication with patients is desirable.

Various dimensions of pain in HNC patients were reflected partly as a strenuous support situation and as mental anguish for relatives. To reduce anxiety and suffering of relatives, early assessment and treatment of symptoms, as increased knowledge of relatives in pain management, could be adequate interventions.

Anne Schaller är legitimerad sjuksköterska och doktorand vid Smärtenheten, Universitetssjukhuset i Linköping. Anne Schaller har specialistkompetens inom anestesi-, akut- och ambulanssjukvård och har tjänstgjort inom området klinisk smärtsjukvård seden 2004. Smärtenheten har en konsultverksamhet för inneliggande patienter med cancerrelaterad smärta, postoperativ smärta och akut smärta samt en mottagning för patienter med långvarigt smärttillstånd.

Anne Schallers avhandlingsarbete handlar om att hos patienter som drabbas av öron-, näs- och hals cancer (ÖNHC) utveckla smärtbehandling och rehabilitering för att minimera smärta och bibehålla eller öka livskvalitet och dagliga funktioner. Det är inte ovanligt att cancer behandlingen inkluderar strålbehandling och att ÖNHC patienten drabbas av en omfattande smärtproblematik samt flertalet andra funktionsnedsättningar som under lång tid kan minska deras livskvalitet.