In a patient, squamous cell carcinoma with metastasis in the region of S1 S3. What can be the solution for the treatment of pain in the leg, the sacrum in the back.
Pain may be moderate to severe . Usually cancer patients in metastasis their pain will be controlled with Voveran and due to pain thresh hold - Inj. Morphine for 5 days again any other analgesics - Paracetamol / Diazepam will be prescribed . For such drugs will relieve pain temporarily for hours and may have constipation, anorexia and nausea and vomiting like adverse effects. The practical way of easily control pain is I used for nearly 300 cancer patients CAM - Complementary Medicine and Alternative therapies are very useful . A massage can relieve pain - 15 - 30 minutes simple technique massage ( Gentle stroke , Circular motion , Kneading , Rotation) can relive pain for 2 -4 hours without any adverse effects- patient mostly go for sleep during or after massage !. Sometimes the massage can not use directly to the part - do it in opposite part - it improves circulation and if any injured area - it heals fastly. This can be used 4 times a day - can easy to teach care giver / relatives . Touch therapy also can be useful for mild pain.
You are actually dealing with radicular pain from tumor invasion of the roots forming the sacroiliac plexus...!
A rational approach would be to use external beam radiation to the affected area, i.e. the sacrum in that case. The other part of treatment is palliating pain with opioids (fentanyl patches, sublingual or transnasal fast-acting fentanyl for breakthrough pain, etc), drugs specific for neuropathic pain, such as pregabalin or gabapentin, and NSAIDs !
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