Is Leukemia Painful?

Leukemia is considered to be a cancer of the blood cells and bone marrow, as the abnormality causes an increase in the growth of blood cells, particularly the white blood cells, which in time can over power the normal healthy blood cells. This leads to the manifestations of different signs and symptoms. The signs and symptoms of leukemia are dependent on the type of leukemia the person has, as it arises from the loss of normal healthy blood cells due to the overwhelming amount of abnormal immature blood cells.

Signs and symptoms of leukemia include night sweats, fever, and swollen lymph nodes that are oftentimes painless. Feelings of fatigue and tiredness are due to the disease’s effect on the red blood cells. The red blood cells are responsible for transporting the oxygen throughout the body. Due to the disease’s effect on the platelets, there are recurring nosebleeds, easy bleeding, and/or bruising, which appears as a purplish or bluish patch on the skin or tiny red spots on the skin. The immune system becomes impaired; hence, there is an increase in the frequency of infections. Weight loss is also observable. This weight loss seems to be unexplained or is a result of loss of appetite. Commonly, petechiae or red spots on the skin are seen. Lastly, occurrence of bone or joint pain is one of the most common complaints of patients diagnosed with leukemia.

Leukemia is generally associated with joint or bone pain. The presence of bone or joint pains associated with leukemia is brought about by the overcrowding of cancer cells in the bone marrow, since the disease causes a rapid growth and division of blood cells. In many other cases, these cells can also form an abnormal mass near the nerve ending of the spinal cord or at the joints in the body. Oftentimes, the pain felt arises due to certain side effects of the treatments for leukemia, as some pharmacological treatments and radiation therapy have the ability to damage the nerves which can lead to neuropathic pain. About 25% of patients diagnosed with acute lymphocytic leukemia experience bone pain during the early stages of the disease. However, with acute myeloid leukemia, the presence of bone pain is less common. The bone pain felt is mostly present in the long bones of the arms and legs, as well as in the sternum of the rib cage and directly in the ribs. In some cases, following bone pains, there is swelling in the large joints with accompanying joint pain, primarily in the hips and shoulders.

What is pain management?

Pain is physical and real. Managing the pain, irrespective of the cause, is as important as controlling the root cause of it. Pain management can be simple or complex, depending on the pain being felt by the patient. Therefore, it is an advanced branch of medicine that focuses on reducing the pain through an integrated approach. Pain management also improves the quality of life for leukemia patients. This approach is majorly important for cancer patients, as the cancerous growth adversely affects the nerves, bones, and organs. Pain can also result from common treatments like chemotherapy, radiation, and surgery, which are all used to treat cancer.

Pain management is a priority for all the stages of cancer, as it reduces the pain and manages the symptoms to make the patients feel more comfortable. Many techniques and disciplines are used to manage, control, and/or treat cancer-associated pain, such as:

• Prescribed medicines and drugs
• Physical therapy
• Massage therapy
• Nerve block techniques
• Guided imagery technique
• Relaxation therapy
• Auriculotherapy
• Chiropractic therapy
• Implanted pain pumps
• Acupuncture

The team approach involved in pain management for leukemia patients is very critical for excellent prognosis and treatment. Integrative oncology approaches include advanced oncology rehabilitation, naturopathic medicine, and mind-body relaxation therapy. For patients who are hospitalized, comfort rounds are conducted to analyse the relief in pain and plan the further treatment protocol.

Pain Management for Leukemia

The pain management for leukemia is done through a team approach to control pain. Many good practitioners and oncologists recommend an oncology rehabilitation program, which consists of physical therapy, massage, counselling, relaxation techniques, stress management, etc. to reduce the pain by increasing the mobility of the patient. The techniques are highly focused on alleviating the symptoms that are causing pain.

Pain management should be considered as an important part of leukemia treatment, since a patient who is experiencing constant pain may hamper the progression of the treatment. Different management for leukemia may be required due to the discomforts felt by the patient and the mental altering effect of pain. During the entire course of the leukemia treatment, the oncologist, as well as the other members of the medical management team, will look into and anticipate the possible presence of cancer-related pain that may arise and plan different ways to manage it. Pain medications that will be provided are not just aimed at providing pain relief, but also at addressing the discomforts brought about by nausea, drowsiness, and digestive problems, such as constipation, that may arise. The focus is putting a balance between eliminating the cancer cells and controlling the pain, but still maintaining the person’s quality of life.

The goal of pain management is not just alleviating the pain associated with cancer, which is due to the tumor or cancer cells impinging the nerves, bones, or organs, causing significant discomfort, but also the associated pain that can be experienced following certain leukemia treatments, such as radiation therapy, chemotherapy, and surgery. Certain discomforts, called peripheral neuropathy, that will be felt following chemotherapy are as follows: weakness, tingling, and numbness in the arms and hands or the feet and legs. There are several pain interventions that can be employed based on the stage of the cancer, reaction of the patient, and severity of the pain and other symptoms present, such as prescription or pharmacological medications, nerve block therapies, implanted pain pumps, massage therapy, physical therapy, acupuncture and auriculotherapy, chiropractic treatment, as well as relaxation techniques and guided imagery.

Since certain prescription drugs to treat leukemia have side effects that involve pain and discomfort, the doctor will continuously monitor the patient to adjust the dosage and frequency of the medications and/or eliminate or replace it with another medication as the need arises.

Final Thoughts

Leukemia may have many pains and discomforts associated with it and its treatments, but the pain can be managed to provide better quality of life.