(Please note that the following was written for oncology professionals and general practitioners.  If you are a cancer patient or survivor, please comment and ask any clarifying questions.)

A diagnosis of cancer can be devastating, especially if it brings with it the fear that cancer automatically means pain, yet in most patient's pain can be effectively controlled.   Pain control and alertness are not mutually exclusive.  It is entirely possible to be pain-free AND alert. For effective pain management an there are three basic things which must be done.

1. Assessment is the most important. Initial Pain Assessment is essential, because it identifies the TYPES of pain being experienced. There are eight different types of pain and only two of them are fully opioids responsive, three are semi-responsive and three are usually opioid resistant.  Most patients have more than one pain. Indeed, one third of patients have four pains or more. Before medications are prescribed, we need to know which types of pain are being experienced, so that the appropriate medications can be prescribed.  
2. Titration  - adjusting the dosage of medication, which can mean an increase or a decrease, to achieve pain relief with minimum or no side effects. Once the medications are prescribed, the dosage has to be carefully adjusted until the pain is under control. If the patient has three types of pain, they may need three types of medications, which will need to be adjusted individually until each pain is brought under control. Some medications can be titrated fairly quickly. Others may take several weeks to titrate. The patients need to be able to differentiate between the different types of pain so that they will know which medication to take.
   

   
   
3. Regular and frequent monitoring. Pain is dynamic - it increases, it decreases and it changes in nature. The medications may need to be adjusted accordingly.

 Pain Can and SHOULD be controlled. There is nothing to fear but fear itself.