People with life-threatening conditions may have fears about pain and other symptoms as their disease progresses. These fears may be based on the previous experiences of family and friends when advanced pain and symptom management was unavailable. With recent developments in treatment, pain and other distressing symptoms can be minimized.

Pain
Most pain associated with terminal illnesses can now be adequately controlled through the appropriate use of a variety of pain medications or a combination of medications and non-drug therapies. One barrier to effective pain control is inadequate education of healthcare professionals in the assessment and treatment of pain. Other barriers include the fears patients may have about possible side effects or addiction and the misconception that pain medications, if taken regularly, will lose their benefits.

It is important to accurately report the type and intensity of your pain to your doctor or nurse. Some people are reluctant to disclose their level of discomfort, either because they do not want to complain or because they believe that pain is simply a part of their illness that they must tolerate. However, there is no need to suffer in pain. Side effects of pain medications can generally be anticipated and prevented. Furthermore, efforts to be "strong" by tolerating moderate or high levels of pain are misguided. By delaying taking medication until the pain gets more severe, you may then need higher dosages to achieve adequate pain control. Overall, unrelieved pain has high financial, functional, and emotional costs.

Some people find that complementary therapies such as relaxation, visualization, massage, or acupuncture are helpful in treating pain when used along with pain medication. Talk with your healthcare provider about whether any of these techniques may help you. Also, check your health insurance coverage to determine whether your policy covers these therapies.

Other Distressing Symptoms
Life-threatening illnesses and their treatments often involve symptoms that, if untreated, can cause a great deal of discomfort. Common symptoms include shortness of breath or difficulty breathing; anxiety; depression; weakness; fatigue; altered mental state, such as confusion, difficulty thinking, and sleepiness; constipation; diarrhea; mouth sores; nausea; vomiting; and fears of loneliness, loss of meaning, loss of control, and loss of dignity. These symptoms can affect your quality of life.

It is important to describe any distressing symptoms to your healthcare provider, since most can be controlled with oral medications. As with pain, ask your healthcare provider about complementary therapies as well as medications that may be helpful in managing discomfort and other types of distress.

For other information and resources:
	American Alliance of Cancer Pain Initiatives website: www.aacpi.org
	American Pain Foundation website: www.painfoundation.org
	American Pain Society website: www.ampainsoc.org
	American Academy of Pain Management website: www.aapainmanage.org
	Department of Pain Management and Palliative Care at Beth Israel Medical Center in New York City, NY website: www.stoppain.org
	Massachusetts Pain Initiative website: www.masspaininitiative.org
	PainEDU website: www.painedu.org
	Partners Against Pain website: www.partnersagainstpain.com
	Pain.com website: www.pain.com
	Cancer Doesn't Have to Hurt, by Pamela J. Haylock and Carol P. Curtiss
	Handbook for Mortals, by Joanne Lynn

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