Ugh. My mom has been fighting cancer for four years, but lately there’s one spot that just isn’t responding to radiation.
Since she’s in more pain lately than she has been in the past, her doctor is switching her to oxycontin. This feels ominous to me, like it’s the beginning of giving up on treatment options.
Any dopers have any experience with this kind of thing? I know each case is different but I’m kind of freaking out.
Switched her to Oxycontin for pain relief or terminated other treatment options and are now only treating pain?
It’s not giving up, it’s just realizing that the daily pain of the cancer has become worse than the *possibility *that she may get addicted to pain killers. Lesser of two evils.
I’d go with this. My first wife’s mom drank and smoked hard for 50 years before her kids finally wrung her out. She’d been sober and smoke free for 6 months when she went to the ER with abdominal pain, thinkng her apendix was acting up. Turns out her pancreas was gestating a pretty decent tumor. Her oncologist’s instructions were clear: get your affairs in order, and do it quickly. He prescribed oxycontin for the pain and recommended an alcohol injection to destry the affected nerves. Her kids were there with her and the oldest started to object, given her propensity to addiciton. The doctor let him finish and just quietly reassured him he didn’t anticipate there being a protracted relapse in her sobriety. That sort of drove the point home with a sledge hammer.
Cancer’s a bitch. Sometimes you beat it, often you don’t. When you’re not beating it you’re dealing with the symptoms.
Pain can drag a person down. Cancer treatments are harsh. Chemo and radiation both harm the body in an attempt to harm the cancer more. In this situation, pain can weaken the constitution enough tip the balance, so that the treatment, together with the pain, harms the body too much. That’s bad.
Proper pain management is a necessary part of cancer treatment. In the past, fear of addiction kept doctors from prescribing some pain meds until it was obvious that the patient was terminal. This meant that, in addition to patients suffering pain that they didn’t need to suffer, some patients died from just being worn out by the pain. If your Mother’s doctor is making sure that isn’t happening, that’s a good thing.
Many people are prescribed Oxy without being terminal or even having cancer. It’s for pain management and nothing more. Needing it when she didn’t need it before may mean that your Mother’s situation is now worse than it had been, and you’re right to be concerned about that. But she’s not necessarily on a slippery slope just because of the Oxy.
I’m at my desk here trying to keep it together, just…thanks to all of you for the quick replies. You are an awesome group.
IME, cancer docs are pretty straightforward. If the doc was intending to start palliative care rather than treatment, s/he’d have said so.
I think it’s more likely what others have said. For whatever reason, your mom needs a higher level or different kind of pain meds now. It’s a very good thing that she’s getting what she needs.
As was already mentioned, doctors are more generous with pain killers for cancer patients than in the past.
My best friend had a double mastectomy on May 31st together with preparations for reconstruction surgery. She was on morphine pills until last week and is off now, without any symptoms of dependance.
Good luck and good vibes to your Mom.
Oxycontin’s a very useful drug for the pain of malignant cancer. I’ve patients on it both in and out of hospice. It’s much longer-acting than regular oxycodone so is useful in staying ahead of the pain. It’s not at all restricted to patients whose diagnosis is terminal.
I’d suggest a frank talk with Mom about the status of her treatment plan and where she wants to go with it.
First, moejoe, sorry to hear about your mom – hope everything works out. Wishing you and your family peace and strength as you go through this.
Second – medical threads go in IMHO, so I’ll move this there for you.
twickster, MPSIMS moderator
Once upon a time, Oxycontin was only really used for the treatment of chronic pain related to cancer, or for palliative care. Nowadays, it’s about the first thing written for a most patients with seemingly any sort of chronic pain, post-op, etc. It’s a really great drug for a lot of people who wouldn’t be able to function without it, but it’s far from a death sentence. If they were trying for palliative care they would not be very sneaky about it.
Thanks Twickster for moving the thread, and to everyone else who replied with information and good thoughts.
I had a great conversation with mom about my fears and it turns out she’s starting a new kind of treatment soon and they want her strong and pain free for it. Her doctor says there are still a few things to try before they give up and send her home to rest on the veranda. 
She’s 75 so there won’t be any dramatic cure, but it is within the realm of possibility that she can have a few really great years still to go.
So…a round of donuts on me!
Good news for a change. That’s great!
I’m agreeing with this. A friend of mine, who does not have cancer, but has had some severe pain issues and several surgeries trying to sort her out, has been on oxy for a while. The other stuff doesnt really help her get through her day. I don’t know if the doctors are going to change her script out at some point or not, as it seems to me that she has been on it a little too long, but I am not *any *doctor, much less hers.
And moejoe, I am so sorry for what you and your mom are going through. I’m glad the new treatment has potential!
Proper treatment for pain is a good thing. It doesn’t mean you’re at death’s door. I only had a broken shoulder, but nobody (least of all me) liked being woken up in the middle of the night by my sudden screams of pain. It’s embarrassing to wake up that way. Not “manly” at all.
Properly prescribed and managed, opiates are a good thing. And you won’t get addicted if it’s done properly.
ETA: I was prescribed Vicodin. Great stuff, when used properly. The Darvocet once that prescription ran out? Marginal, at best. I woke up screaming much more often in the third week than the first.
Cheshire Human, Darvocet has been withdrawn from the market due to a lousy efficacy/side effect profile - it’s not really much better than plain old acetaminophen. I am sorry for but not surprised by your experience.
Moejoe, thinking of you and your mother.
My sister has lung cancer and has been given oxycontin, but the doctors are still treating the disease and keeping her alive and fighting, so I don’t think t means palliative care necessarily.
Interesting. I don’t recall any side effects, but the lousy efficacy I can certainly attest to. 