Missed edit window. I want to make clear that in the above post was I referring VERY specifically to post-surgical pain. I just reread the OP and it is referring to malignant pain, which is entirely different.
I had a partner that died of terminal cancer. We were very lucky in that he was a personal friend of his oncologist. He got very good and very effective pain medication. I have since known other people with the the same terminal illness. Sometimes I give them a recommendation on pain management ( ask your doctor about x and y ) based on what he got. And the doctors usually refuse, citing the potential for addiction. Which is ridiculous when you have 6 months to live.
Conversely, my mother’s latest hospital stay was for small-intestine surgery; the hospital is the one where Dad used to be the Purchasing Manager. Even those members of the personnel who we wouldn’t call “friends”, we know each other well enough that we can talk in terms that would be considered positively rude among strangers; they don’t try to sugarcoat things and we don’t worry about hurting anybody’s feelings if we ask a question. If she hadn’t had a previous history of addiction to opioids, she would have been prescribed a small dose, precisely to keep things from moving too much in the first few days after the surgery.
Something like “pain management”, which affects all branches of medicine, is going to always be complex: we don’t expect the same solution to work for a flu as for an apendicitis, but we often do not realize that the associated pain will also need different treatments.
Yeah - steroids are frequently used for various types of cancer. My mother in law was on a year-long oral chemo regimen for multiple myeloma. In addition to thalidomide and one other, she was given dexamethasone (which I believe ls longer-acting than prednisone).
It’s a tradeoff of course. I’m not overly familiar with how it affects wound healing - it does tend to thin the skin and make you bruise more, as well as playing hell with your blood sugar. Presumably the benefits outweigh those side effects.
To the best of my knowledge, she was not tapered when it was all over with. While “a year” is quite different from “a couple of weeks” (as an asthmatic I’m quite familiar with the latter), my understanding is that tapering is no longer routine for those shorter courses.
The care the OP’s friend received prior to being moved to oncology is insane. Please make sure she (and her regular doctor(s)) write a LOT of letters about it. The floor she was on may not have been onc, but any medical practitioner should be able to deal with severe acute pain.
Thank you. I’ll urge her to write as you suggest. Her regular doc is a naturopath, so I don’t know how much weight her complaints would carry. (Personally, I would never go to a naturopath, but not my call.)
I hadn’t known how long she was going to be on it. She will probably take 100mg daily for 5 days in each cycle; I’ve seen other dosing regimens used, and this probably depends on the patient.