For minor pain: Drugs such as aspirin, paracetamol and codeine may be taken as tablets, oral mixtures, suppositories, patches or injections.
For moderate to severe pain: Morphine can be taken as a tablet, oral mixture, suppository, patch or injection and is commonly used because it is quick acting and long lasting. Its reputation as only a drug for addicts or people who are dying is undeserved.
You do not become addicted to morphine if you are taking it to relieve pain.  Actually, research shows that addiction to morphine among cancer patients is rare.
Morphine can cause sedation and constipation. Laxatives can relieve or prevent constipation. Drowsiness will decrease after the initial doses. Your health care team can help you manage this.
Nerve block: If the cancer affects nerves, or if nothing else is working, a drug such as a local anaesthetic may be injected into the nerve to stop pain signals from reaching the brain.
Chemotherapy, radiotherapy and surgery: These treatments are used against primary cancers but they can also control the symptoms of some advanced cancers (see ‘Considering further treatment?’ in this chapter). Chemotherapy may shrink a cancer that is causing pain in a particular spot. Also, short courses of radiotherapy may relieve symptoms such as headaches and bone pain caused by metastases (secondary cancers). In some cases, surgery may improve the results from chemotherapy and radiotherapy.
Q: If I start vomiting after taking morphine, does that mean I have taken too much?
A: Not necessarily, since morphine often causes nausea, especially the first few times it is taken. A medication to suppress nausea or vomiting such as maxolon or cyclizine, can be prescribed with morphine to alleviate this problem. Ask your health care provider about other options for pain relief if vomiting continues.
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Life, Hope & Reality was developed and written by Afaf Girgis, Claire Johnson, and Sylvie Lambert with funding from the NHMRC and Cancer Council NSW.
Last updated 30 August 2015