March 11, 2012 1:16:13 AM WATime
Hi Adele
Yes, these are quite high levels of pain medication, but dosage is very individual to each person and situation. Many people worry about possible addiction, however the main aspect with administering pain medication is to control the pain sufficiently. When using these types of medication, most people build up resistance to the drug over time - this is termed 'tolerance'. The dosage may then need to be increased to achieve the same level of pain relief, and this pattern may continue with needing increasingly larger doses, or changing medications until the right balance is achieved to provide adequate relief.
A number of methods may be used to gain pain relief with bone mets, depending upon location and extent of disease. Radiation, chemotherapy & other forms of medication may be beneficial in certain circumstances. Oncologists specialising in these areas determine whether these treatments are likely to be helpful.
Chronic pain is very difficult to bear, and many aspects may lead to the experience of pain being worse for a person. Tiredness, despair, sadness, grief, fear, loneliness, anger, irritability, guilt and depression are all feelings that may intensify pain. Good assessment and management of all these aspects is vital for providing a 'holistic' approach and best possible outcome. Management may need to include specialist psychologists or counsellors to help in these areas.
This type of pain management does need careful monitoring by an experienced team. 'Pain Clinics' and Palliative Care teams are available to provide specialist management. These teams often include doctors, nurses, counsellors, therapists and other support personnel.
In most situations pain can be well managed, and everyone deserves to be as comfortable as possible. The extent of pain is not always reflective of the extent of cancer - it is very individual. I would strongly encourage a thorough assessment of all these factors by a specialist team. You may contact her GP or treating team and request a review, **however your mum's willingness to be involved and to reveal honestly her levels of pain are very important. Many people feel they must not complain or be a nuisance and will 'down-play' their symptoms. Seeking help from a support person such as a breast care nurse (or other cancer support person) is available in most areas. Contact the Cancer Council 131120 for support services in your area. In WA, other free services include Breast Cancer Care WA, providing nurses and counsellors for support (08 9324 3703), the Breast Cancer Clinical Psychology Service provides trained psychologists (08 9224 1629), or in rural areas the Rural Cancer Nurse Coordinator will assist with advice and contacting local supports (Peggy Briggs - 0429 208 625 or via Cancer Council).
It must be so very hard for you and others in your family to see your mum in pain Adele. Please ensure you also seek help for yourself and other family members - it's very important for you all to be able to be strong in supporting your mum and each other. Support services are usually available free to family members as well.
I very much hope some relief for your mum (and yourself) is able to happen soon. Please stay in touch and let us know how things go.
Love Glenys, BCN xx
The Click Breast Care Nurse 
