ABSTRACT

Background : Cancer has been considered a public health problem and well-known as the
silent killer. One of many problems which really bothers cancer patients is the pain. The pain
management of cancer is still below standard. The most important thing in treating cancer is
to determine the type and level of pain suffered by patients. After that, the treatment will be
done by using three-step analgesic ladder.

Case Presentation : Mrs. A, 67 years old, has had breast cancer and stroke since 2014. Mrs.
A in her treatment is taken care by care giver. Mrs. A now could only lie in bed and
occasionally taught by her care-giver to sit and can only survive a few moments because if
she sits too long, she feel the pain and Mrs. A is fed and drink through a naso-gastric tube
(NGT) and occasionally given to eat and drink through the mouth by spoon-fed by a care
giver, because if Mrs. A moves too much she will feel pain. In addition, Mrs. A is very
sensitive and always respond to something with her tears even though she is laughing, it
happens because the affected organ is central nervous. Mrs. A is also difficult to
communicate with because she can only respond to the conversation of others with a very
weak audio frequency. It has been known since the beginning of the treatment in 2014, Mrs.
A has experienced a better progress.

Disscussion : In palliative care that promote the quality of life for the patient, there are aspect
of the pain management. The pain management is done in order to improve the quality of life
of the patient and also to reduce the suffering of cancer patients, by giving them anti-
inflammatory drug at least the patient could still do easy activities which could not be done
before due to the pain. Generally, the pain management is done based on the level of pain and
the type of pain. So, it is important for the medical staffs to understand how to give anti-
inflammatory drug properly and appropriately. Sometimes, the medical staffs have given the
anti-inflammatory drugs properly and appropriately, but the patient or the person who takes
care of the patient did not follow the rules recommended by the medical staffs, just by giving
or consuming the anti-inflammatory drugs only when the patient felt the pain. On some
observations, the pain management of the patient is seen not only from general knowledge,
but also from religious knowledge.

Conclusion : Cancer pain must be dealt adequately in order to reduce the suffering of cancer
patients. In pain treatment or pain management, medical staffs must follow three-step
analgesic ladder which is in giving therapy, medical staffs should pay attention to the level
and type of pain experienced by cancer patients. Besides, medical staffs are also expected to
educate the cancer patients or care giver who takes care of the patients in taking the anti-
inflammatory drugs properly so that the patients can avoid overdose and drug resistance.

Keyword : cancer, pain managemet, cancer pain, palliative care