Terminal Lung Cancer Pain Management

2 weeks ago my father was diagnosed to have lul bronchogenic carcinoma with liver mets, stage 4.  He was given tramadol for his pains and he has round the clock oxygen.  Every time the pain attacks it usually lasted 15-30 minutes.  He has breathing difficulty.  The scene is very traumatic for us.  What measures can we do, to at least ease his pains and make him as comfortable as possible as he nears his end.  I love my father so much. Please help.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
I am sorry to hear of this situation.
Pain can be managed effectively using a variety of drugs. The most effective ones are tramadol, morphine, and fentanyl patches.
If he has focal pain, a short course of radiation will reduce pain. Bony pain due to metastatic cancer sometimes responds to zoledronic acid injections.
Please consult your team of oncologists, including the pain specialist, to ensure that your father does not suffer needlessly.
All the very best. Be strong. God Bless!