Got pain? There’s an app for that.

Posted On: Friday, November 30th, 2018

Guest blog on palliative care and support for caregivers

As palliative and hospice care month winds down, the American Society of Clinical Oncology (ASCO) has posted that there is a new smartphone app for treating pain. The app, ePAL, gives patients nearly instantaneous pain management. In a clinical study of more than 100 patients, the app significantly reduced patients’ pain over standard palliative care. This, by itself, is a major breakthrough.

But palliative care is not just pain management. Palliative care is any care designed to reduce symptoms and stress. Pain is a common symptom of serious maladies. So is anxiety.

The app also reduced patients’ anxiety. More accurately, it stabilized anxiety for patients actually experiencing pain while increasing anxiety for those who were not in significant pain. In what appears to be a contradiction, though, the study also found that patients using the app were less negative (let’s face it, when you are in pain, you are never going to be overly positive about things) about their pain management than those without the app. Speaking as a former cancer caregiver (for my late wife), I can tell you that is a trade I would gladly make.

It is uniquely devastating emotionally to see your spouse sobbing on the floor from pain and lack the tools to do anything to alleviate the pain. For the patient, it is absolute agony.

At the same time, waiting for a doctor to write a prescription, or even call you back, is awful. Every minute matters when your wife is screaming in pain. Even when the pain isn’t that bad, it eats away at you and drives your blood pressure through the roof when you wait for an appointment with the doctor or a call back from the doctor’s office. “When is the doctor going to call back? We need something NOW. Doesn’t he understand how urgent this is,” runs continually through your head. So does, “What can I do? Do I have anything that can help with this?” Then you frantically run to the drug store and buy literally every off the shelf treatment to try to find anything that works on the right pathway. And that is what the caregiver goes through; it is far worse for the patient.

And those calls from the doctor’s office routinely take hours and sometimes days. Appointments are virtually never timely from the perspective of the patient when the pain is uncontrolled. Instead, patients with uncontrolled pain are routinely forced to rush to the emergency room.

And the emergency room is a terrible place to be, especially for cancer patients. Cancer patients have compromised immune systems. And who is in the emergency room? Sick people. This exposes the patient to potentially fatal infections that would not be a big deal if the patient weren’t sick, and any illness makes chemo far, far harder even if it isn’t fatal.

What’s more, many emergency room doctors are reasonably hesitant to treat cancer patients. More than anything else, chemotherapy throws off numerous lab results. For people who do not regularly treat cancer, it is bewildering to know what to do when the blood test shows everything is off. The doctor often is thinking, “I have no idea if this is safe to give this patient this drug, and I don’t want to cause more harm.” So, you often run into the emergency, thereby jeopardizing your loved one’s life, only to receive no effective treatment.

Thus, the trial findings on the efficacy of the app show great promise for improving patients’ and their families’ lives. The trial showed that patients had less pain and had more positive feelings toward their pain management (even though some had increased anxiety) with the app than without. Patients were also drastically less likely to go to the emergency room to deal with pain.

Being able to promptly and effectively deal with pain is one of the most important elements of cancer care. A number of studies have shown that cancer patients receiving effective palliative care have longer survival. The most recent study showed that lung cancer patient survived almost 20% longer if they had palliative care early on.

20% more life is nothing to sneeze at. Nor is effective pain management. It is awfully hard to want to live when every moment of every day is consumed with agony. Being on top of the pain early and often is a great thing. That’s why we should all be glad there’s an app for that.

Daniell Reiff, founder of Betsy's Team, writes about the need for good palliative careDaniel Reiff has been a coalition member since 2018. He works as an attorney in Minneapolis and is the founder of the non-profit Betsy’s Team, named after Reiff’s late wife, who passed away of colon cancer in 2017. Betsy’s Team helps patients and caregivers make sense of cancer diagnoses and navigate a medical system that can be difficult to understand. The organization pairs cancer patients with advocates who remain up to date on the research into various cancer treatments and provide coaching, educational resources, mentorship, and Christian counseling, helping the patient and caregiver take charge of the patient’s medical care to get the care they want. 

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