I recently underwent surgery and was unable to move for two days afterward because of the pain. I remember feeling truly relieved when the pain-relief IV gradually took effect and eased the pain, and once again realizing how grateful I was for a life without pain.
That experience led me to attend a public lecture to learn more about managing pain. The lecture focused on ways to cope with cancer-related pain. The speaker was Dr. Kiyohiro Sakai, a physician in the Palliative Care Department at Kurashiki Central Hospital.
He explained in an easy-to-understand way, drawing on his professional knowledge, topics such as medical narcotics, which many people tend to misunderstand, and how to communicate the pain you are experiencing.
When diagnosed with cancer, many people may fear “pain.”
Dr. Sakai says, “I hope you won’t endure the pain in silence or give up on telling your doctor or nurse about your symptoms.”
Here is a report on pain care that can ease pain and help you live your everyday life in your own way.
The information presented was accurate when this article was published in July 2025. Please note that it may differ from current information.
Overview of “Managing Cancer-Related Pain: Appropriate Use of Medical Narcotics”
The lecture was held on Tuesday, June 10, 2025, at the Kokuga Hall in the Kurashiki Central Hospital Preventive Medicine Plaza.
Kurashiki Central Hospital’s Preventive Medicine Plaza was completed in 2019. It aims to serve as a regional disease-prevention hub and offers services such as comprehensive health checkups, exercise classes, and health education classes.
The public lecture series, “Kurachu Medical Gathering,” is held once a month, with physicians from Kurashiki Central Hospital giving talks on illnesses and everyday health measures.
Despite the rain, more than 100 people attended the lecture. Their attentive listening also showed how much interest there was in the topic.
“Please, just make sure I’m not in pain”: What patients wish for
It seems that about one in two Japanese people will develop cancer, and one in three will die from it.
About 70% of cancer patients may experience pain, and some may also experience symptoms such as shortness of breath, nausea, loss of appetite, depression, and anxiety.
And many patients reportedly say, “Please, just make sure I’m not in pain.”
Why do they wish to be free of pain above all else?
- Pain is often the first symptom of cancer to appear and may continue until the end
- They have seen someone close to them suffer from pain
- Pain is a symptom that everyone has experienced
I learned that controlling pain is an important part of treatment.
Controlling pain with multiple painkillers
In medical practice, several medications are combined according to the nature and severity of the pain.
Pain can take many forms, such as “sharp, throbbing pain,” “tingling, numb pain,” “pain that lasts all day,” and “pain that comes on suddenly.” Multiple medications are used in combination to control pain effectively while minimizing side effects as much as possible.
The types of painkillers (generic names) are as follows.
- Non-opioid analgesics
Antipyretic analgesics. They tend to work well for sharp pain. Specific medications include:
Acetaminophen
NSAIDs (nonsteroidal anti-inflammatory drugs): such as loxoprofen - Opioid analgesics
“Opioid” is a general term for substances that, when they enter the body, produce pharmacological effects like those of morphine, a narcotic with a strong pain-relieving effect.
They are divided into “weak opioids” and “strong opioids” according to their strength. Strong opioids are classified as “medical narcotics.” They tend to work well for dull visceral pain. - Adjuvant analgesics
These are mainly used for the prickling, tingling pain caused by nerve damage (neuropathic pain). Some antidepressants, antiepileptic drugs, and steroids are used as adjuvant analgesics.
There are three stages of pain-relief goals for cancer pain (pain caused by cancer).
- First goal: Sleep through the night without pain
- Second goal: Control pain while at rest
- Third goal: Control pain even while moving
Pain is controlled in stages while monitoring for side effects from painkillers.
“Medical narcotics are dangerous” is a misconception
When people hear the word “narcotics,” negative images such as “Are they dangerous?” or “Will I become dependent on them?” often come to mind. Dr. Sakai says these concerns are based on misconceptions.
He answered questions such as the following.
- Will using narcotics shorten my life?
There is no particular medical evidence that appropriate use of medical narcotics shortens life expectancy. - Will I become dependent on the medication?
When used to treat pain under a doctor’s supervision, dependence on medical narcotics is extremely rare—fewer than one in 500 people—if they are used appropriately.
If treatment eliminates the cause of the pain, it may also be possible to reduce or stop using medical narcotics. - Are they only used to treat terminal cancer?
They may be used even in the early stages of cancer treatment if the pain is severe. - Will I be arrested for possessing the medication?
You will not be arrested for possessing medical narcotics prescribed by a doctor.
That said, medical narcotics are not a cure-all. Dr. Sakai also explained some precautions.
- They can cause drowsiness as a side effect, so driving may be restricted
- Care is needed when taking them overseas for travel or business trips
- Laws differ by country, so it is important to check in advance
More than medication: diverse approaches to easing pain
Palliative care is not limited to medication. There are also things patients and their families can do.
These include massage, applying heat or cold, supporting the affected area with a brace, and light exercise or stretching.
Most important of all is not to face it alone.
Anxiety and loneliness can make pain feel worse. Dr. Sakai says that talking with family or friends and immersing yourself in a hobby are also important forms of emotional care and palliative care.
Write a “pain communication note” for better treatment
Dr. Sakai says, “Even if your treatment reaches a difficult stage, please don’t give up on palliative care to ease your symptoms.”
He went on to explain why:
“Patients may hold back from saying what they really think, worrying, ‘If I say what’s on my mind, the doctor might dislike me and stop treating me.’ Meanwhile, doctors tend to interpret ‘If they don’t say anything, there must be no problem’. This disconnect can get in the way of appropriate pain care.”
For this reason, he said, “If you can’t tell your doctor everything you want to during your appointment, write it down in a note and give it to them later.”
You don’t need to overthink what to write. A simple message like one of the following is fine.
- What is troubling you
- What you can no longer do because of the pain
- What you would like to be able to do if the pain were controlled
He has had cases where a note from a patient helped him recognize an underlying issue that could not be identified during the limited time available for an outpatient appointment, leading to better treatment.
For patients, a note is a “good-luck charm to help them remember what they want to say”; for doctors, it is “important information that lets them hear the patient’s inner voice and use it to guide treatment.”
“No doctor will brush you off for handing them a note, so please feel free to write one and give it to them,” Dr. Sakai told us.
Using medication appropriately and hoping to live life on your own terms
I learned a great deal from this lecture about how to face cancer pain and medical narcotics.
I had some misconceptions about “medical narcotics” based on the image the term evokes, but now I feel that, when used appropriately, they are important medications for controlling pain. I also realized that it is important for patients themselves to communicate their pain.
After the lecture, I had a chance to speak with Dr. Sakai. When I asked why he had chosen to specialize in palliative care, he told me:
Dr. Sakai
“Since I was about elementary-school age, I’ve wondered what it means for a person to reach the end of their life, and what the meaning of life is. Everyone who is born eventually comes to the end of their life.
“At that final stage, I want to ease symptoms as much as possible so patients can feel, ‘I’m glad I was born,’ or ‘I’m a little less afraid of reaching the end.’
“I work to provide every treatment and support I can so that people can reach the end of their lives while remaining true to themselves.”
In the future, more and more people are likely to want to spend their final days in a familiar place, living life on their own terms, with their pain eased as much as possible—not only in hospitals but also at home.
This lecture gave me hope that, with healthcare professionals like Dr. Sakai who sincerely engage with each person’s life, patients can live in a way that is true to themselves.
Articles about Kurashiki Central Hospital
Public Lecture: Kurachu Medical Gathering “How to Manage Cancer Pain: Appropriate Use of Medical Narcotics” Information
| Name | Public Lecture: Kurachu Medical Gathering “How to Manage Cancer Pain: Appropriate Use of Medical Narcotics” |
|---|---|
| Date | June 10, 2025 |
| Location | 1-11-11 Tsurugata, Kurashiki City, Okayama Prefecture |
| Admission (tax included) | Free |
| Website | Kurashiki Central Hospital Preventive Medicine Plaza |
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