Myths and Misconceptions: Medication

In the second of our myths and misconceptions series, we look at common questions and statements related to medications.

You may find yourself prescribed a lot of new (and probably unheard of) medications when diagnosed with cancer. And that’s not taking into account treatment. People may need multiple pills a day, which can cause confusion and low adherence. Additionally, some medications, such as morphine, are stigmatised and can lead to misinformation.

I don’t feel well. I must need antibiotics

Antibiotics are often a source of comfort when fallen ill. At the first sign of a cough or cold, people commonly look to their doctor to prescribe them antibiotics.

Antibiotics kill bacteria, but different antibiotics kill different bacteria. Therefore, taking antibiotics that you were prescribed for contact dermatitis, for example, may not work if you start taking them for a chest infection. Also, antibiotics will not work if your symptoms are not bacterial related.

In the last few years, healthcare professionals are seeing more patients becoming resistant to antibiotics due to overuse. This can be problematic in the cancer setting if you become unwell and need antibiotics; as you may find the bacteria is resistant to the antibiotics you are prescribed.

I don’t want to take morphine because I don’t want to become addicted

Morphine is commonly prescribed in the cancer setting for pain relief. It comes in many forms and can be taken orally, injected into the skin (subcutaneous) or directly into the vein. For patients with advanced cancer, pain can become a significant problem that will affect their quality of life. Morphine and other types of opiates are clinically proven to help alleviate pain, and most importantly, improve functionality associated with pain.

There is a misconception, though, that if you take morphine or any type of opiate you will become addicted. And to a degree this is true; opiates, such as morphine and heroin are abused and often sought for their euphoric “high” effect. But if you are experiencing pain that can be controlled by opiates and are not experiencing these highs it is highly unlikely you will become addicted.

Patients can develop tolerances to opiates, meaning the dose or medication they previously used may not be as effective over a period time and you may be required to increase your dose of medication or add/change medication. Tolerance and addiction are different, and not necessarily associated together. Many patients worry that they are on too high a dose of pain relief, due to tolerance, but if it relieves your pain and allows you to keep up activities without side effects, it is the correct dose.

I feel better, I can stop taking my medication

Although medications can help dull side effects and symptoms, they can also treat conditions.

If you complain of a headache and take pain relief, it is usually acceptable to stop taking pain relief once your symptoms resolve. However, for some side effects or symptoms, they may return if you stop taking your medication. There are some medications, as well, where you don’t feel any different while taking them. Equally, for some medications, such as steroids or antidepressants, stopping medications, as oppose to slowly decreasing the dose over a period of days to weeks can be problematic.

Your doctor should be more than happy to discuss your medications and whether you need to continue taking them. But it is very important to follow the instructions given by the healthcare professional.

If the symptom doesn’t go away, it’s ok to take more medication

All medication has something called a therapeutic window. The therapeutic window is the range of medication where it is effective and you won’t experience toxic side effects (you could think of it as Goldilocks trying the three different porridges).

Taking more than the recommended dose puts you at risk of having toxic side effects, some of which can be very harmful to your kidneys and liver. Your doctor or emergency department should be contacted immediately should you find yourself in immense pain, or with severe side effects or symptoms that you cannot manage with medication dose prescribed.

The more medication you need, the more unwell you must be

Not necessarily true. Cancer is a complex disease, and people often find themselves on more medication during their cancer treatment then they have taken in the entire lives! Just because you find yourself on more medications that someone in a similar position to you, does not mean you are more unwell. Being a complex disease, everyone reacts uniquely to information, treatment, and medications; and this may cause you to need more medications, or at a higher dose.

I’m taking a medication and don’t feel well, but I guess that’s to be expected

No, if you start experiencing side effects of medication, whether mild or severe, it is very important to inform your treating doctor or nurse immediately.

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