Podcast: Managing mental health & chronic pain
- Emotional & Physical Effects
- Anemia and Cancer
- Appetite Changes
- Bleeding and Bruising
- Blood Clots and Anticoagulants
- Body Image
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- Bowel Management
- CAR T-cell Therapy Side Effects
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- Infections
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- Managing Medications
- Nausea
- Peripheral Neuropathy
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- Cancer Pain Management
- Sexuality and Cancer
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- Stem Cell Transplant Treatment Side Effects
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- Weight Loss
Cancer Pain Management
Nearly half of cancer patients experience pain. Cancer pain can be a presenting symptom that leads to diagnosis, or it may only be felt in late-stage disease.
Many cancer patients do not experience any pain associated with cancer. For those that do it can be mild, moderate or severe. Since each patient’s cancer pain is unique, treatment plans for pain management should be tailored the individual’s needs.
Causes of cancer pain
Cancer pain can come from different sources.
- Pain from the tumor: Most cancer pain occurs when a tumor presses on bone, nerves or organs. The pain level may vary according to the tumor’s location.
- Treatment-related pain: Chemotherapy, radiation therapy and surgery can cause pain. Certain painful conditions are more likely to occur in patients with a suppressed immune system, which is often a result of these therapies.
- Post-operative pain: Relieving pain resulting from surgery helps people recover more quickly and heal more effectively.
Treating cancer pain
Cancer pain is very treatable. About nine out of 10 cancer pain patients find relief using a combination of medications. Some medications are general pain relievers, while others target specific types of pain and may require a prescription.
It is important to have your pain evaluated so your care team can provide the best methods for treatment. This will often include rating your pain on a scale, where 0 is no pain and 10 is the most severe. If your cancer pain is making it hard to take care of yourself, limiting daily activities or keeping you from sleeping, share this with your healthcare team.
Treatment usually begins with over-the-counter medications such as acetaminophen or ibuprofen. If these are insufficient for moderate to severe pain, prescription-strength medications may be necessary.
Your care team may recommend specific medications based on the type of cancer pain you have.
Mild to moderate pain
Non-opioids: Examples are acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin and ibuprofen. Most non-opioids can be purchased over-the-counter without a prescription.
Moderate to severe pain
Opioids: Examples are morphine, hydromorphone, oxycodone, hydrocodone, codeine, fentanyl and methadone.
Tingling and burning pain
- Antidepressants: Examples are amitriptyline, imipramine, doxepin and trazodone. Taking an antidepressant does not mean that you are depressed or have a mental illness.
- Antiepileptics: An example is gabapentin. Taking an antiepileptic does not mean that you are going to have seizures.
Pain caused by swelling
Steroids: Examples are prednisone and dexamethasone.
Non-drug cancer pain treatment options
Your care team may recommend non-drug treatments for managing your cancer pain in addition to your pain medication. These treatments may help your medicines work better and relieve other symptoms, but they should not be used instead of medication.
- Biofeedback: A technique that makes the patient aware of bodily processes often considered involuntary (blood pressure, skin temperature and heart rate). Patients can gain some control of these processes, which can influence pain levels.
- Breathing and relaxation exercises: These methods focus the patient’s attention on performing a specific task, instead of concentrating on the pain.
- Distraction: A method used to shift attention to a more pleasant event, object or situation.
- Heat or cold: Uses temperature to control pain with cold packs or heating pads.
- Hypnosis: A focused state of consciousness that allows the patient to better process information.
- Imagery: Uses soothing, positive mental images that allow the patient to relax.
- Massage, pressure and vibration: Physical stimulation of muscles or nerves can help with relaxation and relieve painful muscle spasms or contractions.
- Transcutaneous electrical nerve stimulation (TENS): A mild electric current is applied to the skin at the site of the pain.
- Acupuncture: Practitioners insert fine needles into the skin. The needles may be manipulated manually or stimulated with small electrical currents (electroacupuncture).
- Cognitive therapy: A type of psychotherapy that helps patients by changing the way they think and feel about certain things.
How cancer pain medicine is taken
Most pain medicine is taken by mouth either in pill or liquid form. Other methods for administering pain medications include:
- Rectal suppositories
- Transdermal patches
- Injections
When medicine is not enough
You may have pain that is not relieved by medicine or the non-drug treatment options. Cancer-related pain can be treated in ways outside of medication and complementary therapies. These methods may also reduce pain:
Radiation therapy: Radiation therapy uses powerful, focused beams of energy to kill cancer cells. There are several different radiation therapy techniques. Doctors can use these to accurately target a tumor while minimizing damage to healthy tissue.
Learn more about radiation therapy.
Surgery: When a tumor is pressing on nerves or other body parts, operations to remove all or part of the tumor can relieve pain.
Nerve blocks/implanted pump: Certain nerve blocks (temporary or permanent) may help relieve some painful conditions. Implanted pain pumps can also provide relief in some patients.
Neurosurgery: Nerves (usually in the spinal cord) are cut to relieve pain.
Frequently asked questions
What does cancer pain feel like?
Cancer pain can feel like an achy, throbbing, or sharp pain that happens when tumors develop and damage body tissue. Somatic pain is in the muscles, bones, or soft tissues. Visceral pain is in the internal organs and blood vessels and is often described as a deep, squeezing discomfort.
Cancer pain can affect the nervous system. It may feel like pins and needles, shooting pain, a burning sensation, or an electric type of pain like a shock. This can also be caused by tumors and/or pressure on a nerve or the spinal cord.
Do certain cancers cause more pain than others?
Recurrent or advanced cancers that have spread to other areas of the body can cause more pain.
Does cancer pain come and go?
Some types of cancer pain come and go. In this situation, taking pain medication only as needed or integrative therapy may be helpful. If the pain is persistent or happens often throughout the day, a long-acting or time-release medication may be a better solution.
Will my cancer pain medications cause side effects?
People often have concerns about side effects from pain medications. Patients worry they will become too tired, be unable to work, or sleep too much while taking them. It is common to be drowsy when first starting the medications but that should resolve in a few days. Common side effects of opioid pain medications include nausea, itching and constipation. It is important to discuss any side effects from pain medications with your care team so your treatment plan can be adjusted as needed.
Pain Management Resources
Find information on managing cancer pain from The Learning Center.
How is pain psychology used in cancer care?
How interventional radiology is used to manage...
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