Facts About Cancer Pain
Having cancer does not always mean having pain. But if you do have pain, there are many different kinds of medicines, different ways to take the medicines, and non-drug methods that can help relieve it.
Pain can affect all parts of your life. If you have pain, you might not be able to take part in your normal day-to-day activities. You may have trouble sleeping and eating. You may be irritable with the people you love. It’s easy to get frustrated, sad, and even angry when you’re in pain. Family and friends don’t always understand how you’re feeling, and you may feel very alone.
You should never accept pain as a normal part of having cancer. All pain can be treated, and most pain can be controlled or relieved. When pain is controlled, people can sleep and eat better, enjoy being with family and friends, and continue with their work and hobbies.
Types of cancer pain
The type of pain you have determines the type of treatment you will need to best relieve it. People with cancer pain often notice that their pain changes throughout the day.
Acute pain is severe and lasts a fairly short time. It’s most often a sign that the body has been injured in some way. This pain generally goes away as the injury heals.
Chronic or persistent pain
Chronic or persistent pain lasts for long periods of time (longer than 3 months). It can disrupt your life if it’s not well treated. It may range from mild to severe. Chronic pain doesn’t go away but it can usually be controlled by taking pain medicines on a regular schedule.
People with chronic pain that’s mostly controlled by medicine can have another type of pain called breakthrough pain.
Breakthrough pain is a flare of pain that happens even though you are taking pain medicine regularly for chronic pain. It’s called breakthrough pain because it “breaks through” the pain relief you get from the regular pain medicine. Breakthrough pain is not controlled by the regular doses of pain medicines. It varies in intensity and usually cannot be predicted.
As a rule, it comes on quickly, lasts as long as an hour, and feels much like chronic pain except that it’s worse – more severe or intense. It can happen many times a day, even when the chronic pain is controlled by the regular pain medicine.
Breakthrough pain often has the same cause as chronic pain. It may be the cancer itself or it may be related to cancer treatment. Some people have breakthrough pain during a certain activity, like walking or dressing. For others, it happens unexpectedly without any clear cause. It’s also very important to manage this type of pain.
What causes pain in people with cancer?
Pain is most often caused by the cancer itself. The amount of pain you have depends on the type of cancer, its stage (extent), and your pain threshold (tolerance for pain). People with advanced cancer are more likely to have pain.
Pain can also be caused by cancer-related treatment or tests. You may also have pain that has nothing to do with the cancer or its treatment. Like anyone, you can get headaches, muscle strains, and other aches and pains.
Pain from the cancer itself
Pain from the cancer can be caused by a tumor pressing on bones, nerves, or body organs.
Spinal cord compression: When a tumor spreads to the spine, it can press on the spinal cord. This is called spinal cord compression. The first sign of compression is usually back and/or neck pain, sometimes with pain, numbness, or weakness in an arm or leg. Coughing, sneezing, or other movements often make it worse. If you have this pain, get help right away. This compression must be treated quickly to keep you from losing control of your bladder or bowel or being paralyzed. Your cancer care team can treat the cause of the pain and give you medicine to help relieve the pain. If you’re treated for the compression soon after the pain begins, you can usually avoid serious outcomes. Treatments usually involve radiation therapy and steroids to shrink the tumor. Or you may have surgery to remove a tumor that’s pressing on the spine, which may then be followed by radiation.
Bone pain: This type of pain can happen when cancer spreads to the bones. Treatment may be aimed at controlling the cancer, or it can focus on protecting the affected bones. External radiation may be used to treat the weakened bone. Sometimes a radioactive medicine is given that settles in the affected areas of bone and helps to make them stronger. Bisphosphonates are other medicines that can help make diseased bones stronger and help keep the bones from breaking. These are examples of treatments that are aimed at stopping the cause of the bone pain. You may still need pain medicines, but sometimes these treatments can greatly reduce your pain.
Pain from cancer treatments
Procedures and testing: Some tests used to diagnose cancer and see how well treatment is working are painful. If such a procedure is needed, concern about pain should not keep you from having it done. Any pain you have during and after the procedure can usually be relieved. Your needs and the type of procedure to be done should dictate the kinds of medicine you get for the pain. You may be told that the pain from the procedure can’t be avoided or that it won’t last long. Even so, you should ask for pain medicine if you need it.
Surgical pain: Surgery is often part of the treatment for cancers that grow as solid tumors. Depending on the kind of surgery you have, some amount of pain is usually expected. You’ll be given pain medicines so you won’t be in pain when your surgery is over. Pain due to surgery can last from a few days to a few weeks, depending on the type of surgery.
Phantom pain: Phantom pain is a longer-lasting effect of surgery, beyond the usual surgical pain. If you’ve had an arm, leg, or even a breast removed, you may still feel pain or other unusual or unpleasant feelings that seem to be coming from the absent (phantom) body part. Doctors are not sure why this happens, but phantom pain is real; it’s not “all in your head.”
No single pain relief method controls phantom pain in all patients all the time. Many methods have been used to treat this type of pain, including pain medicine, physical therapy, antidepressant medicines, and transcutaneous electric nerve stimulation (TENS). If you’re having phantom pain, ask your cancer care team what can be done.
Side effects of chemotherapy and radiation treatments: Some treatment side effects cause pain. Pain can even cause some people to stop treatment if it’s not managed. Talk to your cancer care team about any changes you notice or any pain you have.
Here are some examples of pain caused by cancer treatment:
- Peripheral neuropathy (PN). This condition refers to pain, burning, tingling, numbness, weakness, clumsiness, trouble walking, or unusual sensations in the hands and arms and/or legs and feet. Peripheral neuropathy is due to nerve damage caused by certain types of chemotherapy, by vitamin deficiencies, cancer, and other problems. Be sure to tell your doctor right away if you notice these kinds of problems.
- Mouth sores (stomatitis or mucositis). Chemotherapy can cause sores and pain in the mouth and throat. The pain can cause people to have trouble eating, drinking, and even talking.
- Radiation mucositis and other radiation injuries. Pain from external radiation depends on the part of the body that’s treated. Radiation can cause skin burns, mucositis (mouth sores), and scarring – all of which can cause pain. The throat, intestine, and bladder are also prone to radiation injury, and you may have pain if these areas are treated.
Last Medical Review: September 23, 2015 Last Revised: September 23, 2015
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