Cancer and Pain

Pain related to cancer comes in many different forms. Pain can be caused by the cancer itself, or it can be a side effect of treatment.

For the best pain management, you and your healthcare team will first need to find out the cause of your pain. Be prepared to answer these questions:

  • How severe is your pain?
  • Is there anything that makes it better?
  • Is there anything that makes it worse?
  • What does it feel like—an ache or a sharp pain, dull, throbbing, or tingling?
  • Is the pain in only one part of your body?
  • How does the pain interfere with your daily life?

Keeping a pain journal can be helpful to help you identify activities or events that make the pain worse or better.

Is the pain a side effect of treatment?

Chemotherapy, radiation, and surgery are the three most common cancer treatments, and pain is a potential side effect for all three. However, the type of pain caused by each is different.

Chemotherapy can cause the following types of pain: muscle and joint aches, mouth sores, headaches, and neuropathy. Neuropathy is an unpleasant tingling or numbness, usually in the hands or feet. Damage to nerve endings causes this feeling.

Radiation causes the skin at the treatment site to become dry, red, and painful like a mild to moderate sunburn. Sometimes these burns blister. Depending on the location of radiation, there may be other side effects. For example, radiation to the brain may cause headaches.

Surgery causes pain at the incision site. Depending on the extent and location of the surgery, this pain could be mild to severe. Surgery can damage muscles and tissues leading to range of motion problems. Surgery can also damage nerves and cause neuropathy. Amputations and mastectomies can lead to “phantom” pains where the removed limb or breast used to be.

Is the pain a side effect of the cancer itself?

Depending on size and location of the tumor, pain could be from the cancer itself. If the tumor is pressing on nerves, joints, or bones, it can cause pain. This type of pain is more common with advanced or metastatic cancer, especially when the cancer spreads to the bones. Tumors in the bones can cause fractures as the tumors continue to grow.

Pain Management Plans

Your healthcare team can help create the best pain management plan for you. If the first plan you try does not work, tell your healthcare team. You may need to try a different plan. Open and honest communication with your healthcare team is very important. Pain is a difficult side effect to treat. It may take a few tries to find the best plan for you. Do not be afraid to seek a second opinion if needed.

Your pain management plan may include:

Pain Medications

Your doctor may prescribe pain medications or suggest over-the-counter pain medications. Ask your doctor before taking any over-the-counter medications. Some pain medications can cause nausea or constipation. Your doctor may be able to suggest additional medications to help with these side effects. You may have to try a few different types of medications or dosages to find what works for you.

Physical Therapy

Physical therapy uses exercises to help improve strength and motion. If your pain is related to loss of range of motion or difficulty doing physical activities such as walking, physical therapy may help ease pain.

Exercise

Regular exercise, even something as simple as a daily walk, may also help with pain. Exercising is good for the body. It can also make you feel better mentally too. Exercising releases endorphins, natural chemicals that make you feel happier. Exercising also combats fatigue which is a common side effect along with pain. Always ask your doctor before beginning an exercise plan.

Complementary and Alternative Medicine

Some cancer survivors find success at relieving pain with complementary and alternative medicine (CAM) such as acupuncture, guided imagery, massage, supplements and vitamins, or yoga. The phrase “complementary and alternative medicine” means treatments outside the standard scope of what you would find at a hospital or treatment center. Complementary medicine is used along with standard treatment. Alternative medicine is used instead of standard treatment.

Always discuss the pros and cons of each treatment you consider with your healthcare team. If you are considering a complementary treatment, inform your medical team BEFORE you are treated to make sure it will not negatively interact with your standard treatment. If you are considering quitting standard treatment for an alternative treatment, remember: standard treatments go through a long and careful research process to ensure that they are safe and effective, but less is known about most types of CAM.

For more information on CAM, visit the National Center for Complementary and Alternative Medicine.

Palliative Care

Palliative care provides relief from pain and other symptoms, but it does not provide a cure. For cancer survivors, common palliative therapies include surgery, radiation, or chemotherapy as a method of shrinking tumors that are causing pain. Palliative care is most commonly used for advanced or metastatic cancers.

Emotional Support

Taking care of your emotional well-being can also help manage pain. There are a number of ways to find emotional support—peer partnering programs, support groups, and one-on-one counseling.

Your doctor may even prescribe antidepressants, which have been shown to help with nerve pain as well as emotional well-being.

Managing Other Side Effects

Other side effects of treatment, such as fatigue, nausea, or loss of appetite, may be making your pain worse. You may be able to manage many of these side effects with simple nutrition and habit changes. Visit Managing Cancer Side Effects to learn more.

For more information on managing pain:

American Chronic Pain Association

American Society of Clinical Oncology