Pain and cancer - Maggie's Centres

Pain and cancer

Pain doesn’t affect everyone with cancer, but it is a symptom that many people are worried about.  It is an unpleasant physical sensation and can be caused by the cancer itself, and sometimes as a side effect of treatment. 

The information on this page will help you to find out more about pain, and ways to manage it, during and after cancer treatment.

Many people worry that pain is an inevitable symptom for anyone diagnosed with cancer.  Cancer doesn’t mean you’ll experience pain, but if you do develop pain symptoms, there are many ways to help ease it.

What Causes pain?

Cancer pain can have several causes. It will depend where the cancer is and which parts of the body are involved. There are also non-cancer related pains, which can still happen during cancer and it’s treatments - and cause anxiety, if you’re not sure what is causing them.

Cancer treatments sometimes cause pain and discomfort too.  For example, surgery can cause temporary postoperative pain, and some chemotherapies can trigger nerve pain (neuropathy).  

Pain can feel worse if you’re anxious, stressed or low in mood.  You may feel that you have to put up with any pain you’re experiencing, and find it hard to talk about.  It’s important to tell your healthcare team about pain you are feeling, so that your symptoms can be checked and improved.  Nearly all cancer related pain can be treated effectively, with a range of pain relief strategies available. 

Describing pain

Pain may be hard to describe to others. Thinking about the following factors might help you:

  • How bad is the pain? You may be asked to rate your pain on a scale of 0-1 with 0 being no pain and 10 being the worst pain you have ever felt.
  • How often do you feel the pain, for how long and at what time of the day is it usually the least or worst.
  • Is the pain in one place or several places? Can you pinpoint where the pain is?
  • Try to describe the pain – is it burning, sharp, stabbing or is it more of an ache?
  • What makes the pain better or worse? - For example,  is it on movement, at rest, standing, sitting?

Managing pain

The goal of pain management for people with cancer is prevention or complete control of the pain. Significant advances in pain management have been made over the last decade and many treatment options are available.

Most people are treated with medications initially, but other options include surgery, radiotherapy or neurosurgery. Most people diagnosed with cancer will have complete relief of pain with appropriate management.

Working together with your healthcare team can help achieve the best result for you. Once the reason for your pain has been identified - the first step is usually choosing the correct medication. There may be a period of trial and error while your healthcare team tries to find the right medication and dose for you. Pain medications may be given as pills, liquids, suppositories, skin patches, lozenges or injections.

For mild pain, an over the counter medicine such as aspirin, paracetamol or ibuprofen may be sufficient. Check with your healthcare team before taking any medications as they may interact with any cancer treatments you are on.

If the pain is not relieved with over the counter medications - the next step may be stronger medication. This may be an ‘opioid’ (morphine based) which includes medications such as codeine, morphine, fentanyl and palladone. There are additional drugs which can help relieve nerve pain and bone pain.

All your medications should be regularly reviewed (including over the counter ones) with your healthcare team to ensure there are no risks in combinations and the amounts of medicines.

Pain medication can cause side effects - including drowsiness, constipation, diarrhoea and gastric problems. This may affect your ability to drive, as well as be physically draining.  If side effects occur let your healthcare team know as they can oten be managed by changes to the dose or type of  your medication. 

Occasionally, pain relief medications can be addictive. If you’re on a strong pain medication, you may be concerned this will happen to you - sometimes feeling reluctant to take them. Discuss your worries with your doctor, as medication, properly managed,  is aimed to control your pain without causing addiction problems.

If you are experiencing severe pain and previous medications have not helped - ask your healthcare team about referral to a pain specialist. These are health care professionals who have specialist experience in pain management . 

There are also non-medication ways to relieve pain which work for some people.  Techniques such as visualisation, relaxation and breathing exercises, massage, acupuncture, light exercise, music therapy and psychological support may help. These do not treat the pain itself but promote relaxation which increases your ability to cope with distressing symptoms. 

Transcutaneous electrical nerve stimulation (TENS) units may also be used in some circumstances. TENS involves giving small non-painful electrical bursts to specific areas in the skin. Hot or cold packs may also provide relief from discomfort.

The Maggie’s team can help you to find out more about pain management specialists and non drug treatments. Ask about the range of relaxation and therapies available in your nearest centre.

Tips to help manage your pain:

  • Take your pain medication regularly and before the pain becomes severe.
  • Take anti-sickness and stool softeners and/or laxatives recommended by your healthcare team.

  • Tell your healthcare team about your pain. Learn how to describe your pain to make it easier for them to understand how you are feeling.

  • Keep a record  to note your medications and the level of your pain.
  • Let your healthcare team know about any side effects you experience, if the pain is worsening or if you develop bowel or bladder problems.
  • Try non-drug techniques or diversional activities, and practice relaxation techniques.

What now?

Talk with your doctor about pain you may be experiencing. It may not be cancer related, and if it is due to cancer and cancer treatments there are lots of medicines and support available to help.

Have a read through the links to blogs and information we have suggested on this page.

Visit your local Maggie’s Centre or join in our online forums, where you can learn strategies to manage your pain, and speak with others about your experiences.

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