Pain doesn’t affect everyone with cancer but it is a symptom that people worry about.
The information on this page will help you to find out more about pain, and ways to manage it, during and after cancer treatment.
What causes pain?
Cancer pain can have several causes. It depends on where the cancer is and which parts of the body are involved.
Non-cancer related pains can still happen during cancer and its treatments. These can 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.
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. There are a range of pain relief measures available.
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 0-10. 0 represents 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, or sitting?
The goal of pain management for people with cancer is to prevent or control the pain. There are many treatment options are available.
Most people are treated with medications to start with. Other options include surgery, radiotherapy or neurosurgery. It's possible 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. Pain medications may be given as pills, liquids, skin patches, suppositories, lozenges or injections.
For mild pain, an 'over the counter' (OTC) 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 OTC medicines - 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 make sure 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 .
Other ways to manage pain
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.