Pain and Cancer

The simple versionExplain▾

Having cancer doesn't mean that you'll have pain. But if you do, pain can usually be controlled with pain medicine and non-drug approaches. Pain may be caused by the cancer or by cancer treatment.

Controlling pain is an important part of your cancer treatment plan. Treating pain effectively can improve your mood, help you sleep better, and give you energy. Trying to just "deal with" pain can make it harder to control later, so it helps to speak up.

Types and causes of painExplain▾

People with cancer may have different types of pain:

• Acute pain may feel sharp, come on quickly, and last only a short time.
• Breakthrough pain comes on suddenly even while you're taking medicine for chronic pain, and usually lasts a short time.
• Chronic pain (also called persistent pain) usually lasts more than three months. It may be mild or severe and may come and go or be constant.

Pain can come from the cancer itself—for example, if a tumor presses on nerves or other parts of the body. Some treatments or tests, such as surgery, cause pain. Pain can also be a side effect of treatment, such as mouth sores, nerve problems, or skin reactions.

Building a pain control planExplain▾

Your doctor will develop a plan to control your pain based on your description of it, your symptoms, a physical exam, and sometimes imaging tests. Some hospitals have pain specialists who work as a team, which may include a palliative care specialist, nurse, pharmacist, and others.

Describing your pain clearly helps your team treat it. Be as specific as you can. Your team may ask where the pain is, what it feels like (sharp, burning, shooting, or throbbing), whether it's constant or comes and goes, when it starts and how long it lasts, and how bad it is on a scale of 1 to 10. It also helps to note what makes it better or worse and whether it affects eating, sleeping, or daily activities. Some people track this in a notebook or a phone app.

Contact your doctor or nurse if you feel new pain, if pain isn't decreasing with medicine, or if you have side effects from the medicine.

Taking pain medicineExplain▾

Different types of pain medicine (also called painkillers, pain relievers, and analgesics) are used to control pain:

• Over-the-counter medicines such as aspirin, acetaminophen, ibuprofen, or naproxen.
• Prescription medicines such as antidepressants, antiseizure medicines, muscle relaxants, or steroids.
• Opioids (also called narcotics) for moderate to severe cancer pain.

Take the prescribed amount at the scheduled time. Don't wait until your pain gets bad—waiting can make it take longer to go away. Tell your doctor if the medicine isn't working, and never stop taking it without talking to your doctor first, since stopping suddenly could cause withdrawal.

Common side effects of pain medicine include constipation, drowsiness, and nausea or vomiting. Some may fade as your body adjusts.

Tolerance, dependence, and addictionExplain▾

It's common to worry about becoming addicted to pain medicine. It helps to understand three different things:

• Drug tolerance happens when your body gets used to a medicine and it works less well; your doctor may adjust the dose or switch medicines.
• Physical dependence means the body gets used to a certain level of medicine and has symptoms if it's suddenly stopped. This can happen even when a drug is taken as instructed.
• Addiction involves compulsive drug seeking and being unable to stop despite harmful consequences.

Needing a higher dose, or having symptoms when a dose is lowered, is not the same as addiction. Your doctor carefully prescribes and monitors your medicine. Most people with cancer who take strong pain medicine use it safely and effectively.

Non-drug approachesExplain▾

In addition to medicine, your team may suggest complementary and integrative practices, sometimes called natural pain relief:

• Acupuncture — inserting very thin needles into specific points on the body.
• Biofeedback — learning to control functions like heartbeat and muscle tension.
• Distraction — shifting attention away from pain, such as music or a movie.
• Guided imagery — focusing on positive scenes or experiences.
• Hypnosis — a deeply relaxed, trance-like state.
• Meditation — relaxing the mind and body to improve well-being.

Ask your health care team which of these options might be best for you.