Pain is common among people with cancer, but not everyone with cancer will have problems with pain.
Cancer-related pain is more likely in people with advanced or metastatic disease that has spread from its original site. Tumors that press against nerves or the spinal cord can cause nerve pain, often accompanied by burning or tingling. Cancer that spreads to the bones can cause deep or throbbing pain.
Cancer treatment can also contribute to pain. Pain after surgery is common because of damage to tissues and nerves or from scarring during the healing process. Radiation and chemotherapy can cause painful side effects, including mouth sores, joint pain and skin rash or burns. Some chemotherapy can cause peripheral neuropathy, or nerve damage, resulting in pain, tingling or numbness in the hands and feet. Medications administered by injection or infusion can result in soreness at the injection site. Some survivors continue to experience pain even after completing treatment.
Because different kinds of pain arise from different sources, there are many approaches to pain management. Sometimes simple measures such as using ice packs or heating pads can help. Often, treatment can be adjusted to lessen side effects. For example, chemotherapy may be given in smaller doses to reduce neuropathy. Sometimes radiation or chemotherapy that shrinks tumors can relieve pain even if it doesn’t cure the cancer or prolong survival.
For some people, over-the-counter pain medications are enough, while others will need stronger prescription medications. These may include nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids (drugs related to opiates like morphine). Medications may be administered as pills, patches or by self-controlled pumps.
Some people don’t get enough relief from standard pain medications and may need to be referred to a pain specialist. Counselors can help teach skills for coping with chronic pain. In cases of advanced cancer with a poor prognosis, a palliative care team may be brought in. This type of care focuses on making patients comfortable rather than trying to treat their cancer.
Complementary approaches for managing pain include physical therapy, acupuncture, meditation, massage and hypnosis. Studies have shown that medical cannabis can relieve pain in people with cancer. These approaches may be used alone or in combination.
Be sure to discuss pain with your care team, especially if it is severe, long-lasting or interferes with daily activities. The National Cancer Institute recommends keeping a pain diary to help explain your pain to providers.
Often, it takes time and trial and error to get cancer-related pain under control, but it can usually be managed at all stages of disease.