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Causes
Pain can come from the tumor itself or may be a result of cancer
treatment.
Pain from the tumor. As tumors grow and spread to the bones or
other organs, they can put pressure on nerves and damage them, causing pain.
If cancer spreads or grows around the spinal cord, it can cause a
compression of the spinal cord, which can cause severe pain or paralysis
if not treated.
Pain from surgery. It is normal to experience pain from cancer
surgery. Some people may have persistent pain for months or years from
permanent damage to the nerves. Common procedures that cause pain
afterward include the following:
- Mastectomy (removal of
the breast and, occasionally, the surrounding tissue)
- Chest surgery
- Neck surgery
- Amputation of a limb
Pain from radiation therapy. Pain may
develop after radiation therapy and go away on its own. It can also
develop months or years after treatment, especially after radiation
therapy to the chest, breast, or spinal cord.
Pain from chemotherapy. Certain chemotherapy can cause pain along
with numbness in the fingers and toes. Usually this pain goes away when
treatment is finished, but sometimes the damage is permanent.
Diagnosis
You know your own pain best. The doctor's job in managing pain is to
listen to you, believe you, offer a solution, and keep repeating this
process as long as the pain lasts. Your doctor may ask the following
questions about your pain:
- Where it hurts
- When the pain stops and
starts
- How long it has been
there
- How intense the pain is
The doctor may also ask you to describe the pain using a
scale from 1 to 10 or offer words that help describe the pain, such as
burning, stabbing, or throbbing.
Managing pain
Doctors can treat pain in several ways:
- Fixing the source of
pain, such as treating the tumor or reducing inflammation
- Changing the perception
of pain, usually with pain-killing medications
- Interfering with pain
signals sent to the brain, through spinal treatments or nerve blocks
Depending on the source of the pain and the patient's
health, there are many different combinations of medications and ways to
give them. Most doctors know how to manage most pain, most of the time.
Sometimes, pain and palliative care specialists (specialists who care for
the physical, spiritual, psychological, and social needs of a person with
cancer) are available as a resource to help patients manage more intense
pain.
Pain medications
ASCO recommends the use of the pain treatment ladder developed by the
World Health Organization (WHO). Using this system, mild to moderate pain
is treated with mild painkillers (analgesics), and if the pain increases
to moderate or severe, it is treated with opioid
drugs, such as morphine. Pain medicines can be given in different ways,
depending on the drug and the patient's overall condition:
- By mouth (oral)
- Under the tongue or
inside the cheek
- Under the skin
- Into the veins
(intravenous or IV)
- Into the spine or area
around the spine
- By rectum
Often doctors will give patients a device where they can
control the release of medicine into their own body, called
patient-controlled analgesia (PCA). Pain medications are often given
around the clock, with appropriate "rescue" doses for pain that
surges suddenly through regular pain medications (called breakthrough
pain).
Side effects. Pain medication, especially opioids,
can
cause constipation, nausea, sleepiness, confusion, or
hallucinations. Many side effects can be treated, either with other
medications, supplements, or by switching to another drug.
Managing pain without medication
Many people have found that other methods besides medication help
control pain. Your doctor may be able to help you manage pain using more
than one method. Make sure you share with your doctor what methods have
previously worked for you.
- Physical therapy or
occupational therapy can help you use devices, such as prostheses,
splints, or braces, to help ease pain.
- Relaxation, distraction,
hypnosis, or biofeedback
- Nutritional support
- Acupuncture
Your doctor or a pain specialist can help you learn more
about these methods for controlling pain.
More Information
PLWC Feature: Cancer Pain
PLWC: Managing Side Effects
Cancersymptoms.org: Pain
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