What is cancer pain?

Cancer pain may be caused by the cancer or by the treatments and tests used. The pain may make it hard for you to do your normal activities, such as sleeping or eating. Over time, cancer pain can cause appetite and sleep problems, isolation, and depression.

But most cancer pain can be managed with medicines and other methods. This may not mean that you have no pain but that it stays at a level that you can bear. Treating your pain will make you feel better. You will be more active, eat and sleep better, and enjoy your family and friends.

What are some key points about cancer pain?

• You are the only person who can say how much pain you have. If you tell your doctor when you have pain or when pain changes, your doctor can help you.
• Cancer pain can almost always be relieved if you work with your doctor to create a treatment plan that is right for you.
• Pain is often easier to control right after it starts instead of waiting until it becomes bad.
• Take your medicines exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine.
• You may find that taking your medicine works most of the time, but your pain flares up during extra activity or for no clear reason. This is called breakthrough pain. Ask your doctor what you can do if this happens. Your doctor can give you a prescription for fast-acting medicines that you can take for breakthrough pain.
• People who take opioid pain medicines for cancer pain rarely develop opioid use disorder. Moderate to severe opioid use disorder is sometimes called addiction. Your doctor will assess your risk for opioid use disorder and help you to use opioids safely. Your body may come to expect daily doses of medicine to control the pain. But your doctor can gradually lower the amount you are taking when and if the cause of your pain is gone.

What treatments can help you manage cancer pain?

Medical treatments to manage cancer pain include:

• Prescription and over-the-counter medicines. Many types of medicines are used. Your doctor may suggest different combinations of medicines.
• Surgery, chemotherapy, radiation, and hormone therapy. These may be used to remove or destroy a tumour that is causing pain.
• Injection of cement into the spine to stabilize bones that have collapsed.
• Nerve treatments. These are used to help with nerve pain. They include:
  • A nerve block that uses medicine injected into or near the nerve.
  • A nerve surgery that cuts the nerve to stop the pain.
  • Other treatments, such as injecting a chemical or using heat or cold, to destroy the nerve and stop the pain.

Non-medical treatments include:

• Physiotherapy, gentle massage, acupuncture, and heat or cold to ease pain.
• Stretching, yoga, and exercises to help you keep your strength, flexibility, and mobility.
• Relaxation, biofeedback, and meditation to relieve stress and anxiety.
• Counselling. This may help you manage your cancer pain or the pain from treatments.
• Education and emotional support. Learning as much as you can about your pain may help. So can sharing your feelings with others. A support group can be a safe and comfortable place to talk about your illness.

How can you manage cancer pain?

Your doctor needs all the information you can give about what your pain feels like. It often helps to write things down in a pain diary.

• Write down when your pain starts, what it feels like, and how long it lasts. Use words like dull, aching, sharp, shooting, throbbing, or burning.
• Note changes in your pain. Is it constant, or does it come and go? Do you have more than one kind of pain? How long does it last?
• Rate your pain on a scale of 0 to 10, with 0 being no pain and 10 being the worst pain you can imagine.
• Write exactly where you feel pain. You can use a drawing. Say whether the pain is just in that one place or several places at once. Or tell your doctor if it travels from one place to another.
• Write down what makes your pain better or worse. Note when you used a treatment, how well it worked, and any side effects.

If you and your doctor are not able to control your pain, ask about seeing a pain specialist. A pain specialist is a health professional who focuses on treating resistant pain.

Talk to your doctor if you are having problems with depression. Treating depression can make it easier to manage your cancer pain.