Cancer pain can be controlled in almost every case. This does not mean that you have no pain, but it does mean that the pain stays at a level that you can bear.
Cancer and its treatments can be painful. A tumor that presses on bones, nerves, or organs can cause pain. Surgery for cancer can cause pain. So can chemotherapy and radiation. Some medical tests, such as bone marrow aspiration, can also cause pain. There are a number of ways to control each of these kinds of pain.
There are different kinds of cancer pain. These include:
There are a number of ways to control each of these kinds of pain.
You are the only person who can say how much pain you have or if a certain pain medicine is working for you. Telling your doctor exactly how you feel is one of the most important parts of controlling pain.
The more specific you can be about your pain, the more your doctor will be able to treat it. It often helps to write everything down. Include:
Tell your doctor exactly where you feel pain. You can use a drawing. Say if the pain is just in one place, if it is in several places at the same time, or if it moves from one place to another.
Pain control often starts with medicine. Many drugs are used to treat pain. You and your doctor may need to adjust your medicine as your pain changes. Your doctor may suggest different drugs, combinations of drugs, or higher doses.
For a tumor that causes pain, removing or destroying all or part of the tumor, if possible, often helps. Doctors use radiation, surgery, and other treatments to do this.
For nerve pain, doctors may use nerve blocks. With a nerve block, medicine is injected right into the nerve that affects the painful area. They provide short-term pain relief by preventing the nerve from sending pain signals. Or sometimes medicine is delivered directly to the spine, as with spinal anesthesia or an epidural.
There are many other ways to control cancer pain, including:
Older adults are at risk for not getting enough pain medicine. If you are a caregiver for an older adult who has cancer, talk with that person to make sure that the pain is under control. Talk with the person's doctor, too, about a pain management plan.
Learning as much as you can about your pain may help. Talking to a counselor can help you manage your cancer pain or the discomfort from cancer treatments. Emotional support from your friends and family may also help.
This is a record of your pain treatment and how it helped or did not help you. You can write down when you used each treatment, how it worked, and any side effects it caused. Having it written down helps you let your health care team know exactly how well your treatment is working.
Many people who take opioid pain medicines worry about developing opioid use disorder. Moderate to severe opioid use disorder is sometimes called addiction. Your doctor will monitor you closely for signs of this disorder. When you no longer need these medicines, your doctor will slowly lower the amount you are getting until your body no longer needs the medicine.
Do not let this fear get in the way of pain relief. Ask for pain relief if you need it. Pain is easier to control when you treat it as soon as it starts. You may also be able to predict pain and treat it before it begins, such as before physical activity. Pain is harder to control if you wait until it is bad.
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Cancer pain may be caused by the cancer or by the treatments and tests used. The kind of pain may vary depending on the cause. The first step in managing your pain is understanding what is causing it.
Pain from the cancer itself can happen when:
Because some cancer spreads far and fast, treatments have to be strong. As a result, they often cause pain and other side effects that require more treatment. Pressure on or damage to a nerve may cause tingling or burning. Treatments such as surgery, radiation, and chemotherapy may also cause pain.
The type of cancer pain you feel depends on the type of cancer you have and how it affects your body. For example:
Acute pain is bad pain that lasts a short time. Chronic pain is pain that comes and goes for a long time. It is a side effect of the cancer or treatment. Chronic pain can range from mild to severe. Breakthrough pain is strong pain that occurs while you are taking medicines that usually control your pain. This kind of pain usually begins suddenly and lasts for a short period of time.
Not everyone feels pain in the same way. Only you can describe how much pain you have. The key to getting your pain under control is being able to tell your doctor what it feels like and what does and doesn't work for you.
If you have cancer, call your doctor if:
The following health professionals can help treat cancer pain:
Your pain may be managed by a team that may include doctors (including pain specialists or palliative care specialists), nurses, psychologists, social workers, and pharmacists. Be sure that all the members of your health care team know about any changes in your pain control diary. You may wish to use one person, such as your medical oncologist, as a team leader who will make sure that all team members share information.
You are the only one who knows how your cancer pain feels. You may need different combinations of treatments. Don't be surprised if your pain control plan needs to be changed often. Don't let that discourage you. Be honest and specific about what does and does not work for you. Staying on top of your pain and in control of your pain will improve your quality of life during every stage of your disease.
Drugs that you can buy without a doctor's prescription may be enough to relieve your pain at times. Acetaminophen, such as Tylenol, relieves pain, while other drugs such as ibuprofen and aspirin relieve pain and also decrease swelling. But talk with your doctor before you take these medicines. And don't take more than the label says unless your doctor tells you to.
Drugs that need a doctor's prescription may be stronger or work differently than nonprescription drugs. Follow your doctor's orders about taking them. Prescription drugs include:
Medicines for breakthrough pain
This is extra medicine for when strong pain comes on suddenly. These prescription medicines are usually fast-acting opioids given by mouth, such as morphine or oxycodone. Or you may be given fentanyl in a nasal spray or in lozenges that dissolve under your tongue.
Medical treatments can help relieve pain from tumors and nerve pain.
Non-medical ways to relieve pain are often used along with pain medicine. These include:
For more information about what you can do, see:
Additional information about pain management is provided by the National Cancer Institute at www.cancer.gov/cancertopics/pdq/supportivecare/pain/Patient.
Palliative care is a kind of care for people who have a serious illness. It's different from care to cure your illness. Its goal is to improve your quality of life—not just in your body but also in your mind and spirit.
You can have this care along with treatment to cure your illness. You can also have it if treatment to cure your illness no longer seems like a good choice.
Palliative care providers will work to help control pain or side effects. They may help you decide what treatment you want or don't want. And they can help your loved ones understand how to support you.
If you're interested in palliative care, talk to your doctor.
For more information, see the topic Palliative Care.
The best way to control cancer pain is to tell your doctor exactly how your pain feels, where it is, and what works or does not work to control it. A written pain control diary will help you do this.
Your family and health care team can help you create a pain control diary . This diary will help you keep track of when you use each treatment, how it works, and any side effects that you may have. This written record will track your progress, and will help your health care team know what you need. It will be easier for your doctor to see how well your pain treatment is working.
You can also use your pain control diary to write down questions for your doctor, the answers to your questions, and any changes that you and your doctor have made to your treatment. Be sure to include information such as clear instructions about who and when to call if you have problems or questions.
Older adults are at risk for not getting enough pain medicine. If you are a caregiver for an older adult who has cancer, talk with that person to make sure their pain is under control. Talk with the person's doctor, too, about a pain management plan.
There are many things you can do at home to reduce your cancer pain, manage side effects, and feel better in your mind and body. Follow your doctor's advice. Talk to your doctor about any home treatment you want to try.
You may find that drugs you can buy without a prescription are enough to ease your pain at times. Acetaminophen, such as Tylenol, relieves pain. Anti-inflammatory drugs, such as ibuprofen and aspirin, relieve pain and also decrease swelling. Be sure you know how to safely use these drugs. Talk with your doctor before taking these medicines, especially if you have had kidney or liver disease, gastrointestinal bleeding, or a stomach ulcer. And don't take more than the label says, unless your doctor tells you to do so.
Some pain medicines may cause problems like nausea, sleepiness, and constipation. Nausea and sleepiness usually go away in the first couple of days, but constipation may be an ongoing problem. To help manage these side effects at home, the following may help:
Other home treatments for pain include:
Having cancer can be very stressful, and it may feel overwhelming to face the challenges of cancer. Finding new ways of coping with the symptoms of stress may improve your overall quality of life. These ideas may help:
It is not unusual for people who have cancer to become depressed. If you are feeling depressed, talk with your doctor. Depression can make your cancer pain harder to treat. And treating your depression will help you with managing your pain.
Emotional support is important when you are dealing with cancer pain. If you feel like you need help, talk with your doctor. He or she can refer you to the social services department of your local cancer treatment center or hospital.
Learning all you can about your condition and treatments for pain can help you understand your options. It can also help you when you talk with your doctor about your pain management plan.
For more information about managing cancer pain, read "Pain Control: Support for People With Cancer" from the National Cancer Institute. This booklet is available online at www.cancer.gov/cancertopics/coping/paincontrol.
Many different drugs are used to treat cancer pain. If you are already taking pain medicine for another problem, tell your doctor how often you are taking it and how well it works.
The key to controlling cancer pain is to take your medicine on a regular schedule. Do not wait until your pain gets bad. Pain is easier to control when you treat it just after it starts. Painkilling drugs work to control cancer pain in most people.
Be careful when taking nonprescription medicines. Talk with your doctor before you take these medicines, especially if you have a fever or have had kidney or liver disease, gastrointestinal bleeding, or a stomach ulcer. And don't take more than the label says, unless your doctor tells you to do so.
Medicines you can buy without a prescription may be enough to relieve your pain at times. These medicines include:
People who have cancer pain often need stronger medicines that their doctors prescribe. Be sure to follow your doctor's orders when you take these stronger medicines. If you still have pain, call your doctor.
Prescription medicines may be used alone or with other medicines. Depending on your pain, some of these medicines work better than others. Prescription medicines include:
Medical marijuana also may help relieve cancer pain. It is available as marijuana cigarettes or as dronabinol, which is made from an active ingredient of marijuana. Dronabinol is available as a capsule.
Medicines for cancer pain are usually given by mouth. When a person is having trouble swallowing or faster pain relief is needed, medicine can be taken in other ways. Here are ways that medicines may be given:
Surgery is sometimes used to relieve cancer pain. Removing a tumor that is pressing on nerves, bones, or your spinal cord can help your pain. Surgery can also remove tumors that block the intestine and cause pain. The type of surgery that you may have depends on the type of cancer you have, which parts of your body are affected, and what treatments you have had before.
When medicines are not enough to relieve cancer pain or when they cause troublesome side effects, other treatments may help.
Exercise can help reduce pain and fatigue. It can also prevent muscle spasms and stiffness in your joints. But be sure to talk to your doctor before increasing your level of physical activity.
Being physically active also can help with your emotional and mental health. It can be hard to be active when you don't feel well. But if you are able, going for a walk or going swimming may help you feel better, especially during cancer treatment.
Short-term crisis counseling or cognitive-behavioral therapy (CBT) may help you manage cancer pain or the discomfort from cancer treatments. Counseling may also help your partner or family members.
People sometimes use complementary therapies along with medical treatment to help relieve symptoms and side effects of cancer treatments. Some of the complementary therapies that may be helpful include:
These mind-body treatments may help you feel better. They can make it easier to cope with treatment. They also may reduce chronic low back pain, joint pain, headaches, and pain from treatments.
Before you try a complementary therapy, talk to your doctor about the possible value and potential side effects. Let your doctor know if you are already using any such therapies. They are not meant to take the place of standard medical treatment.
Other Works Consulted
- Keeley PW (2009). Nausea and vomiting in people with cancer and other chronic diseases, search date April 2008. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
- National Cancer Institute (2012). Pain Control: Support for People with Cancer. Available online: http://www.cancer.gov/cancertopics/coping/paincontrol.
- National Comprehensive Cancer Network (2013). Antiemesis. NCCN Clinical Practice Guidelines in Oncology, version 1.2013. Available online: http://www.nccn.org/professionals/physician_gls/pdf/antiemesis.pdf.
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