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Pain is an important part of your body's natural defense system. Pain is your body's way of warning you of something that might hurt or telling you that it is injured in some way. For example, the pain you feel when you touch a hot stove warns you to pull your hand away to avoid getting burned. The pain you feel if you break your leg prevents you from walking around or using your leg so that it can properly heal.
About 75% of cancer patients with advanced disease and 35% of cancer patients undergoing treatment experience some pain. Cancer pain may be caused by the cancer itself, the side effects of treatment, or both. Here are some ways that cancer and its treatments can cause pain:
Pain management is an important part of cancer treatment, and you should report any pain you experience to your treatment team. Pain can be debilitating and can greatly diminish your quality of life if it goes untreated, but there are many effective ways to manage and treat your cancer pain.
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Your healthcare team will usually ask you the following questions to assess the severity and cause of your pain:
Your doctor will use your responses to these questions to determine the exact cause of your pain and develop a treatment plan for you. Control of pain is of utmost importance in the care of patients with cancer. Your doctor will tailor your pain control plan to your specific condition, depending on the type, duration, and intensity of your pain. Your doctor will continue to ask you these questions throughout treatment to determine whether or not you are responding well.
There are many different treatment options for managing cancer pain. Your doctor will try to remove or shrink the tumor causing the pain with surgery, chemotherapy, or radiation therapy. Your doctor may also prescribe pain medication, which has been proven to effectively reduce pain in most cancer patients. If pain medication does not work for you, there are other procedures the doctor can perform to treat your pain.
Surgically removing all or part of a tumor pressing on your organs, nerves, or bones may be able to relieve your pain.
Chemotherapy uses drugs that travel through the bloodstream and destroy any cancer cells they encounter. Chemotherapy may be able to reduce the size of your tumor(s) and relieve pain, especially when it is pressing against your organs or nerves.
Radiation therapy uses waves of high energy rays to target and kill cancer cells. Radiation therapy may be able to reduce the size of your tumor(s) and relieve pain.
Nonopioids are drugs commonly used to treat mild to moderate pain. Many nonopioids such as acetaminophen, ibuprofen, and aspirin are available over-the-counter, meaning you do not need a prescription to buy them. Theses medications include acetaminophen, which can be very helpful in reducing pain, and NSAIDs such as ibuprofen and naproxen, which can reduce pain and inflammation.
Opioids are stronger prescription pain medications used to treat moderate to severe pain. Opioids may be used alone or in combination with nonopioids such as acetaminophen, ibuprofen, and aspirin. People who take opioids for cancer pain may become tolerant to their effects after awhile, meaning they may need to take larger doses or stronger drugs to achieve the same level of pain relief. These drugs are also associated with common side effects like nausea, drowsiness, and constipation. For these reasons, you must remember to never increase your dose of your medicine on your own, and to increase the dose only under your doctor's order.
While cancer patients sometimes fear becoming "addicted" to medications for pain, it is important to realize that these medications exist for the relief of pain, which is a real and valid symptom common among patients with cancer. These medications can be safely administered without becoming addictive under the watchful supervision of your doctor.
Your doctor may also prescribe other medications such as antidepressants, anticonvulsants, and steroids to manage cancer pain. These drugs are usually used to treat conditions other than pain, but are very effective in treating specific types of pain. These drugs may be combined with nonopioids or opioids with better results.
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Nerve blocks are commonly used to provide relief from acute pain. In this procedure, your doctor will inject an anesthetic (a drug that causes loss of sensation, such as pain) into the nerves in the part of your body experiencing pain or into your spinal cord. The anesthetic disrupts the pain signals from your body to your brain and provides temporary relief. In a similar procedure called neurolysis, your doctor injects ethyl alcohol to destroy your nerve tissue and provide more long-lasting relief.
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Pumps are commonly used to provide relief from more widespread or chronic pain. In this procedure, your doctor implants a pump in or around your spinal cord. The pump disrupts pain signals to your brain by delivering medication to your nerves.
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TENS is another procedure that targets the nerves carrying pain signals to your brain to relieve pain. TENS uses a gentle electric current produced by a small device to stimulate your nerve fibers and provide relief.
Your doctor may recommend neurosurgery for extremely severe pain. In this procedure, the surgeon cuts the nerves that carry pain signals to your brain.
Your doctor may talk to you about other non-drug treatments in addition to your pain medication. Relaxation techniques, mediation, yoga, acupuncture, massage therapy, biofeedback, hypnosis, and imagery may help you feel better.
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