Pain

Having cancer does not always mean that you will have pain, but cancer itself or treatments such as surgery or certain cancer drugs can cause pain. Most types of pain can be managed with different medicines and treatments. 

What are the different types of pain?

1. Acute pain ranges from mild to severe. It comes on quickly and lasts a short time. 
2. Chronic pain ranges from mild to severe and persists or progresses over a long period of time. 
3. Breakthrough pain is an intense rise in pain that happens suddenly or is felt for a short time. It can happen by itself or in relation to a certain activity. It can happen even when you are taking the right dose of medicine. 

What causes pain?

• The cancer itself
• Cancer treatment. For example, while you are recovering from surgery 
• Cancer drugs, which can cause joint or muscle pain
• Nerve damage from the tumour or cancer treatments
• Other medical conditions that have nothing to do with your cancer

Why is it important to control pain?

It’s important that your pain is under control so that you can enjoy your normal activities. 

Pain can make you feel depressed and affect your ability to:

• Move
• Work 
• Enjoy normal activities
• Sleep

What should I do if I have symptoms?

Talk with your doctor if you are in pain. There are drugs and other treatments that can help. You may also be referred to doctors who specialise in pain relief.

Describing your pain

You’re the only one who knows what your pain feels like. Describing how you’re feeling and how the pain is affecting you as fully as possible can help your medical team to work out the best way to treat your pain. 

• Is it a dull or sharp pain?
• Is the pain sudden, always there or does it come over you in waves?
• Is it mild or severe? 
• What makes it better or worse?
• Do you wake up in pain during the night? 
• It can help to write down a description of the pain, the time of the pain and any medication you took to manage the pain and its effect. 

How is pain treated?

Painkilling drugs

There are lots of really effective painkillers for example:

• Over-the-counter drugs like paracetamol
• Strong prescription painkillers such as opioids
• Other drugs, e.g. antidepressants (good for nerve pain), steroids
• Nerve blocks (injecting local anaesthetic in or near your nerves)
• Epidural injections (injection into your spinal cord)
• If you cannot eat properly, you will be given painkillers by injection or in liquid form through a nasogastric or PEG tube. You may have a device called a syringe driver that continually delivers the medication under the skin.
• Antiflammatory drugs or bone strengthening drugs. These can help if you have bone pain
• Cancer treatments. Radiotherapy is very good at treating bone pain from metastatic cancer. Usually you only need 1 dose of radiotherapy. This is called palliative radiotherapy, which means treatment to improve your symptoms rather than to cure the cancer.  Chemotherapy may reduce the size of tumour that is causing pain 
• Complementary therapies. Some complementary therapies may help relieve your pain, depending on what’s causing it and how severe it is. For example, acupuncture, relaxation techniques or gentle massage. Check with your medical team first, to make sure the therapy you’re thinking about is safe for you 

Hints and tips - Taking pain medication

• It is better to take medication regularly, rather than waiting for pain to strike. Take your painkillers regularly as advised, even if you don’t have pain at a particular time. They will help to keep your pain under control. 
• If one doesn’t work, tell your doctor or nurse so they can try something else. They may arrange for you to try out different painkillers to find out what suits you best. 
• Tell your doctor or pharmacist if you’re bothered by side-effects. Some painkillers have side-effects, especially the strong ones. These side-effects may include constipation, feeling sick (nausea) and drowsiness. They may recommend medication to help. 
• Discuss with your doctor or nurse if the pain is worse at night and wakes you up or if you have times when the pain ‘flares up’ and isn’t controlled by your usual pain relief. You can get extra medication to help with this ‘breakthrough pain’.
• If you are constipated from the painkillers, talk to your doctor or nurse. They may suggest you take a laxative every day. Drink plenty of fluids such as water and fruit juice to keep your bowel habits regular. Your doctor or nurse will give you something stronger if your bowels have not opened for 2 or 3 days.
• Don’t drive or work machinery if you feel drowsy.