Pain: Causes and Diagnosis

This section has been reviewed and approved by the Cancer.Net Editorial Board, 07/2014

Pain is a common symptom in people with cancer. However, it may help to know that up to 95% of cancer pain can be treated successfully. Untreated pain can make other aspects of cancer seem worse, such as fatigue, weakness, shortness of breath, nausea, constipation, sleep disturbances, depression, anxiety, and mental confusion.

Some people with cancer don’t benefit from pain relief strategies because they don't share the symptoms with their health care team. Other people worry that pain medication is addictive or will make them sleepy or groggy. Your doctor or a pain specialist can help you find a medication that works for you and suggest other methods of pain relief in addition to medication.

Relieving side effects, also called symptom management, palliative care, or supportive care, is an important part of cancer care and treatment. Talk with your health care team about any symptoms of pain you may experience, including any new symptoms or a change in symptoms.

Causes

Pain can come from the tumor itself, the cancer treatment, or it could be from causes not related to cancer. A good pain treatment plan will take care of pain from all causes.

The tumor. A tumor growing in an organ, such as the liver, may stretch part of the organ, and this stretching causes pain. If a tumor grows and spreads to the bones or other organs, it may put pressure on nerves and damage them, causing pain. Or, if a tumor spreads or grows around the spinal cord, it can cause a compression of the spinal cord, which eventually leads to severe pain or paralysis if not treated.

Surgery. It is normal to experience pain from cancer surgery. Most pain goes away after a while, but some people may have persistent pain for months or years from permanent damage to the nerves and the development of scar tissue.

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.

Chemotherapy. Some 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. Learn more about peripheral neuropathy.

Find out more about the side effects of surgery, radiation therapy, and chemotherapy.

Other causes. People with cancer can still have pain from other causes, like migraines, arthritis, or chronic low back pain. The treatment plan your doctors develop with you should also include these kinds of pain, because any pain decreases your quality of life.

Diagnosis

You know your own pain best. To help your doctor better understand your pain, he or she may ask the following questions:

  • Where does it hurt?
  • When does the pain stop and start?
  • How long has it been there?
  • How intense is the pain?
  • What does the pain feel like, in your own words?

The doctor may also ask you to describe how much pain you are having by using a scale from 0 to 10, or offer words that help describe the pain, such as burning, stabbing, or throbbing.

Management and treatment

There are variety of ways to manage and treat cancer pain, including medication and methods that don't use medication. Read about managing pain with medication and additional ways to manage pain for more information.

More Information

ASCO Answers Fact Sheet: Managing Pain (PDF)

Side Effects

Additional Resources

LIVESTRONG: Chronic Pain

National Cancer Institute: Pain