Pain: Treating Pain with Medication

Approved by the Cancer.Net Editorial Board, 08/2015

People living with cancer may experience pain as a symptom of cancer or as a side effect of cancer treatment. However, your health care team can successfully treat and help you manage nearly all cancer-related pain.

Addressing pain, fatigue, and other symptoms that affect your quality of life is known as palliative care. It is an important part of your overall cancer treatment plan. Your doctor or another member of your health care team will help you find the most effective pain-relief strategies.

The importance of pain relief

There are different types of cancer pain. Pain may last just a short time after a particular treatment or other event. Pain may only occur from time to time. Or, pain may be long-lasting and constant. Pain may also increase suddenly even though it is being treated. This is called breakthrough pain and usually happens during or after some type of activity.

No matter what type of pain you experience, tell your doctor, your nurse, or another member of your health care team. If you do not address cancer-related pain, it can make other symptoms or side effects of cancer seem worse. A person may also experience unnecessary fatigue, depression, anger, worry, or stress. Finding a solution will help you remain active, sleep better, improve your appetite, and enjoy activities and time spent with your family and friends.

Talking with your doctor about managing pain

The type, intensity, and location of pain is different for everyone. Identifying the cause and finding an effective solution requires teamwork between you and your doctor. To make it easier to talk with your doctor about how you are feeling, consider keeping a pain journal. Be sure to include information about pain caused by other health conditions you may have, such as diabetes and arthritis.

To start keeping a pain journal:

  • Write down the date and time you experienced the pain and how long it lasted.

  • Note what activities you were doing when the pain started.

  • Describe where in your body the pain started and if it was specific to one area or spread to other parts of the body.

  • Give your pain a number on a scale of zero to 10, with 10 being the highest level of pain.

  • Use words that describe the type of pain, such as “burning,” “stabbing,” or “throbbing.”

  • Track the pain control methods you tried and how effectively they worked.

Along with this information, your doctor will consider several other factors when deciding how to best manage your pain, such as: 

  • The type of cancer

  • Where the cancer is located

  • The stage of your cancer

  • Your tolerance for pain

  • Your personal preferences for treatment

  • Previous treatments for pain and how well they worked

Types of pain-relief strategies

After thoroughly assessing your pain, your doctor will help you develop a pain-relief plan. Some hospitals have pain specialists and palliative care specialists who focus on the physical and emotional side effects of cancer. They help patients who have pain that is hard to control.

Doctors can treat or manage cancer-related pain in different ways:

  • Treating the source of the pain. For example, pain is often caused by a tumor putting pressure on nerves. Removing the tumor with surgery or shrinking it with radiation therapy or chemotherapy could reduce or eliminate the pain. 

  • Changing the perception of pain. Some medications change how your body feels pain, making it more tolerable.

  • Interfering with pain signals sent to the brain. If medication does not work, your doctor may consider specialized medical procedures. These include spinal treatments or pain medication injected into a nerve or tissue surrounding a nerve to interfere with a pain signal.

Medications for pain

Preventing pain from developing or getting worse is one of the most effective ways to treat cancer-related pain. When using medication to treat pain, patients usually receive it at regular, scheduled times. But doctors also use “rescue” or extra doses to help control breakthrough pain if it occurs.

Many different pain-relief medications, called analgesics, are available. Depending on the drug and the patient’s condition, doctors give them in different ways. Some are taken by mouth, while others are injected into a vein or worn as a skin patch.

  • Non-opioid medications, including acetaminophen (such as Tylenol) and ibuprofen (such as Advil and Motrin), are used to treat mild or moderate pain. Doctors also sometimes prescribe them along with other pain medicines for severe pain. You can usually buy these pain relievers without a prescription. But you should talk with your doctor about how often and how long to use them and the appropriate dose. It is very important to tell your doctor if you are using any of these medications regularly without a recommendation from a doctor.

  • Opioids, which are also called narcotics, are used for moderate to severe pain. They are often taken along with non-opioid medications. A doctor must prescribe these drugs, which include hydrocodone, fentanyl, hydromorphone, methadone, morphine, oxycodone, and oxymorphone (each of these has multiple brand names). Store these extra strong pain relievers securely so other people cannot get them without your permission. If someone uses them without a medical reason, serious side effects and even overdose can happen.

  • Other medications, such as antidepressants and anti-seizure medicines, may be recommended to help relieve some types of pain, especially nerve-related pain.

Medication is not the only option for controlling pain. Many other methods are available, some of which are referred to as complementary therapy. These are treatments used in addition to conventional medicine. You may consider physical therapy, distraction techniques, acupuncture, and massage. The most complete and potentially successful approach to pain control often combines several methods. Learn about additional ways to manage pain.

Common pain management concerns

Some patients do not want to tell their doctor they are experiencing pain because they are scared it means the cancer has worsened or spread. Others feel like pain is simply a part of living with cancer and that they should not complain. Although these thoughts are understandable, there are many reasons pain occurs, and every patient has the right to live without pain.

Some patients worry about becoming addicted to pain medication. This is a valid concern, but it is uncommon if medication is used appropriately. Your health care team is trained to carefully monitor people taking pain medication. And they can help safely decrease your dose when you no longer need treatment. If you or family members have a history of alcohol or drug abuse, tell your doctor so he or she can help you prevent a problem from developing.

It is also normal for patients with cancer to worry about the side effects of medications. Although some medications, particularly those for moderate or severe pain, cause side effects such as constipation, nausea, sleepiness, or confusion, not everyone experiences them. If you do, they often go away over time or are treatable. If a side effect does not go away, or if a medication you are taking is not effective, tell your doctor. Changing the timing, dose, or type of the medication may help.

More Information

ASCO Answers: Safe Storage & Disposal of Pain Medications

ASCO Answers: Managing Pain

Pain: Causes and Diagnosis

Additional Resources

National Cancer Institute: Pain Control—Support for People with Cancer

U.S. Food and Drug Administration: A Guide to Safe Use of Pain Medicine