Many people don't know that nearly all cancer pain can be treated successfully, either with or without the use of medication. In addition, many options are available to control or prevent pain related to cancer. In this two-part series, learn practical tips to better manage your pain. This article discusses basic facts about cancer-related pain, medications used to control it, and tips to document and communicate your pain issues with your health-care team.

Facts about cancer-related pain

Pain in people with cancer may occur due to (1) the effects of the cancer itself; (2) side effects of the cancer treatment; and (3) causes unrelated to the cancer, including other diseases, such as arthritis and diabetes. The following are some important facts for you to know about cancer pain and pain management:

• Emotional distress can worsen pain, and pain can contribute to emotional distress.
  
  
• Sleep deprivation can intensify pain, and uncontrolled pain can lead to sleep deprivation.
  
  
• Lack of communication with health-care providers can result in pain not being managed as well as it could be.
  
  
• The most complete and potentially successful approach often combines medical treatment with nonmedical treatment in an individualized plan.

Communication is important

After a thorough medical assessment of any pain, it is important to discuss your concerns and develop a plan with your health-care team. Some hospitals have professionals called pain specialists who are trained in helping people manage cancer pain. Nurses, pharmacists, and other health-care professionals can also help you learn about your options for controlling pain.

Although having cancer doesn't mean you will always have pain, it is important to talk with your doctor about any pain you are experiencing. He or she can help determine the cause of your pain and help select the best treatment options with you.

Patients know their own pain best. So, it is important to discuss the pain you are feeling with your doctor in as specific terms as possible. In fact, a doctor's role in managing pain is to listen to patients and offer an effective pain control solution.

• Consider keeping a pain diary noting the date, time, and intensity level.
  
  
• Keep a record of when the pain started, how long it lasted, and what activities aggravated the pain.
  
  
• Make sure you communicate to a member of your health-care team where the pain started and if the pain was specific to one area or spread to other parts of the body.
  
  
• It may be helpful to describe pain on a scale of 0 to 10, in addition to using words that describe the type of pain, such as "burning," "stabbing," or "throbbing."
  
  
• Note what type of pain control method you tried for relief and its level of effectiveness.

Every person's need for pain relief is different

The intensity, type, and location of pain experienced differs from person to person. Therefore, the options used to treat and manage pain should also be individualized and should remain flexible. When choosing a pain management strategy, the doctor, patient, and patient's family need to consider the stage, location, and type of cancer; the intensity of the pain, the patient's tolerance for pain (called pain threshold), personal preferences, and previous responses to treatment. Finding an effective pain management solution is a collaboration between the cancer care team, the patient, and the family.

Controlling cancer pain

Controlling pain caused by cancer should be part of the overall cancer treatment plan. Preventing pain from occurring or worsening is one of the most effective ways to treat pain caused by cancer. When using medications to treat pain, patients should receive the medication at regular, scheduled intervals, with "rescue" doses for breakthrough pain (pain that surges suddenly through regular pain medications). Rarely is addiction to pain medication a problem. However, if it becomes a problem, there are still ways to manage the pain, even if pain medications called opioids (also called narcotics) are needed. When pain is not managed correctly, a person may experience fatigue, depression, anger, worry, and stress. With effective pain management, people can remain active, sleep better, improve their appetite, and enjoy activities and time spent with family and friends.

Doctors can treat pain in several ways.

• Treating the source of the pain (such as the tumor or inflammation)
  
  
• Changing the perception of pain (usually with pain medications)
  
  
• Interfering with pain signals sent to the brain (through techniques such as spinal treatments or nerve blocks, whereby pain medication is injected into a nerve or surrounding a nerve to interfere with a pain signal)

Often, if pain control is not achieved, switching the dose or type of medication may be helpful, as there are many different drugs and ways to give them, depending on the source of the pain and the person's overall health.

You may experience some side effects while taking pain medication. Opioids, which are used for moderate to severe pain, can cause constipation, nausea, sleepiness, confusion, or hallucinations. Several opioids are marketed under various brand names, but the generic names include fentanyl, hydromorphone, methadone, morphine, oxycodone, and oxymorphone. Opioids used for breakthrough pain include fentanyl and fentanyl citrate. Also, short-acting versions of hydrocodone, hydromorphone, morphine, oxycodone, and oxymorphone may be used. Be sure to tell your doctor if you experience any side effects from your pain medication, as most side effects are easily treatable, sometimes by changing the timing, dose, or type of drug.

More Information

Cancer.Net Feature: Managing and Treating Cancer Pain (Part II)

Managing Side Effects: Pain

Additional Resources

CancerCare: Controlling Cancer Pain: What You Need to Know to Get Relief

National Cancer Institute: Pain Control