Pain: Causes and Diagnosis

Approved by the Cancer.Net Editorial Board, 09/2019

People with cancer commonly experience pain. However, up to 95% of cancer pain can be treated successfully. Untreated pain can make other aspects of cancer seem worse. These include:

  • Fatigue

  • Weakness

  • Shortness of breath

  • Nausea

  • Constipation

  • Sleep disturbances

  • Depression

  • Anxiety

  • Mental confusion

Causes of pain

Pain can come from the tumor itself, the cancer treatment, or causes unrelated 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. 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 compress the spinal cord. This 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 pain that lasts for months or years. This long-lasting pain can be 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 radiation therapy to some parts of the body, such as the chest, breast, or spinal cord.

Chemotherapy. Some chemotherapy can cause pain and numbness in the fingers and toes, called peripheral neuropathy. Usually this pain goes away when treatment is finished. But sometimes the damage is permanent.

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

Other causes. People with cancer can still have pain from other causes. These include migraines, arthritis, or chronic low back pain. The treatment plan your health care team develops with you should include these kinds of pain. Any pain decreases your quality of life.

Diagnosing pain

You know your pain best. So it is important to discuss any new symptoms or a change in symptoms with your doctor or a pain specialist. They can help you find a medication or other pain relief method that works for you.

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 the pain been there?

  • How much pain are you having on a scale of 0 to 10?

  • What does the pain feel like, in your own words? For example, is it burning, stabbing, throbbing, or aching?

Managing and treating pain

Some people worry that pain medication is addictive or will make them sleepy or groggy. But there are many ways to manage and treat cancer pain, including medication and methods that don't use medication. Talk with your doctor to find the best treatment for your pain.

Related Resources

ASCO Answers: Managing Pain

What is Palliative Care?

More Information

LIVESTRONG: Chronic Pain

National Cancer Institute: Cancer Pain

ASCOanswers Managing Cancer-Related Pain24th Annual Communicator Awards: Distinction, PrintDownload ASCO’s free booklet, Managing Cancer-Related Pain in English and in Spanish. This 36-page printable PDF provides information about the importance of pain relief, including its causes, how it is diagnosed, and types of pain-relief strategies. It also includes a pain tracking sheet to help patients record how pain affects them. Order printed copies of the booklet in English from the ASCO Store.