Finding Relief from Cancer Pain

Remember to talk to your doctor or healthcare team about any symptoms you are experiencing and before starting any medications or other treatments.

How do I cope or relieve cancer pain?

Coping with cancer pain can be challenging. While cancer pain may not be able to be completely relieved, your doctor may help you control and lessen it as much as possible. Pain does not need to be a normal part of having cancer, it can be treated. Only you know how much pain you are experiencing, so it is important to know how to describe and explain your pain to your doctor.

Your doctor will likely start by doing a pain assessment to better understand your pain. This may include a physical exam or other tests to understand the location and possible cause of the pain, how severe it is, and the medicines that you are willing to try. You may use a pain rating scale with your doctor to describe how much pain you are feeling. If you are experiencing no pain, your pain rating would be 0, whereas 10 means the worst pain that you can imagine.

You can use the rating scale to describe:

• How bad your pain can get

• What your pain feels like most of the time

• Fluctuations in your pain

If the number scale doesn’t work for you, ask your cancer care team if they have another pain rating tool to use.

Your doctor also needs to understand:

• Where you feel pain

• What the pain feels like (sharp, dull, throbbing, gnawing, burning, shooting, or steady)

• How strong the pain is (using a pain rating scale)

• How long the pain lasts

• What makes the pain better

• What makes the pain worse

• How the pain affects your daily activities

• What medicines you are taking for the pain and how much relief you get from them

Once you complete your pain assessment, you and your doctor can start thinking about managing the pain. Together you can develop a plan for pain control. Creating this plan should take into account:

• Your diagnosis (type and stage of cancer)

• Any other health conditions you may have

• Other medications you are taking

• What your personal response to pain is

• Personal and family history of substance use

• Personal history of mental health disorders

• Your own personal preferences

Pain control can improve your quality of life, so it is important that your pain management plan is unique to you and your needs. There are a number of different options available to relieve your pain and your healthcare team can help you explore them.

What medicines treat cancer pain?

Depending on the type, location, and severity of your pain, there are methods and medications created to help provide relief. Here are some medications specifically designed to relieve pain:

• Opioids (narcotics)

  These types of medications are to treat moderate to severe pain. They are often a necessary part of a pain relief plan for cancer patients. Opioids should be used with caution because they could interfere with other medications and may affect people differently. Although most patients use opioids safely, there is a possibility of developing an addiction to opioids. Work with your doctor to carefully monitor your doses, so that you are treated for pain safely

• Non-opioids (non-narcotics)

  Non-opioids or non-narcotics, like acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) control mild to moderate pain. Some can be bought over-the-counter and some are prescribed. Most of the time, non-opioids are all you will need to relieve your pain, especially if you take pain relievers regularly, and not wait until your pain level becomes too intense. Waiting too long can make the pain harder to treat

• Others

  There are other medication options to help treat your pain that include: antidepressants, steroids, antihistamines, anti-anxiety, and anticonvulsants. Some of these medicines can help relieve pain or increase the effect of the pain medicine. Others lessen the side effects of pain medicines. Your doctor and cancer care team can help find the right medications for you

Can I treat my pain without medications?

If you want to explore other options to manage your pain, or if your pain is not relieved by medications, there are other treatments that you can try.

• Surgery

  Surgery can alter the nerve pathways that carry pain signals to the brain. When the nerves that carry pain impulses are cut, the area becomes numb. This is a treatment that cannot be reversed

• Nerve block

  This is a procedure that involves injecting a local anesthetic (a numbing drug), usually combined with a steroid, into or around a nerve, or into the space around the spinal cord to block pain

• Spinal analgesia

  Low doses of pain medicine may be injected into the fluid around the spine (called intrathecal injection) through a tube and a pump. You will need surgery to put the small pump and tube into your body

• Epidural or intrathecal injections

  Certain kinds of pain may respond to pain medicine that’s injected into the space around the layers of the spine. If this works, a pump can be implanted so that you can get pain medicines right around the nerves. This may cause numbness or weakness of the treated area

Are there non-medical treatments for pain?

There are non-medical treatments you can use that are not part of standard medical care to help you cope with cancer pain in addition to your medications. It's important to talk with your doctor about using these kinds of therapeutic solutions, and remember these methods should not be used in place of your pain management plan you have set up with your cancer care team.

Here are some general guidelines for using non-medical methods to manage pain:

• Use these methods along with your regular pain medicines
• Decide how much effort you can give. When you are rested, you can use a method that demands more attention and energy. When you are more tired, you may need to use a method that requires less effort
• Try different methods to see what works best for you. Be open-minded, and keep a diary of what helps and what doesn’t so you can talk to your doctor about it

Mental focus

Below are some methods based on mental focus, breathing, and movement that may help relax the mind and body.

• Biofeedback: Special equipment helps monitor your bodily functions like breathing, heart rate, and blood pressure to help you understand how your body reacts to stress. Biofeedback sessions can be used to learn relaxation techniques that help focus and control bodily functions while you are experiencing pain

• Meditation: Using the power of your focus to concentrate on guiding breathing or repetition of words or phrases to cope with pain

• Imagery: This can be a type of meditation where you hold continuous focus on images you deem as positive like your favorite landscapes, scenes, pictures, or life experiences may help relieve stress in the body

• Yoga/stretching: You can find some physical relief through gentle stretches and poses that you hold for a certain amount of time to focus and relax. Part of a yoga practice is meditation and controlled breathing, which aid in calming the body and mind

• Creative focus: Turning your mind to focus on different forms of expression like art, poetry, music, or dance may bring some relief, relaxation, and maybe even joy that will help you concentrate on other things rather than your cancer and pain