The Basics of Cancer Pain

What causes cancer pain?

Pain can be caused by cancer, cancer treatment, or a combination of factors. It is one of the most common symptoms in people with cancer. There are various reasons for the pain, it could be from the cancer itself or from tumors, surgery, or even treatments for the cancer like chemotherapy, radiation therapy, and targeted therapy.

Cancer pain is experienced differently from person to person. The level of pain you may be experiencing depends on different factors: the type of cancer, the stage of the cancer, or other health problems you may have, and your tolerance for pain. You may have pain that has nothing to do with the cancer or its treatment. Like anyone, you can get aches or pains from stress or various other lifestyle factors. 

Cancer pain can be categorized as acute, chronic, or breakthrough.

• Acute pain
  Acute pain happens because of damage from an injury, such as surgery. The pain often lasts for a short time, and the pain generally goes away when the wound heals
• Chronic pain
  Chronic pain is a persistent type of pain that lasts for at least three months. Chronic pain may continue long after the injury or treatment is over and ranges from mild to severe. Unfortunately, it can persist and be constant or worsen over time, and it typically does not go away unless the underlying cause is treated
• Breakthrough pain
  Breakthrough pain often has the same cause as chronic pain. It could be the cancer itself or it could be related to cancer treatment. This kind of pain is like a flare that may occur even though you may be taking pain medicine for chronic pain. That’s why it’s called “breakthrough.” It is not predictable and comes on quickly, lasts as long as an hour, and can feel a lot like chronic pain, but can vary in intensity

There are different types of cancer pain. It is helpful for your healthcare team to know what type of pain you are experiencing, so they can find the right medical treatment that may help alleviate the pain for you.

What are the different types of pain? 

Different types of pain require different treatments. Once you and your doctor understand what type of pain you are experiencing, they can help you treat it.   

To understand more about your pain, your doctor may ask you:

• When the pain started
• How long the pain lasts
• Where the pain is located
• How strong the pain is (you may be asked to rate your pain between 1-10, with higher numbers expressing stronger pain)
• If there are any changes in where or when the pain occurs
• If the pain worsens during certain times of the day or night

Here are some different types of cancer pain to help you understand the various ways pain can manifest in the body.

• Surgical pain
  For cancers that grow as solid tumors, surgery is usually part of the treatment plan. Depending on the type of surgery you have, you can expect some amount of pain that usually lasts from a few days to weeks. Your doctor can help you determine what pain medicines you may need after surgery.
• Nerve pain
  Nerve pain is also called “neuropathic” pain. It can feel like a burning, shooting, crawling, or tingling sensation under your skin. Nerve pain can be caused by damage to the nerves from cancer treatment (i.e, radiotherapy or chemotherapy) or internal pressure on the nerves. Some people have long-term nerve pain after surgery and often the pain subsides after the nerves heal over time. However, some types of nerve pain can be difficult to treat.
• Bone pain
  This type of pain is also called “somatic” pain and can feel like a dull aching or throbbing sensation. When cancer spreads into the bone, it can cause pain by damaging the bone tissues and affecting one specific area of bone or several areas.
• Soft tissue pain
  Soft tissue pain is also called “referred” pain, which means pain from an organ or muscle. Sometimes people can feel pain from an organ that is manifesting elsewhere in the body. For example, because a swollen liver can press on the nerves, you might feel it in the right shoulder, even though the liver is under the ribs. Or you could have pain in your back that is caused by tissue damage to the kidney. This kind of pain can be hard to pinpoint, but it is usually described as sharp, cramping, aching, or throbbing pain.
• Phantom pain
  Phantom pain is a long-lasting effect of surgery, beyond the usual surgical pain, that shows up after a part of the body is removed. For example, if you’ve had a leg, arm, or breast removed, you may still feel pain or other unusual or unpleasant sensations that seem to be coming from the absent (phantom) body part. Doctors are not sure why this happens, but phantom pain is real.