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Cancer: Controlling Cancer Pain

Introduction

Having cancer does not mean that you have to live with pain. Cancer and some of the treatments for it can cause pain. But most people who have cancer are able to manage their pain well. 1

  • Cancer pain can almost always be controlled. Only you know how you feel and how much pain you have. Tell your health care team what your pain feels like and what works and does not work.
  • Don't wait for pain to get bad. Your pain medicine will work best if you use it when you first notice pain, before it becomes bad.
  • If you are taking pain medicine regularly for cancer pain, have a plan (and medicines on hand) for breakthrough pain . This is sudden and intense pain that can happen while you are already taking pain medicine.
  • The risk of becoming addicted to pain medicines is very small. Do not let this fear stop you from getting the pain relief you need.
  • Managing your pain can mean treating other problems, too. Uncontrolled cancer pain can lead to anxiety, sleep problems, or depression.

How can I control the pain caused by cancer?

Keep track of your pain and your treatments

Your doctor needs all the information you can give about what your pain feels like. Your doctor needs to know how your treatment is working or not working. It may be easier to give your doctor information if you write it down. Use a daily diary to rate your pain . Write down what drugs you are taking and how well they are working. Write down any other methods you are using to control your pain.

Pay attention to the details of your pain so you can tell your doctor. Is it burning? Throbbing? Steady? How long does it last? Take your written information and your questions with you when you see your doctor.

Use a calendar or a pain control diary (What is a PDF document?) to keep track of your treatment. Write down how strong your pain is and when it comes and goes. Most doctors use a "0 to 10" scale to measure pain. On this scale, "0" means no pain and "10" means the worst possible pain.

It is easy to get confused about medicines when you are in pain and are looking for something to help you feel better. You may have prescriptions from more than one doctor. Keeping a written medicine record (What is a PDF document?) can help you and your doctors work together.

Stay on top of your pain

Your pain will be harder to control if you let it get worse before you take your medicine. Make the most of your pain medicines by following these rules:

  • Take them on time (by the clock).
  • Do not skip a dose or wait until you think you need it.
  • Be prepared for breakthrough pain. You may find that taking your medicine works most of the time, but your pain flares up during extra activity or even for no clear reason. This is called breakthrough pain. Your doctor can give you a prescription for fast-acting medicines that you can take for breakthrough pain.
  • Ask one of your doctors to be your team leader. It is best to have one doctor in charge of all your medicines. If more than one doctor prescribes pain medicine, make sure they talk to each other about it.

Manage the side effects

Pain medicines may cause side effects. For example, opiate pain relievers may cause drowsiness, constipation, nausea, and vomiting. Some anti-inflammatory drugs, including aspirin, may cause stomach upset or bleeding. Before you start taking a drug, ask your doctor about the possible side effects.

There are things you can do to manage some side effects.

  • Home treatment for nausea or vomiting includes eating clear soups, mild foods, and liquids if you feel nauseated. Watch for and treat early signs of dehydration. Older adults can quickly become dehydrated from vomiting.
  • Home treatment for constipation includes making sure that you drink enough fluids and include fruits, vegetables, and fiber in your diet each day. Do not use a laxative without first talking to your doctor.

Try complementary medicine

Complementary medicine is the term for a wide variety of health care practices that may be used along with or in place of standard medical treatment. If you use one or more of these practices, you may be able to take a lower dose of pain medicines.

Most of these therapies have not been subjected to the same degree of rigorous scientific testing for safety and effectiveness that standard medical treatments must go through before they are approved in the United States. Be sure to talk with your doctor about which therapies might be best for you.

Behavioral therapies
  • Biofeedback is a method of consciously controlling a body function that is normally controlled unconsciously, such as skin temperature, muscle tension, heart rate, or blood pressure.
  • Cognitive-behavioral therapy is a type of counseling that can help you cope with pain by modifying certain thought and behavior patterns.
  • Relaxation exercises, music therapy, humor therapy, and prayer may reduce tension, help you feel relaxed, and reduce stress.
  • Guided imagery is a series of thoughts and suggestions that direct your imagination toward a relaxed, focused state. You can use an instructor, tapes, or scripts to guide you through this process.
  • Hypnosis is a state of focused concentration that allows you to become less aware of your surroundings.
Physical therapies
Other therapies
  • Acupuncture is a form of traditional Chinese medicine. It is done by inserting very thin needles into the skin at certain points on the body. Acupuncture may help relieve pain. 2
  • Aromatherapy is the therapeutic use of aroma-producing oils (essential oils) extracted from a plant's flowers, leaves, stalks, bark, rind, or roots. These oils are mixed with another substance, such as oil, alcohol, or lotion, and then applied to the skin, sprayed in the air, or inhaled.
  • Healing touch is the conscious influence of one person on another, without physical means of intervention, to benefit the recipient's physical or emotional well-being.
  • Meditation is the practice of focusing your attention to alter your state of consciousness, usually directed toward feeling calm and having a clear awareness about your life.
  • Yoga is a meditation program that includes exercises to help improve flexibility and breathing, decrease stress, and maintain health.

For more information on these therapies, see the topic Complementary Medicine.

References

Citations

  1. National Cancer Institute (2013). Pain PDQ – Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/supportivecare/pain/Patient.
  2. National Comprehensive Cancer Network (2013). Adult cancer pain. NCCN Clinical Practice Guidelines in Oncology, version 1.2013. Available online: http://www.nccn.org/professionals/physician_gls/pdf/pain.pdf.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Michael Seth Rabin, MD - Medical Oncology
Current as of March 12, 2014

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