Pain

Older man in pain sitting in bed

Having cancer does not always mean that you will have pain, but cancer itself or treatments such as surgery or certain cancer drugs can cause pain. Most types of pain can be controlled with different medicines and treatments. 

What are the different types of pain?

  1. Acute pain ranges from mild to severe. It comes on quickly and lasts a short time. 
  2. Chronic pain ranges from mild to severe and persists or progresses over a long period of time. 
  3. Breakthrough pain is an intense rise in pain that happens suddenly or is felt for a short time. It can happen by itself or in relation to a certain activity. It can happen even when you are taking the right dose of medicine. 

What causes pain?

  • The cancer itself.
  • Cancer treatment. For example, while you are recovering from surgery. 
  • Cancer drugs, which can cause joint or muscle pain.
  • Nerve damage from the tumour or cancer treatments.
  • Other medical conditions that have nothing to do with your cancer.

Why is it important to control pain?

It’s important that your pain is under control so that you can enjoy your normal activities. 

Pain can make you feel depressed and affect your ability to:

  • Move
  • Work 
  • Enjoy normal activities
  • Sleep
Man in hospital with a pain

What should I do if I have symptoms?

Talk with your doctor if you are in pain. There are drugs and other treatments that can help. You may also be referred to doctors who specialise in pain relief.

Describing your pain

You’re the only one who knows what your pain feels like. Describing you’re feeling and how the pain is affecting you as fully as possible can help your medical team to work out the best way to treat your pain. 

  • Is it a dull or sharp pain?
  • Is the pain sudden, always there or does it come over you in waves?
  • Is it mild or severe? 
  • What makes it better or worse?
  • Do you wake up in pain during the night? 
  • It may help to write down the times you get pain.

Tip: Try to score your pain on a scale of 0 to 10, where 0 means no pain at all and 10 means the worst pain you can imagine.

How is pain treated?

Painkilling drugs

There are lots of really effective painkillers for example:

  • Over-the-counter drugs like paracetamol.
  • Strong prescription painkillers.
  • Other drugs, e.g. antidepressants (good for nerve pain), steroids.
  • Nerve blocks (injecting local anaesthetic in or near your nerves).
  • Epidural injections (injection into your spinal cord).
  • PCP (pump that delivers pain relief when you press a button).
  • If you cannot eat properly you will be given painkillers by injection or in liquid form through a nasogastric or PEG tube.
  • Antiflammatory drugs or bone strengthening drugs. These can help if you have bone pain.
  • Cancer treatments. Radiotherapy is very good at treating bone pain from metastatic cancer. Usually you only need 1 dose of radiotherapy. This is called palliative radiotherapy, which means treatment to improve your symptoms rather than to cure the cancer.  Chemotherapy may reduce the size of tumour that is causing pain. 
  • Complementary therapies. Some complementary therapies may help relieve your pain, depending on what’s causing it and how severe it is. For example, acupuncture, relaxation techniques or gentle massage. Check with your medical team first, to make sure the therapy you’re thinking about is safe for you. 

Hints and tips - Taking pain medication

  • It is better to take medication regularly, rather than waiting for pain to strike. Take your painkillers regularly as advised, even if you don’t have pain at a particular time. They will help to keep your pain under control. 
  • If one doesn’t work, tell your doctor or nurse so they can try something else. They may arrange for you to try out different painkillers to find out what suits you best. 
  • Tell your doctor or pharmacist if you’re bothered by side-effects. Some painkillers have side-effects, especially the strong ones. These side-effects may include constipation, feeling sick (nausea) and drowsiness. They may recommend medication to help 
  • Discuss with your doctor or nurse if the pain is worse at night and wakes you up or if you have times when the pain ‘flares up’ and isn’t controlled by your usual pain relief. You can get extra medication to help with this ‘breakthrough pain’.
  • If you are constipated from the painkillers, talk to your doctor or nurse. They may suggest you take a laxative every day. Drink plenty of fluids such as water and fruit juice to keep your bowel habits regular. Your doctor or nurse will give you something stronger if your bowels have not opened for 2 or 3 days.
  • Don’t drive or work machinery if you feel drowsy.

If one drug isn’t working to control your pain, go back to your medical team for help. They can change your medication or increase the dose.

Myths about pain

I shouldn’t take painkillers until my pain is really bad

Pain is more difficult to control when it’s not treated early. Take your painkillers regularly as prescribed by your doctor, even if you don’t have pain at a particular time.

I will get addicted to painkillers

You will not get addicted to painkillers as long as you have physical pain. You need them to reduce your pain. 

Strong painkillers should be left for later or there’ll be nothing left to give

There are lots of options. There’s never a case where nothing can be given.

If I have a lot of pain in means that my cancer is growing

The amount of pain you have doesn’t always relate to the size of your cancer. A very small tumour can cause a lot of pain if it’s pressing on a nerve.

If I have to take morphine it means my cancer is very bad

The amount of pain you have doesn’t always relate to the amount of cancer you have. If you are prescribed morphine it doesn’t mean your cancer is very advanced. Morphine is an opioid painkiller. Opioids are good for moderate to severe pain. They are safe when used correctly and many people taking morphine to control their pain are leading normal lives. 

If I’m put on a pump it will shorten my life

You can be put on a pump (syringe driver) for various reasons. For example, if you’re fasting, can’t swallow or you’re very sick. The same amount of painkillers you’re taking by mouth will be put into the pump, so it won’t shorten your life. 

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