Coping with cancer – pain

Not everybody gets pain from cancer but if you do, it’s natural to feel anxious about what it means and what you should do about it.

Here we ask one of the consultants who specialise in palliative medicine at the LOC, Dr David Feuer, some questions about pain and what to do about it.

Why am I in pain from cancer?

When any part of your body is injured or damaged, your nervous system sends a message to your brain. And when your brain receives these messages, you feel pain. How much pain and what it feels like is very individual so varies a lot between people.

Around half of people who have treatment for cancer have some pain. This injury can happen as a result of surgery, chemotherapy or radiotherapy, as these can all damage your body tissue and sometimes nerves as well. You can also get pain from the cancer itself if the tumour is pressing on your bones, nerves or organs.

Is pain always caused by cancer?

Not at all. Although your focus will naturally be on your cancer, it’s important to remember that there are plenty of common causes of pain – things that you had well before your diagnosis (such as back pain). You can get a headache if you’re dehydrated, for example, or perhaps you have sore muscles after a game of tennis, or you have arthritis. Pain doesn’t always relate to cancer.

Does pain mean the cancer is getting worse – or coming back?

If you have a lot of pain, it’s natural to be worried by this and it might make you think that your cancer is growing. But being in more pain doesn’t necessarily mean your cancer is worse or more advanced. A very small tumour that’s pressing on a nerve can be extremely painful whereas a very large tumour somewhere else might not be painful at all.

Having pain after treatment for cancer doesn’t necessarily mean that your cancer has come back either. Some people find they start to get pain or it gets worse, months or even years after treatment. This can happen when your nervous system ‘rewires’ itself if your nerves were damaged during treatment. The nerves then send pain signals. However, if pain has come back or is getting worse it is important that you discuss with your oncologist.

Can I treat the pain at home?

If you are not already taking any pain medication it may be worth trying some over-the-counter painkillers to see if they help. If you have mild pain, paracetamol might well relieve your pain. If that is not effective or pain persists or is getting worse, it is very important that you speak to your oncologist so that the right investigations can be carried out.

Should I tell my doctor if I’m in pain?

If you’re in pain, it’s vital that you let your doctor know early on, as they can almost always do something to help. And the earlier you treat pain, the more effective that treatment will be. Your doctor or nurse can also ensure you get the emotional support you might need as pain can sometimes feel overwhelming. There’s no need to suffer in silence, help is out there.

Who can help me?

If you’re in pain, you can talk to any of the healthcare professionals involved in your care, including:

How often should I take painkillers?

It’s really important to take painkillers regularly, as prescribed by your doctor. Some people don’t like the idea of taking medicines and try to take as few as possible. Perhaps you wait until the pain is unbearable before you’ll take a pill. But this goes against the way they’re intended to work.

The idea is that you should take your next dose before you’re in pain again so you keep on top of the pain. By missing doses, you lose control and you can be in pain when you don’t need to be.

Can I manage pain without taking medicines?

There are lots of complementary therapies out there that you might find help with pain. Some complementary treatments aim to help you cope better with pain, such as techniques like meditation, while others aim to relieve the physical pain, such as acupuncture and massage therapy. While there’s generally little scientific evidence to prove these work, some people find them helpful so you might wish to give them a go. But it’s important to let your doctor know first in case they affect your medical treatment. Always go to a qualified therapist too. The British Complementary Medicine Association (BCMA) has a list of qualified therapists on its website.

There are other things you can do to make your pain easier to cope with at home. Here are just a few ideas, though prescribed analgesic s may also play a very important role in controlling your pain: