There are different ways to treat cancer pain. Treatment that is aimed at relieving pain, rather than curing the disease, is called palliation or palliative treatment.
Depending on the cancer you have, and the location and nature of your pain, the treatments below may be used specifically for pain management.
Surgery – An operation can relieve discomfort caused by tumours that obstruct organs, press on nerves or cause bleeding. Examples are unblocking the bile duct to relieve jaundice, which occurs in pancreatic cancer, or removing a painful bowel obstruction, which can occur with ovarian or bowel cancer.
Radiotherapy – This treatment injures cancer cells so that tumours shrink and stop causing discomfort. For example,
radiotherapy can relieve bone pain caused by the spread of cancer, and headaches caused by increased pressure in the brain due to cancer.
Chemotherapy – Cytotoxic drugs used to kill cancer cells or slow their growth. In some cases, chemotherapy can’t cure cancer but can shrink tumours that are causing pain, such as a tumour on the spine that cannot be operated on.
Hormone therapy – Cancers that grow in response to chemical messengers (hormones) in the body can often be slowed down by taking drugs that stop the body’s production of those hormones. The drugs may also shrink tumours that are causing discomfort, reduce inflammation and relieve symptoms of advanced cancer, such as bone pain. Corticosteroids are a type of hormone that lessens swelling around a brain tumour.
Using pain medications
Medications that relieve pain are called analgesics. They do not affect the cause of the pain, but they can reduce pain effectively. The medication that is best for you depends on the type of pain you have and how severe it is.
Taking your medication regularly is the best way to prevent pain from starting or getting worse. Some people call this ‘staying on top of the pain’. It may mean you can use lower doses of a pain reliever than if you wait until the pain gets bad. Don’t be afraid to admit that you have pain.
Different pain medications take different amounts of time to work. For some medication, it is only a few minutes. For others, it is several hours. Some pain medication even needs to be taken for several days or weeks before you get the best relief, so it is important to keep taking it, even if you think it’s not working.
Pain relief from different medications varies greatly from person to person. It also depends on how much medication you take (the dose) and how often you take it (the frequency). A dose of pain medication should be enough to control the pain until the next scheduled dose.
If the pain relief is wearing off before the next dose is due, tell your doctor or nurse. Check if you need to take larger doses to keep the pain under control – your dose may need to change over time.
Ways medications are given
Pain medications are given in several ways, depending on the type of medication and the form that it is available in.
- tablet or capsule – this is the most common form of pain medication. Take medication with water or another drink, unless the doctor tells you otherwise. Don’t take a tablet or capsule with alcohol.
- liquid – this may be an option if you have trouble swallowing tablets or for convenience.
- lozenges – these are rubbed on the inside of your cheeks and gums until they dissolve.
- injection – a needle is briefly inserted into a vein (intravenously), into a muscle (intramuscularly), or under the skin (subcutaneously). You may be able to do your own subcutaneous injections, but other types must be done by a doctor or nurse.
- skin patch – this gradually releases medication into the body.
- subcutaneous infusion – medication is slowly injected under the skin using a small plastic tube and pump for many hours or days.
- intravenous infusion – medication is slowly injected into a vein using a small plastic tube and pump over many hours or days.
- intrathecal injection or infusion – liquid medicine that is delivered into the fluid surrounding the spinal cord. It is commonly used to treat the most severe cancer pain.
- suppository – a pellet placed in the rectum. This may be suitable for someone who has nausea or trouble swallowing.
Prescription and non-prescription medications
Mild pain relief is available from chemists and supermarkets without a prescription. These are known as over-the-counter or non-prescription medications.
Stronger pain medications need a prescription, which means a doctor authorises you to have them (prescribes them). Only a pharmacist can give (dispense) them to you. If you’re in hospital, medications are organised by pharmacists and nurses there.
Generic trade names
Medications have a generic name, which identifies the chemical compounds in the drug, and a trade name, which is the manufacturer’s version of the drug. A medication often has more than one trade name, as different companies may produce it.
Medication safety information
You should take precautions when managing or storing your medications to avoid potential dangerous mix-ups. Medicines come in many forms, so you may be taking other substances that you didn’t realise were considered medication. For instance, vitamin supplements and herbal remedies are considered medications.
Ask your doctor, nurse or pharmacist about taking any other medications at the same time as your pain relief. This is because different medications may react with each other, stop the substance from working properly in the body, or cause dangerous side effects.
Many pills for colds and flu, and other over-the-counter medications, can be taken with analgesics without any harmful effects. However, some over-the-counter medications contain pain relievers, so a lower dose of pain medication may be needed.
Medications for colds, menstrual (period) pain, headaches and joint or muscle aches often contain a mixture of drugs, including aspirin. People receiving chemotherapy should avoid aspirin because it increases the risk of internal bleeding. Any minor cuts are likely to bleed a lot and not stop bleeding (clot) very quickly.
Over-the-counter medications for allergies may cause drowsiness, as can some pain medications. Taking them together can make it dangerous to drive or to operate machinery.
- Ask your doctor, nurse or pharmacist for written information about your pain medications: what they are for, when and how to take them, possible side effects and what you can do about side effects.
- Keep medications in their original packaging so you and other people always know what they’re for.
- Store medication in a safe place that is out of reach of children.
- If you’re worried about forgetting to take medications, write a note for yourself, set an alarm or program a reminder on your phone rather than leaving out pills.
- Regularly check the expiry dates of medications. If they are near or past their expiry, see your doctor for a new prescription. Take old medications to the pharmacy to dispose of them safely. Check whether it is safe to take any complementary medicines, such as nutritional supplements, together with your pain medication.
- For independent information about your medications, call the National Prescribing Service Medicines Line on 1300 633 424.
- Keep track of all of your medications by using a list or a smartphone app, such as the NPS Medicinewise app. See www.nps.org.au.
- If you suspect you’ve had a reaction to any kind of medicine, call the Consumer Adverse Medications Event Line on 1300 134 237 and tell your health care team immediately
This information was last reviewed in November 2013
This information has been reviewed by: Dr Melanie Lovell, Consultant Palliative Care Physician, Senior Lecturer, Sydney Medical School, University of Sydney, NSW; Prof Frances Boyle AM, Professor of Medical Oncology, Mater Hospital and University of Sydney, NSW; Prof Michael J Cousins AM, Professor & Head, Pain Management & Research Centre, Royal North Shore Hospital, NSW; Carol Kanowski, Clinical Nurse Consultant, North Queensland Persistent Pain Management Service, QLD; Brenda Kirkwood, Helpline Operator, Cancer Council QLD; A/Prof Odette Spruyt, Director, Pain and Palliative Care, Peter MacCallum Cancer Centre, VIC; and Sally White, Consumer.View our editoral policy