Many people with advanced cancer worry they will be in pain, but not everyone will have pain. Those who do have pain may not be in pain all the time – it may come and go. The pain may be caused by the cancer itself or by cancer treatment. For example, the tumour may be blocking an organ or pressing on organs, nerves or bone.

If you do experience pain, it can usually be controlled. Pain management is a specialised field, and palliative care doctors and nurses are specifically trained in pain management.

There are many ways to relieve pain, including:

Everyone experiences pain differently, so it may take time to find the most effective pain relief or combination of treatments for you. Using tools, such as a pain scale or pain diary, can help you describe your pain and how it is affecting you. This will help your pain specialists work out the best way to control the pain.

How and where the pain is felt and how it affects your life can change. Regular reviews by pain management experts can help keep the pain under control. It’s better to take medicine regularly, rather than waiting for the pain to build up. This is called staying on top of the pain. Controlling the pain may allow you to continue with activities you enjoy for some time and offer a better quality of life.

Pain medicines

Medicines that relieve pain are called analgesics (also known as pain relievers, painkillers and pain medicines). Depending on the type of pain and how intense it is, you may be offered:

  • mild pain medicines, such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs)
  • moderate pain medicine, such as codeine
  • strong pain medicine, such as the opioids morphine, hydromorphone, oxycodone and fentanyl.

Some people worry about becoming addicted to pain medicine, but this is unlikely when medicines are taken palliatively. Your health care team will monitor you to avoid potential side effects. Any side effects, such as constipation or drowsiness, can usually be managed.

To learn more about managing pain, call Cancer Council 13 11 20, see Pain and cancer, and listen to our podcast on Managing Pain when Cancer is Advanced.

Other pain relief methods

You may also be given other types of medicine to take with the main pain medicine. These could include antidepressants and anticonvulsants for nerve pain; anti-anxiety drugs for muscle spasms; or local anaesthetics for nerve pain.

If the pain is hard to control, a pain specialist may consider a nerve block. The type of nerve block you are offered will vary depending on the type of cancer you have. Delivering the pain medicine directly into the nerves in the spine via a tube (epidural) usually provides short-term relief. If longer-term pain control is needed, the epidural can be connected to a pump.

Cancer treatments for pain relief

Chemotherapy, radiation therapy and surgery may also be used to control pain.

Chemotherapy – Uses drugs to shrink a tumour that is causing pain because of its size or location. It can also slow the growth of the cancer and help control symptoms, including pain, loss of appetite and weight loss.

Radiation therapy – Uses radiation, such as x-rays, to shrink a tumour and reduce discomfort. For example, it may relieve headaches by shrinking cancer that has spread to the brain from another part of the body. Often a single treatment can be used.

Surgery – An operation can remove a single tumour in the soft organs; treat a bowel obstruction that is causing pain; or improve outcomes from chemotherapy and radiation therapy by reducing the size of a tumour.

Click on the icon below to download a PDF booklet on living with advanced cancer.

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Instructions for downloading and reading EPUB files

Apple devices

The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:

  • email EPUB files to yourself and transfer the attachment to iBooks.
  • copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
  • open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.

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To download an EPUB file to your Kobo from a Windows computer:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • select “Open folder to view files” to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

To download an EPUB to your Kobo from a Mac:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • open your “Finder” application.
  • select “Kobo eReader” from the listed devices to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
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Sony Reader

To download an EPUB file on your Sony Reader™:

  • ensure you have already installed the Reader™ Library for PC/Mac software
  • select the eBook you want from our website and click the link to download it.
  • connect the Reader™ to your computer.
  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

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Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit
For more information on accessing a PDF on your Kindle™, visit, log in to your account and click on Personal Document Settings.
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Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.

This information was last reviewed in December 2019
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