Many people with advanced cancer worry they will be in pain, but not everyone with cancer has pain and many find the pain comes and goes. Whether you have pain depends on the location of the cancer and its size.
If you do experience pain, it can usually be controlled. Pain management is a specialised field for doctors and nurses, and palliative care services are specifically trained in pain management.
There are many ways to relieve pain, including:
- pain medicines
- pain-relieving procedures for nerve pain
- complementary therapies such as massage, meditation, yoga, hypnotherapy or cognitive behavioural therapy.
- chemotherapy, radiotherapy or surgery.
Everyone experiences pain differently, so it may take time to find the most effective pain relief or combination of treatments for you. To work out the best pain control method, your pain specialists will ask you to use a variety of tools, such as a pain scale or pain diary, to describe your 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.
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Medicines that relieve pain are called analgesics. 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 known as opioids, such as morphine, oxycodone and fentanyl.
Some people worry about becoming addicted to pain medicine, but this is unlikely when medicines are taken to relieve pain. Any side effects, such as constipation or drowsiness, can usually be managed.
For more information about managing pain and answers to common concerns, call Cancer Council 13 11 20 for a free copy of the Overcoming Cancer Pain booklet, or download a digital copy from this page.
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 manage, 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) can cause fewer side effects, however this is usually temporary.
Cancer treatments for pain relief
Chemotherapy, radiotherapy and surgery may also be used to control pain.
Chemotherapy – This drug treatment can shrink cancer 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.
Radiotherapy – This 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 (brain metastasis).
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 radiotherapy by reducing the size of a tumour.