What is cancer pain?

Pain is an unpleasant physical feeling. The International Association for the Study of Pain defines it as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”.

When there is damage to any part of your body, nerves in that part of the body send messages to your brain. When your brain receives these messages, you feel pain. This includes pain caused by cancer.

Cancer pain is a broad term for the different kinds of pain people may experience when they have cancer. Even people with the same type of cancer can have different experiences. The type of cancer, its stage, the treatment you receive, other health issues, your attitudes and beliefs about pain, and the significance of the pain to you, will also affect the way you feel pain.

Learn more about:

• Does everyone have cancer pain?
• What causes cancer pain? 
• What types of pain are there?
• What affects pain? 
• How is cancer pain managed? 
• When can I use pain medicines?
• Who helps manage my pain? 

Does everyone have cancer pain?

Not everyone with cancer will have pain. Those who do experience pain may not be in pain all the time. It may come and go.

During cancer treatment, about six out of ten people (55%) say they experience some degree of pain. After treatment, about four out of ten people (39%) say they experience pain. People with advanced cancer are more likely to have pain. Advanced cancer is cancer that has spread from its original site or has come back. Nearly seven out of ten people with advanced cancer (66%) have pain.

What causes cancer pain?

Some people with cancer have pain caused by the cancer itself, by the cancer treatment, or by other health issues not related to cancer, such as arthritis. Pain can be experienced at any stage of the disease.

	Before diagnosis Cancer can cause pain before a diagnosis and the pain may come and go. In some cases, pain comes from the tumour itself, e.g. abdominal pain from the tumour pressing on bones, nerves or organs in the body.
	Diagnosis Tests to diagnose cancer can sometimes cause short-term pain or feel uncomfortable, e.g. you may need surgery to remove a sample of tissue for examination. Most pain caused by tests can be relieved.
	During treatment Some treatments cause pain, e.g. surgery; radiation therapy leading to skin redness and irritation; and cancer drug therapies such as chemotherapy, targeted therapy and immunotherapy leading to numbness and tingling in hands and feet (peripheral neuropathy).
	After treatment Pain may continue for months or years. Causes include scars after surgery; numbness in the hands or feet (peripheral neuropathy); swelling caused by a build up of lymph fluid (lymphoedema); and pain in a missing limb or breast.
	Advanced cancer If the cancer has spread, it can cause pain by a tumour pressing on a part of the body such as a nerve, bone or organ.

What types of pain are there?

There are many types of pain. Pain can be described or categorised depending on how long the pain lasts or what parts of the body are affected.

Acute pain – This is pain that starts suddenly and lasts a short time, possibly for a few days or weeks. It may be mild or severe. Acute pain usually occurs because the body is hurt or injured in some way, but it generally disappears when the body has healed.

Chronic pain – This is pain that lasts longer than three months. It may be due to an ongoing problem, but can also develop after any tissue or nerve damage has healed. It is also called persistent pain.

Breakthrough pain – This is a sudden flare-up of pain that can occur despite taking regular pain medicine for cancer pain. It may happen because the dose of medicine is not high enough or because the pain changes when the person changes position or moves around. Other causes of breakthrough pain include stress, anxiety or other illnesses.

Nerve (neuropathic) pain – This is pain caused by pressure on nerves or the spinal cord, or by nerve damage. It can come and go. People often describe nerve pain as numbness, burning or tingling, or as “pins and needles”. Nerve pain can occur anywhere nerves get damaged. For example, after breast surgery, some women have nerve pain in the chest wall or armpit that doesn’t go away over time. This is called post-mastectomy pain syndrome. Nerve damage from some chemotherapy drugs is felt as pain in the hands and feet and is called peripheral neuropathy.

For more on this, see peripheral neuropathy and cancer.

Bone pain – This is pain caused by cancer spreading to the bones and damaging bone tissue in one or more areas. It is often described as dull, aching or throbbing, and it may be worse at night.

Soft tissue pain – This is pain caused by damage to or pressure on soft tissue, including muscle. The pain is often described as sharp, aching or throbbing.

Visceral pain – This is pain caused by damage to or pressure on internal organs. Visceral pain can be difficult to pinpoint. It may cause some people to feel sick in the stomach (nauseous). This type of pain is often described as having a throbbing sensation.

Referred pain – This is pain that is felt in a different area of the body from the area that is damaged (e.g. a swollen liver can cause pain in the right shoulder because the liver presses on nerves that end in the shoulder).

Localised pain – This is pain at the spot where there’s a problem (e.g. pain in the back from a tumour pressing on nerves in the area).

Phantom pain – This is a pain sensation in a body part that is no longer there, such as breast pain after the breast has been removed. This type of pain is very real.

During the treatment, I had pins and needles in my hands and in my feet. Walking just got to be almost impossible because I couldn’t quite walk properly at all.

Read more of Phil’s story