What is pain and its causes?

Pain is not just a sensation that hurts. It is an unpleasant sensory and emotional experience associated with actual or possible tissue damage.

Your emotions, environment and other physical factors also affect pain. These factors act directly or indirectly on the body’s nervous system (the brain, spinal cord and nerves).

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 pain experience. Health professionals assess all these factors to help treat the pain.

Your experience of pain

Only you can describe your pain – it may be steady, burning, throbbing,  stabbing, aching or pinching. Health professionals, family members and carers will rely on your description to work out the level of pain and its impact on your life. Learn more about different ways to let health professionals know how you’re feeling in Describing pain.

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Does everyone with cancer have pain?

Cancer pain is a broad term for different kinds of pain that people may experience when they have cancer.

During treatment, about six out of 10 people (59%) say they experience pain. People with advanced cancer are slightly more likely to experience pain (64%). After treatment, about one in three people (33%) say they experience pain. They may not be in pain all the time – it may come and go.


What causes cancer pain?

People with cancer may have pain for a variety of reasons. It may be caused by the cancer itself or by the cancer treatment, or it may have another cause. Some reasons for pain include:

  • a tumour pressing on organs, nerves or bone
  • a fracture if the cancer has spread to the bones
  • side effects from chemotherapy, radiotherapy or surgery
  • poor circulation due to blocked blood vessels
  • blockage of an organ or tube in the body, such as the bowel
  • infection or swelling and redness (inflammation)
  • muscle stiffness from tension or inactivity
  • poor posture, which can lead to back pain, for example.

New pain or an increase in pain doesn’t necessarily mean that the cancer has advanced or spread to another part of the body (metastasised). This is a common concern for people with changing pain levels.

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What affects pain?

As well as the cause of the pain itself, your emotions, environment and fatigue levels can affect how you feel and react to pain. It’s important for your health care team to understand the way these factors affect you.

Emotions – You may worry or feel easily discouraged when in pain. Some people feel hopeless, helpless, isolated, embarrassed, inadequate, irritable, angry, frightened or frantic.

Environment – Things and people in your environment – at home, at work and elsewhere – can have a positive or negative impact on your pain.

Fatigue – Extreme tiredness can make it harder for you to cope with pain. Lack of sleep can increase your pain. Ask your doctor, nurse practitioner or nurse for help if you are not sleeping well.


How is cancer pain treated?

There are many ways of treating both acute and chronic cancer pain. Treatment depends on the cause of the pain, but relief is still available even if the cause is unknown.

Cancer pain is often treated in a variety of ways, such as:

Many people find a combination of treatments helps, but everyone is different, so it might take time to find the right pain relief for you. 

Different things might work at different times, so it is important to try a variety of pain relief methods and persist in finding the best options for you.

Sometimes it’s not possible to completely control all pain. You may still feel some discomfort. However, your health professionals can help make you as comfortable as possible.

The World Health Organization estimates that the right medicine, in the right dose, given at the right time, can relieve 80–90% of cancer pain.

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When can I use pain relief?

You can use different types of pain relief whenever you feel any level of pain. If you have pain, it’s better to get help and relief as soon as possible. This results in better pain control and less pain overall.

If pain lasts longer than a few days without much relief, see your doctor for advice. It’s important not to let the pain get out of control before doing something about it.

Your doctor will talk to you about how much pain relief to take (the dose) and how often (the frequency).

Many people believe that they should delay using pain-killers for as long as possible, and that they should only get help when pain becomes unbearable. If you do this, it can mean you are in pain when you don’t need to be. It can also make the pain more difficult to control. There is no need to save pain-killers until your pain is severe. Severe pain can cause anxiety and difficulty sleeping. These things can make the pain harder to control. The aim is for pain control to be constant. Learn more about Using pain medicines.

Try various pain relief methods more than once. If the pain doesn’t improve the first time, try it a few more times before you give up. If you’re taking medicine that doesn’t seem to work or has stopped working, talk to your doctor – don’t change the dose yourself.

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Is palliative care the same as pain management?

To ‘palliate’ means to relieve. Pain management is only one aspect of palliative care. The palliative care team includes doctors, nurses, social workers, physiotherapists, occupational therapists and pastoral care workers. They work together to:

  • maintain your quality of life by easing symptoms of cancer
  • ease your physical, practical, emotional and spiritual needs
  • help you feel in control of your situation and make decisions about your treatment and ongoing care.

Your hospital doctor or nurse can put you in touch with a palliative care team for treatment in hospital or at home. Referral to palliative care is possible throughout the course of cancer treatment, not just at end of life.

    Understanding Palliative Care

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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.

Need more help? Visit: http://support.apple.com/kb/HT4059

Kobo

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”.
Need more information? Visit: http://www.kobo.com/help/koboaura/response/?id=3784&type=3

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.

Need more help? Visit: https://au.readerstore.sony.com/apps_and_devices/

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 http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
For more information on accessing a PDF on your Kindle™, visit www.amazon.com/manageyourkindle, log in to your account and click on Personal Document Settings.
Need more help? Visit https://www.amazon.com/gp/help/customer/display.html?nodeId=200375630

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.

Read more

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.

Need more help? Visit: http://support.apple.com/kb/HT4059

Kobo

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”.
Need more information? Visit: http://www.kobo.com/help/koboaura/response/?id=3784&type=3

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.

Need more help? Visit: https://au.readerstore.sony.com/apps_and_devices/

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 http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
For more information on accessing a PDF on your Kindle™, visit www.amazon.com/manageyourkindle, log in to your account and click on Personal Document Settings.
Need more help? Visit https://www.amazon.com/gp/help/customer/display.html?nodeId=200375630

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 September 2015
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