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Cancer Pain

PAIN CONDITION

Cancer Pain: Causes, Treatment & Pain Relief

Dealing with cancer is stressful enough for individuals and their families to go through. Cancer patients who also experience pain during this challenging time can affect their quality of life and overall well-being. Not all cancer causes pain, but approximately 30% of patients will experience moderate to severe pain.[1] Cancer itself, as well as treatments and diagnostics, can cause pain.[2]

Understanding the causes, symptoms, and treatment options for cancer pain is essential for effective management and relief.

About Cancer Pain

Cancer pain is the discomfort related to the disease and the treatment, testing, or complications. Pain can develop at any stage and may vary in intensity. The pain patients experience can be classified as acute, chronic, or breakthrough[3], disrupting daily activities and affecting sleep, mood, and appetite. Other types of cancer pain include nerve (neuropathic), bone, soft tissue and referred pain.[4]

Cancer Pain Symptoms

Symptoms of cancer pain can vary widely due to the type of cancer, the stage, location and individual pain tolerance levels. Pain can change throughout the day, and even where it hurts can vary.

Cancer patients often describe their pain as:

  • Sharp[3]
  • Dull[3]
  • Burning[3]
  • Throbbing[3]
  • Tingling[3]
  • Tight or stiff (muscles)[3]
  • Joint pain[2]
  • Inflammation[2]
  • Dull or achy (bone pain)[4]
  • Painful numbness and tingling in hands and feet (chemotherapy-induced peripheral neuropathy or CIPN)[2]

Cancer Pain Causes

The most common causes of cancer-related pain include:

  • Cancer surgery(Postoperative pain)[2]

  • Tumors pressing on organs or nerves[3]

  • Inflammation[5]

  • Nerve damage[2]

  • Aromatase Inhibitor Therapy[2]

  • Diagnostic testing[6]

  • Chemotherapy[6]

  • Radiotherapy(RT)[6]

  • Targeted therapy (TT)[6]

  • Bone pain[7]

  • Phantom pain[8]

  • Immunotherapy (inflammatory arthritis)[4]

  • Referred pain[8]

  • Soft tissue damage[4]

  • Breakthrough pain[8]

Cancer Pain Management Treatments

Not all cancer patients experience pain, but for those who do, proper diagnosis of the type of pain and intensity is essential for effective pain management.[9] Advanced or returning cancer (cancer that has been treated but has come back) is often associated with moderate to severe pain.[1]

Most cancer pain control can be managed with a multidisciplinary approach tailored to individual needs. Treatment often includes pharmacological and non-pharmacological intervention options. Pharmacological treatment may consist of medications such as opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and adjuvant drugs like antidepressants and anticonvulsants.[10] Other interventions such as nerve blocks, kyphoplasty, intrathecal pumps and radiofrequency ablation are minimally invasive procedures for pain relief.[11] Complementary therapies (non-drug) like acupuncture and relaxation techniques can also help alleviate pain, increase the success of other treatment modalities and improve overall well-being.[10]

When to Consult a Cancer Pain Care Specialist

You do not have to “tough it out” when cancer pain is affecting your physical and mental health. Pain management can improve your quality of life and your well-being. If you or a loved one is experiencing pain due to cancer or treatment, seek professional help to evaluate the pain level and receive life-changing pain management.

Consulting a palliative care physician or pain management specialist is recommended when pain persists despite conventional treatments, interferes significantly with daily activities and quality of life, or when there are concerns about medication side effects or addiction.

Cancer pain is a complex and often debilitating symptom that requires comprehensive assessment and management. Healthcare providers will work collaboratively to optimize pain control and enhance patient’s overall well-being throughout the cancer journey.

Resources:

  1. Cancer Research UK. About cancer pain | Coping with cancer. Cancer Research UK [Internet] Reviewed January 11, 2024. Accessed April 30, 2024. Available from: https://www.cancerresearchuk.org/about-cancer/coping/physically/cancer-and-pain-control/about-cancer-pain
  2. National Cancer Institute. Cancer Pain (PDQ®)–Patient Version. National Cancer Institute [Internet]. March 6, 2019. Accessed April 30, 2024. Available from: https://www.cancer.gov/about-cancer/treatment/side-effects/pain/pain-pdq
  3. Facts About Cancer Pain | Pain from Cancer & Cancer Treatment. American Cancer Society [Internet]. Revised March 29, 2024. Accessed April 30, 2024. Available from: https://www.cancer.org/cancer/managing-cancer/side-effects/pain/cancer-pain/pain-in-people-with-cancer.html
  4. Cancer Research UK. Causes and types of cancer pain | Coping with cancer. Cancer Research UK [Internet]. 2018. Reviewed January 12, 2024. Accessed April 30, 2024. Available from: https://www.cancerresearchuk.org/about-cancer/coping/physically/cancer-and-pain-control/causes-and-types
  5. Singh N, Baby D, Rajguru JP, Patil PB, Thakkannavar SS, Pujari VB. Inflammation and Cancer. Annals of African Medicine [Internet]. 2019;18(3):121-126. doi:https://doi.org/10.4103/aam.aam_56_18 Accessed on April 30, 2024. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6704802/
  6. Ripamonti CI, Bossi P, Santini D, Fallon M. Pain related to cancer treatments and diagnostic procedures: a no man’s land?. Ann Oncol [Internet]. 2014;25(6):1097-1106. doi:10.1093/annonc/mdu011. Accessed April 30, 2024. Available from: https://www.annalsofoncology.org/article/S0923-7534(19)36565-2/fulltext
  7. Jimenez-Andrade JM, Mantyh WG, Bloom AP, Ferng AS, Geffre CP, Mantyh PW. Bone cancer pain. Annals of the New York Academy of Sciences [Internet]. 2010;1198(1):173-181. Accessed April 30, 2024. doi:https://doi.org/10.1111/j.1749-6632.2009.05429.x Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5642911/
  8. Cleveland Clinic. Cancer Pain: Management & Treatment Options. Cleveland Clinic [Internet]. Reviewed October 26, 2022. Accessed April 30, 2024. Available from: https://my.clevelandclinic.org/health/symptoms/17316-pain-management–cancer-care
  9. Mayo Clinic Staff. Cancer pain: Relief is possible. Mayo Clinic [Internet]. October, 12, 2022. Accessed April 30, 2024. Available from: https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-pain/art-20045118
  10. Side Effects: Cancer Pain Management. The University of Texas – MD Anderson Cancer Center [Internet]. 2019. Accessed April 30, 2024. Available from: https://www.mdanderson.org/patients-family/diagnosis-treatment/emotional-physical-effects/cancer-pain-management.html
  11. Kurita G, Sjøgren P, Klepstad P, Mercadante S. Interventional Techniques for the Management of Cancer-Related Pain: Clinical and Critical Aspects. Cancers (Basel) [Internet]. 2019;11(4):443. March 29, 2019. Accessed April 30, 2024. doi: https://doi.org/10.3390/cancers11040443 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520967
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