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by Scholten A

Definition

About one-third of people with cancer have pain. Cancer pain can be affected by:

  • The cancer getting worse
  • Where cancer is in the body
  • A person's physical condition

Most cancer pain can be managed with treatment.

Causes

Cancer pain may be caused by:

  • Tumors pressing on bone, nerves, or an organ.
  • Cancer treatment, such as chemotherapy, radiation therapy, and surgery
Chemotherapy Affects the Whole Body
Chemotherapy
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Risk Factors

Having cancer is the main risk factor for cancer pain.

Symptoms

Cancer pain will vary from person to person. The pain may be:

  • Near or far from the tumor
  • Mild, moderate, or severe
  • Regular and long lasting, or it may come and go
  • Felt as pressure, sharp, dull, throbbing, burning, stabbing, or achy

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. Tests may also be done to find possible causes of the pain. They may include:

Imaging tests such as:

Nerve tests, such as:

Treatment

Treatment depends on the type of pain. It also depends on how the cancer has been treated. The goal is to manage pain. Options may be:

Medicine

  • Non-opioids—to treat mild-to-moderate cancer pain:
    • Acetaminophen
    • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Opioids—often used to treat moderate-to-severe cancer pain
  • Medicines to treat nerve pain:
    • Antidepressants
    • Anticonvulsants
    • Steroids
  • Medicines to treat bone pain:
    • Bisphosphonates
    • Denosumab

Radiation Therapy

Radiation therapy can help to shrink tumors and ease:

  • Bone pain
  • Pain caused by tumors pressing on other structures

Alternative Treatments

Alternative treatments to ease pain may include:

Procedures

Procedures are sometimes used to ease cancer pain. Options may be:

  • Ablation—using cold or heat to destroy cancer cells
  • Injection of a numbing drug and steroid into the spinal cord area
  • Spinal cord stimulation—an implanted device sends impulses to the spinal cord
  • An implanted pump—to deliver numbing medicine

Counseling and support groups may also be advised—to help with coping.

Counseling and support groups may also be advised—to help with coping.

Prevention

Cancer pain usually cannot be prevented.

RESOURCES

American Cancer Society  https://www.cancer.org 

National Cancer Institute  https://www.cancer.gov 

CANADIAN RESOURCES

Canadian Cancer Society  https://www.cancer.ca 

Provincial Health Services Authority  http://www.bccancer.bc.ca 

References

Cancer pain. American Cancer Society website. Available at: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/pain.html. Accessed September 22, 2021.

Cancer pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cancer-pain. Accessed September 22, 2021.

Deng G. Integrative medicine therapies for pain management in cancer patients. Cancer J. 2019;25(5):343-348.

General information about cancer pain. National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/pain/pain-pdq. Accessed September 22, 2021.

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