If you have pain, it’s important to tell your healthcare team. Pain is a common side effect of cancer and its treatments, but having cancer doesn’t mean you have to live with pain. Managing pain is part of your overall treatment plan. Talking about your pain helps your healthcare team understand it and figure out how to control it.
It’s important to manage pain related to cancer because it can affect you physically and emotionally. It can affect healing and cause fatigue, loss of appetite and problems sleeping. Dealing with pain also takes energy that you need to get better and to carry out normal daily activities.
Understanding the type of pain you have can help your healthcare team treat it.
Pain can be described based on how long it lasts or when it happens.
Acute pain is short-term pain. It comes on quickly, lasts a relatively short time and can range from mild to severe. It is caused by an injury, tissue damage or inflammation.
Chronic pain is long-term pain. It may last a few weeks or months or be ongoing. It may be constant or come and go, and it can range from mild to severe. It is caused by changes to the nerves, such as cancer pressing on the nerves or changes in the nerves due to treatment. Chronic pain can start as acute pain and then stay beyond the normal expected healing time. It is also called persistent pain.
Breakthrough pain occurs when pain “breaks through” the regular dose of pain medicine. It can be moderate to severe. When breakthrough pain is related to activity, it is called incident pain. When it occurs as the effects of pain medicine wear off, it is called end-of-dose pain.
Pain can also be described based on the part of the body it affects.
Nerve pain is caused by pressure on the nerves or spinal cord, or by damage to nerves. It may be described as burning or tingling. You may have nerve pain after surgery, radiation therapy or chemotherapy.
Bone pain can develop when cancer spreads to the bone. It may occur in one or more areas of bone. Bone pain is often aching, dull or throbbing.
Soft tissue pain is caused by damage to an organ or muscle. It is usually described as sharp, aching or throbbing.
Visceral pain starts in internal organs such as the intestine. It is often difficult to describe or find the source of visceral pain. It is described as colicky or vague and is often linked with other symptoms such as nausea and sweating.
Phantom pain is pain or changes in sensation in a body part that has been removed. For example, some people feel pain in an arm or leg that has been amputated or in the breast area after a mastectomy.
Causes of pain
Your healthcare team will need to find out what is causing your pain to help control it.
Tumours can cause pain as they grow. They can damage parts of the body or press on organs, nerves or bones. Cancer that spreads to the bones can cause bone pain. Cancer that spreads to the spine can cause spinal cord compression. Cancer can also cause pain if it blocks organs, tubes or blood vessels.
Medical tests or procedures sometimes cause pain. These tests or procedures can include injections (with a needle), placing an intravenous line, a lumbar puncture, a bone marrow aspiration or surgery. Whenever they do a test or procedure, the healthcare team tries to prevent pain as much as possible.
Cancer treatments may cause pain. For example, surgery to remove a tumour can damage tissue or nerves, and some people may develop an infection after surgery. Some chemotherapy drugs may cause vomiting, diarrhea, constipation or mouth sores. Radiation therapy can also cause discomfort or pain, depending on the area treated. Pain can last a long time, even a few years after cancer treatments.
Your entire healthcare team may be involved in treating pain. Some treatment centres may have pain teams that include specialized doctors and nurses. A physiotherapist or occupational therapist may show you ways to move or do things to prevent pain or make you more comfortable. Counsellors, social workers or psychologists can help you develop skills to cope with pain and manage any worries or concerns that may make pain worse. Some hospitals and communities also have palliative care teams, which focus on managing pain and symptoms.
Once your healthcare team assesses your pain and finds the cause of it, they will decide the best way to manage it. You will have a pain control plan that’s just for you. Different treatments can be used to relieve or control pain, including pain medicines, medical therapies and physical, psychological or complementary methods. Each of these treatments may be used alone or in combination. It may take a few hours or days to get your pain under control. How long it takes depends on the type, location and duration of the pain, the type of treatment used and if it causes side effects. Everyone responds differently to each treatment. To find out what works best for you, your healthcare team may try different treatments.
I’m extremely grateful to the Canadian Cancer Society for funding my research with an Innovation Grant.
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