Cancer Pain

Cancer is a devastating diagnosis that rips through the lives of patients and their families. Even with promising new treatment options for all kinds of cancer, cancer pain is one complication that can be challenging to treat. Here’s what you need to know.

What is cancer pain?

Cancer pain is pain that occurs as a side effect of cancer. A report from the Global Year of Against Cancer Pain had these estimates of pain experienced for the following forms of cancer:

  • Head and neck: 67–91%
  • Prostate: 56–94%
  • Uterine: 30–90%
  • Genitourinary: 58–90%
  • Breast: 40–89%
  • Pancreatic: 72–85%

As these percentages illustrate, the rates for pain vary, depending on the type of tumor, the stage of cancer, and the progression of the disease. Another more recent review of studies found the following average rates of pain, divided by treatment stage:

  • During treatment: 55%
  • After curative treatment: 39.3%
  • Advanced terminal cancer: 66.4%

On average, 38% of all patients at every stage and with every type of cancer reported moderate to severe pain. These statistics clearly illustrate that even with advances in cancer treatment options, pain continues to be a common symptom that requires close attention and careful treatment.

What causes cancer pain?

This type of pain is a result of three main occurrences with pain that is:

  1. Related to cancer tumors
  2. Related to treatment
  3. Unrelated to cancer

Pain related to cancerous tumors may be experienced when a tumor presses on nerves. Similarly, when a tumor expands inside a hollow organ, patients may report pain as the tumor grows. Pain due to tumors may be sharp and shooting, or it may be experienced as a burning or radiating pain, depending on which nerves are affected. This type of pain is referred to as neuropathic pain, and it may persist long after the cancerous tumor is treated.

Other pain that is directly related to cancer tumors is when bone marrow infiltration occurs. This bone pain is often throbbing but is also felt as a dull, constant ache.

Pain related to cancer treatment is also unfortunately common. Chemotherapy drugs may cause pain and tingling or numbness in the feet. Pain from radiation is another common side effect of cancer treatment as well.

Pain that is unrelated to cancer tumors or treatment can be as varied as the people who experience it. Some pain, such as soft tissue or visceral pain, may occur due to lingering damage from cancer or its treatment. Phantom pain from an amputation or a mastectomy is a real and serious condition. This is where the brain continues to send pain signals even after the surgery. An estimated 50% of amputees and 33% of women with mastectomy experience phantom limb pain.

8 cancer pain treatments 

There is no one-size-fits-all treatment for this type of pain. The best approach is a comprehensive one designed by you, your doctor, and other supportive medical personnel.

These are some of the most common therapies:

  1. Biofeedback: This is a treatment that teaches you to become aware of processes that are normally thought to be involuntary (e.g., blood pressure, temperature, and heart rate control). Biofeedback trains you to gain some conscious control of these processes, which can influence and improve your level of pain. Put simply, a better awareness of your body can help you relax and this can help relieve pain.
  2. Mindfulness meditation: A 2019 review of 210 studies of mindfulness mediation and its effect on cancer pain offered some astonishing conclusions. Patients who regularly practiced mindfulness meditation reported reduced pain, anxiety, and depression and an improved quality of life. This occurred without side effects, and this treatment is free.
  3. Massage: Gentle focal rubbing of the tender areas may help relieve muscle spasms or contractions and improve associated discomfort. Massage can also help patients relax, decreasing stress and tension.
  4. Acupuncture: A small but scientifically-valid study of patients receiving auricular acupuncture found that 36% of patients receiving acupuncture had significant decreases in pain at two months (compared to a control group with just 2% decrease).

Interventional approaches

In addition to non-invasive therapies, these treatments can help with pain:

  1. Medication (over-the-counter and prescription): Non-steroid anti-inflammatory drugs (e.g., ibuprofen), muscle relaxants, and membrane-stabilizing medications can be very effective in treating this type of pain. Note that opioids are most effective for end-stage pain only.
  2. Nerve blocks: Specific nerve blocks and neurodestructive procedures can help relieve some types of pain due to cancer. Celiac plexus blocks can be extremely effective at treating difficult pain.
  3. Transcutaneous electrical nerve stimulation (TENS): This technique relieves pain by applying mild electric current to the skin at the site of the pain. The electric impulses interfere with normal pain sensations and replace them with a mild tingling sensation.
  4. Intrathecal pumps: Implanted pain pumps are also available, which can be extremely helpful in providing long-term pain control. This treatment is gaining widespread acceptance for long-term pain management in cancer patients.