Your guide to controlling cancer pain

The pain caused by cancer – or its treatments – can and should be managed properly. Here’s how.

04 June 2015
by Rebekah Kendal

Not everyone who has cancer experiences pain. According to Professor Michael Herbst of the Cancer Association of South Africa (CANSA), roughly 50 percent of people who have treatment for cancer experience pain. If the cancer has come back or spread, about seven in 10 people experience pain.

"The way people feel and experience pain varies. Even people with the same type of cancer can have very different experiences," says Professor Herbst. The amount of pain that you experience is not necessarily related to the severity of the cancer and an increase in pain doesn't automatically mean that the cancer is getting worse.

Types of cancer pain

Cancer pain can result from the actual cancer or from the cancer treatment. Surgery is often painful and it takes time to recover. Radiation can leave behind painful scars or a burning sensation, and chemotherapy has many potentially painful side effects.

These are the kinds of pain you may experience:

  1. Nerve pain: Also known as neuropathic pain, this occurs when there is damage to or pressure on nerves and the spinal cord. It is often descried as burning, shooting, tingling or feeling as if something is crawling under your skin.
  2. Bone pain: When cancer damages the bone tissue, it can cause pain. This type of pain, which is also called somatic pain, is often described as aching, dull or throbbing.
  3. Soft tissue pain: Also known as visceral pain, this occurs when the cancer damages your organs or muscles. Sometimes the pain is referred – for example, a swollen liver might cause pain in your right shoulder because it presses on nerves that end in that shoulder. This type of pain can be difficult to pinpoint and is often described as sharp, cramping, aching or throbbing.
  4. Phantom pain: Cancer sometimes results in a body part – such as a breast – being removed. It is possible to feel pain in this body part even though it is no longer there.

Keep track of your pain

It is important to inform your doctor about any pain you might be experiencing because the earlier treatment is given for pain, the more effective it is. Pain that is not well managed can turn into chronic pain, so it is imperative to address it and for example, take pain medication as prescribed.

To keep track of your pain, your doctor may ask you to rate it on a scale of 0 to 10. It may help to keep a pain journal where you record when pain occurs, the type of pain, and whether or not the treatment provides relief.

How to manage your pain

Pain medication includes over-the-counter painkillers such as aspirin, acetaminophen and ibuprofen, weak opioid medications such as codeine, and strong opioid medications such as morphine and oxycodone.

Some people worry about taking stronger pain medications because they fear becoming addicted, however, people who take cancer pain medications as prescribed rarely become addicted to them.

It is important to keep your doctor informed about any medications you might be taking – even the over-the-counter variety – as they may interact negatively with your cancer treatment.

Alternative pain therapies that might help relieve your pain include acupuncture, acupressure, massage, physical therapy, relaxation and meditation.

How to cope with stress and anxiety

Pain is not only a physical sensation, Professor Herbst adds. “Emotions can make the pain better or worse. If one is anxious, one may feel more pain, and if one is relaxed, one may feel less pain," explains Herbst.

Strategies for managing the anxiety and stress brought on by the pain of cancer include counselling, attending support groups, physical exercise and relaxation exercises including meditation and visualisation.

For more info

Visit the CANSA website or call the helpline on 0800 22 66 22.