Pain

Pain is the most frequent symptom that patients with cancer experience, but it shouldn't be. Pain can be prevented or treated. No one should be in pain. Pain may be caused by

• The type of cancer you have
• The stage of the cancer
• Pressure on nerves from tumors
• Inflammation or infection
• Bone fractures from metastases
• Side effects from cancer treatments.

Because so many things can cause cancer-related pain, its treatment is highly individualized. That's why it's important to discuss your pain using specifics (e.g., location, intensity, duration, aggravating factors)-and if your oncology physician or nurse doesn't ask about pain, bring up the subject yourself.

Side effects and dependency

Many people are concerned about becoming dependent on pain medications for relief. Chemical dependency rarely happens. The overarching goal that oncologists have for pain control is to use the least amount of pain medications to achieve lasting relief.

You may be concerned about side effects from opioid-based pain medications. Constipation is a side effect of opioid medications but can be prevented. Your oncology nurse and physician will work with you to proactively address such issues before they happen. For more information, please read that section of this Web site.

Drug combinations

Cancer-induced pain often responds best to a combination of drugs: a primary pain medication, plus a coanalgesic, also called an adjuvant drug. A coanalgesic may be an anti-inflammatory drug or other drug that complements the pain killer to provide more complete relief. It may increase the effectiveness of the primary drug. It may enable the primary pain drug to be given in a lower dose than if it were administered alone. Some of the treatments described in this topic include coanalgesics (adjuvants).

Symptoms that may seem unlikely

Pain can cause a variety of symptoms that you may not associate with it-like fatigue or depression. 

Remember that you never should "tough it out" with pain. An attitude of "pushing on through pain" actually may make the pain worse or more debilitating. The best place to be with pain is to stay ahead of it.

Types of pain

There are two kinds of cancer-related pain.

• Nociceptive pain
• Neuropathic pain

Each is treated differently.

Nociceptive pain is what you experience when you cut your finger, bump into a chair, touch a hot stovetop, etc. The pain is a result of a specific cause (called a stimulus), and the body responds with protective measures. The intensity of the pain response is in proportion to the amount of injury incurred. The pain can be sharp, throbbing, or aching.

A different type of pain occurs when the nervous system malfunctions. The body sends pain messages even when no dangerous stimulus is present. This "misfiring" can be likened to an electric plug with frayed insulation. The way that the "insulation" and even the nerves themselves get damaged is from toxic effects of certain cancer treatments. Neuropathic pain results from damage to the peripheral or central nervous system. It can include myriadweird sensations-anything from "pins and needles" or tingling feelings to heaviness or numbness, shooting pains, or a burning sensation.

Patients with cancer may experience both kinds of pain, which underscores the need for good communication with oncology professionals. No one should have to live with uncontrollable pain.