Cancer pain

Cancer and its treatment can cause various sorts of pain. Pain is the most common and, in terms of quality of life, the most important cancer-related symptom. About half of all cancer patients experience pain.

Most of the pain caused by cancer can be managed with straightforward and regular medical treatment. Regular and sufficient pain medication is an essential aspect of cancer treatment.

Pain may also be the first symptom of cancer. But the onset of pain or an increase in pain is not necessarily a sign that the disease is progressing.

Cancer pain may have many causes. Cancer pain may be nociceptive (affecting tissue) or neuropathic (affecting the nerves). A tumour may cause pain by pressing on the membrane around an organ. A metastasis in the bones may also cause pain.

Cancer patients experience many ordinary aches and pains, such as back pain and headaches, which are not to do with their condition. Initial pain may also induce muscle cramps, or being in bad positions and result in stress pain.

Cancer pain usually starts by being acute and becomes chronic when it persists over time. In many cases pain in a person whose cancer has spread gets worse as the disease progresses. Pain that has persisted for a long time causes changes in the normal pain circuit, and these perpetuate the pain even though its original cause may have disappeared.

Pain also triggers stress hormones that may worsen the pain and induce other symptoms. Pain causes stress, worry, anguish and other psychological problems. Mental states such as anxiety and fear can also exacerbate cancer pain. Prolonged pain also impacts on your social relationships and quality of life.

Cancer pain treatment

Treatment for pain caused by cancer always seeks to eliminate the cause of the pain, if possible. If the tumour cannot be removed, it can often be reduced with radiotherapy or chemotherapy.  If nothing can be done to the source of the pain, the focus is kept on alleviating it in the most effective way. Treatment should be as straightforward and easy as possible. Nearly all drugs can nowadays be taken orally and be as effective as injections into the muscle.

Cancer pain can be treated

  • with drugs: anti-inflammatory drugs, opioids, co analgesics (adjuvant analgesics)
  • special techniques: pain pumps, catheters and nerve blocks, neurosurgical methods, electro nerve stimulation techniques, radiotherapy and cytotoxic drugs
  • other methods: pain management methods and relaxation, assistive devices, physiotherapy / rehabilitation, home remedies

The Cancer Society of Finland runs a cancer pain hotline (Syöpäkipulinja) to support pain management for cancer patients as part of its nationwide advice service. Queries from patients, loved ones and healthcare workers concerning cancer pain are directed to the cancer pain phone service at the Pain Clinic of Helsinki University Central Hospital.

Cancer pain hotline (nationwide advice service)

Sources

Suomen Syöpäpotilaat ry. Syöpäpotilaan kivun hoito. Helsinki, 2015.