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Overview:

Cancer Pain

Cancer is one of the biggest health concerns all over the world and is the second leading cause of death in the United States.

Pain caused by cancer can also be very severe. Whether the pain is caused by the disease or the treatments (or a combination of both), the pain is often agonizing. This is especially true for those who are in the advanced stages of the disease.

What is cancer pain, and how is it caused?

Cancer can cause pain in various ways. Here are some examples:

  • Chemicals and toxins that are released into the body through treatment as well as the body’s response to them (nociceptive pain).
  • Some types of cancers secrete proteins (a paraneoplastic syndrome), which can cause extreme pain.
  • Treatment or diagnostic procedures, such as chemotherapy, radiation, and surgery.
  • Nerves can get compressed or damaged due to tumors spreading and compressing different nerves, bones, or organs or destroying healthy tissue –  can cause pain that is known as neuropathic pain (this can also be caused by cancer treatment).
  • Metastases spreading to other organs.
  • Metastases spreading to the bone.

The pain caused by cancer can be experienced in different ways:

  • Chronic Pain — Sharp throbbing pain that is experienced for a long time. This pain can only be managed and not completely controlled. This pain is usually caused by the death of healthy tissue.
  • Visceral Pain — Sharp, aching, cramping pain experienced in a body organ. This pain is usually caused by tissue damage or pressure on internal organs.
  • Somatic Pain — Dull, achy pain at the skin, muscles, bones and connective tissue caused by direct damage or pressure from growing tumors.
  • Acute Pain — Initial, severe pain due to ulcers or sores that usually abates soon.
  • Breakthrough Pain — Periods of pain above and beyond the normal baseline pain that is being managed with medicines.
  • Referred Pain — Pain experienced in an area that is away from the actual region of the disease.
  • Phantom Pain — Pain experienced in a part of the body that has already been amputated as part of the treatment.
What are the symptoms or characteristics of cancer pain?

Symptoms of cancer pain are diverse. Here are a few:

  • Dull and achy feeling
  • Sharp and burning pain
  • Constant throbbing
  • Swelling
  • Constant lower back pain
  • Back spasms
  • Pricking pain
  • Radiating pain
  • Tenderness with constant background pain
  • Increase in pain during movement
What are the factors that determine the intensity of the pain?

The intensity of the cancer pain varies from person to person based on a few factors that include:

  • Stage of the cancer — Early stage cancers usually are not associated with pain. The stages of cancer range from 1 to 4, with 4 being the most advanced. Pain is most intense in Stage 4.
  • Type of cancer — Some types of cancer such as bone cancer, stomach cancer, pancreatic cancer, and brain cancer are more painful than the others. General health and other health complications may impact the way different people feel the same symptoms or characteristics of pain.
  • Tolerance of pain — This differs from person to person, and is the amount of pain that an individual can handle without severe distress. This is highly subjective.
  • Comorbidities — Pain associated with cancer may seem more intense in people with other underlying health conditions. For example, someone with severe arthritis may feel the implications of bone cancer more intensely.
  • Treatment of cancer — The pain of treatment can contribute significantly to the pain of the disease itself in the case of surgery, chemotherapy, hormone therapy, immunotherapy, targeted therapies, use of angiogenesis inhibitors or radiation.

Stress, anxiety, depression, disturbed sleep and lack of support are other factors that can affect the way cancer pain is experienced. Cancer pain has an enormous emotional component.

When should I see the doctor to get cancer pain diagnosed?

Immediately! Advanced Pain Care can see you the same or next day. Diagnosing cancer pain successfully and accurately begins with correctly understanding the source of the pain. Reaching that diagnosis is not always easy, as the causes of the pain are so diverse.

It is a good practice to keep track of the symptoms you experience using a pain rating scale from 0 to 10 to help your physician understand your pain more accurately.

Keep track of the following along with an assigned pain rating:

  • Severity of the pain
  • Type of pain felt
  • Location of the pain
  • Duration of the pain
  • Cause of the pain
  • What makes it better or worse
  • Pain relieving measures used
  • Other side effects experienced

While it is critical to understand why and where you are experiencing pain, it is also important to receive expert care and advice from a physician or cancer specialist.

As a rule of thumb, if your pain is interfering with your daily routine or activities, or if it becomes persistent, we recommend setting up an appointment with Advanced Pain Care. Call us at 512-244-4272 for same or next day appointments.

How can cancer pain be treated or managed?

Identifying the source or cause of the pain becomes crucial to finding the most effective pain treatments. Pain treatments can and will vary with the symptoms.

  1. The first step is removing the source of the pain by treating the cancer. This can be done through surgery or treatments like chemotherapy and radiation.
  2. If the patient is not in very severe pain, drugs such as non-steroidal anti-inflammatory drugs and COX-2 inhibitors are initially prescribed. If there is no relief in the pain, mild pain medication such as tramadol and codeine are administered. Stronger medications are prescribed in case of severe pain along with non-opioid analgesics.
  3. To prevent pain signals from the nerves in the painful region reaching the brain, neurolytic or nerve block procedures are recommended.
  4. Surgical destruction of central and peripheral nervous tissue such as neurectomy, cingulotomy, and cordotomy is done in some cases.
  5. Procedures like the implantation of intrathecal pumps, spinal cord stimulators, or long-term epidural catheters are also done in specific cases.

Over a third of people who have cancer pain describe it as ranging between moderate to severe, meaning intervention and treatment becomes crucial in pain relief and overall heath.

Those experiencing cancer pain may not report it for fear of side effects or the added financial burden. In some cases, it could be a reluctance to take strong medication over and above what they are already taking.

At Advanced Pain Care, our doctors specialize in pain management and offer expert advice and effective treatments for those experiencing pain. Call us at 512-244-4272 for same and next day appointments. 11 Central Texas locations to serve you.

Frequently Asked Questions

Q: What does the pain feel like when you have cancer?

A: The pain caused by cancer can be experienced in different ways:

  • Acute pain — Initial severe pain due to tissue damage.
  • Chronic pain — Sharp throbbing pain that is experienced for a long time. This is usually caused by the death of healthy tissue or pressure from expanding tumors.
  • Visceral pain — Sharp, aching, cramping pain experienced in a body organ. Usually caused by tissue damage.
  • Somatic pain — Dull, achy pain experienced in muscle or bone.
  • Breakthrough pain — Pain experienced occasionally beyond the normal baseline of chronic pain.
  • Referred pain — Pain experienced in an area that is away from the actual region of the disease.
  • Phantom pain — Pain experienced in a part of the body that has already been amputated as part of the treatment.

The most common symptoms of cancer pain include:

  • Dull and achy feeling
  • Sharp and burning pain
  • Constant throbbing
  • Swelling
  • Pricking pain
  • Radiating pain
  • Tenderness with constant background pain
  • Increase in pain during movement
  • Constant lower back pain
  • Back spasms

Q: What is the best pain relief for cancer?

A: Identifying the best treatment for pain relief of cancer pain depends on the cause of the pain.

Here are some of the most followed steps to help relieve the pain:

  • The first step is removing the source of the pain by treating the cancer. This can be done through surgery or treatments like chemotherapy and radiation.
  • If the patient is not in very severe pain, drugs such as non-steroidal anti-inflammatory drugs and COX-2 inhibitors are initially prescribed.  If there is no relief in the pain, mild pain medication such as tramadol and codeine are administered. Stronger medications are prescribed in case of severe pain along with non-opioid analgesics.
  • To prevent pain signals from the nerves in the painful region reaching the brain, neurolytic or nerve block procedures are recommended.
  • Surgical destruction of central and peripheral nervous tissue such as neurectomy, cingulotomy, and cordotomy is done in some cases.
  • Procedures like the implantation of intrathecal pumps, spinal cord stimulators, or long- term epidural catheters are also done in specific cases.

Q: How bad does cancer hurt?

A: The detection of cancer usually starts with a painless lump or some other symptoms. Pain is not evident at first. The pain experienced initially is likely due to tissue damage or pressure form expanding tumors. However, as the disease progresses to the more advanced stages, there is potential for tremendous pain. It can range from mild to severe, and doctors will ask you to keep track of the pain on a pain rating scale from 0 to 10.

The pain itself can be a dull, achy one, not requiring any medication, or it could escalate to a debilitating one requiring very aggressive opioids such as morphine.

Q: What causes cancer pain?

A: Cancer pain can be caused by different reasons such as:

  • Nerves can get compressed or damaged due to tumors spreading and compressing different nerves, bones, or organs or destroying healthy tissue –  can cause pain that is known as neuropathic pain (this can also be caused by cancer treatment).
  • Metastases spreading to other organs.
  • Metastases spreading to the bone.
  • Chemicals and toxins that are released into the body through treatment as well as the body’s response to them (nociceptive pain).
  • Some types of cancers secrete proteins (for example, a paraneoplastic syndrome in cell lung cancer), which can cause extreme pain.
  • Treatment or diagnostic procedures, such as chemotherapy, radiation, and surgery.

Q: What are some reasons for not receiving adequate treatment for cancer pain?

A: Cancer pain remains predominantly undertreated, with more emphasis being placed on the treating the disease itself. There are several reasons for this. They include:

  • Fear of side effects
  • Reluctance to take on the added financial burden
  • Reluctance to take strong medication
  • Reluctance to undergo further procedures
  • Reluctance to speak about the pain
  • Fear of not being taken seriously, especially in cases of phantom pain

Q: How can you help your doctor understand your cancer pain?

A: Diagnosing cancer pain successfully and accurately begins with correctly understanding the source of the pain. Reaching that diagnosis is not always easy, as the causes of the pain are so diverse.

It is a good practice to keep track of the symptoms you experience using a pain rating scale from 0 to 10 to help your physician understand your pain more accurately.

Keep track of the following along with an assigned pain rating:

  • Severity of the pain
  • Type of pain felt
  • Location of the pain
  • Duration of the pain
  • Cause of the pain
  • What makes it better or worse
  • Pain relieving measures used
  • Other side effects experienced

While it is critical to understand why and where you are experiencing the pain, it is also important to know when to report it to your physician or cancer pain specialist at Advanced Pain Care. As a rule of thumb, if you are finding that the pain you are experiencing interferes with your daily routine or activities or if it becomes persistent, we recommend consulting a physician immediately. Call Advanced Pain Care at 512-244-4272 for same and next day appointments.

Q: What steps can you take to ensure that you are receiving adequate cancer pain treatment?

A: The onus of the management of the cancer pain lies on you as well as on the doctor. Keeping a comprehensive record of the following with a pain rating assigned will help the doctor recommend the best course of treatment:

  • Severity of the pain
  • Type of pain felt
  • Location of the pain
  • Duration of the pain
  • Cause of the pain
  • What makes it better or worse
  • Pain relieving measures used
  • Other side effects experienced

Constantly communicate your symptoms to your doctor so that you are both always on the same page. It also helps to keep specific goals in tracking the reduction in your symptoms.

Advanced Pain Care has a comprehensive pain management program. In case you feel that you are not finding the results that you expected, you can consult with a pain management specialist at APC. We are a multispecialty clinic with board certified experts in pain management, orthopedics, neurosurgery, rheumatology and behavioral health.

Cancer Pain Treatment

Our Pain Care Expertise

Are You Experiencing Pain?

If you are experiencing any back pain or stiffness, call Advanced Pain Care at 512-244-4272 to schedule an appointment with one of our pain care and management specialists.

We have a range of pain management treatment options available right from surgical interventions to non-invasive and minimally invasive treatment options. Our team will work with you to develop a pain management plan based on the severity of your condition.