A Beginner’s Guide to Understanding Cancer Pain Treatments

This year alone, the United States is expected to see 1.96 million new cancer cases and 610,000 cancer-related deaths.

If you or someone close to you has been diagnosed with cancer, you probably wonder how to manage the pain that goes along with it. Know that solutions are available.

This guide examines various treatments that can address different types of cancer pain — short-term, long-lasting, sporadic, or linked to surgery. From simple over-the-counter remedies and prescription drugs to surgical options and complementary therapies, it's important to understand that you don't have to endure cancer pain without relief.

Types of cancer pain

Pain is a personal experience, which means what's painful for one person might not be for another. Cancer pain can stem from various sources, often when the disease affects your bones, nerves and soft tissues.

“Somatic pain is the most common form of cancer pain," said Dr. Alexander Bershadskiy, interim chief of hematology/oncology at Staten Island University Hospital in New York City. "This type of pain can be described as an aching, cramping, or throbbing sensation.”

The Cleveland Clinic breaks it down even more:

• Bone pain: Cancer-related bone pain may feel like a dull ache or a throbbing sensation.
• Nerve pain: When tumors press against your nerves or spinal cord, nerve pain can occur. Cancer treatments might also damage your nerves, causing pain. It could manifest as shooting pain, burning sensations or tingling. Compared to other types of cancer pain, nerve pain can be particularly challenging to manage.
• Soft tissue pain: Cancer affecting organs or soft tissues can result in sharp, cramping, throbbing pain or a persistent ache. "Soft tissue" refers to the supportive elements around bones and internal organs, including muscles, tendons, skin and fat.
• Phantom pain: Phantom pain emerges in body parts that have been surgically removed to eliminate cancerous growth. For instance, those who undergo mastectomy might feel pain in the area where their breast was removed.
• Referred pain: Sometimes, cancer in one part of your body can cause pain in another area. For example, liver cancer might lead to swelling that presses on nerves, causing pain in the right shoulder.

Understanding these various types of cancer pain is key to finding effective ways to manage discomfort.

Cancer pain comes in various forms, each requiring particular approaches for effective relief. These forms include:

• Acute pain: The National Cancer Institute describes this type of cancer pain as short-term and intense. It usually fades as healing occurs.
• Chronic pain: Discomfort that persists beyond the expected healing time. Chronic pain might be linked to nerve damage or ongoing disease.
• Breakthrough pain: This type of cancer pain is sudden and intense and can emerge even while using chronic pain medication. It's temporary, often arising when your current medication's effects diminish, even if you take the right dose.
• Postoperative pain: Following procedures like limb amputations, rectal surgery and mastectomies, 30% to 50% of patients experience postoperative pain. If not managed effectively, this pain can develop into lasting discomfort, PubMed reports.

Cancer pain treatments

“Thankfully," said Bershadskiy, "cancer pain is very treatable.”

And, while the U.S. National Cancer Institute says complete relief from cancer pain might not always be attainable, there are ways to ease pain for most patients. Effective pain management can enhance your quality of life during and after cancer treatment.

Medication treatments

Bershadskiy said some common and effective treatments include over-the-counter and prescription medications. Among them:

• Aspirin
• Acetaminophen (Tylenol, others)
• Ibuprofen (Advil, Motrin IB, others)
• Prescription medications like morphine (Kadian, MS Contin, others)
• Oxycodone (OxyContin, Roxicodone, others)
• Medical marijuana

Complementary therapies

“Nondrug treatment options may also be recommended in addition to pain medication,” Bershadskiy said. Some of these include:

• Acupuncture
• Massage
• Cognitive therapy
• Hypnosis
• Biofeedback
• Breathing and relaxation exercises

“I've seen some patients being very successful in utilization of these techniques," Bershadskiy said. "However, if the pain is not relieved by the medication and the above-mentioned nondrug treatments, other options, such as radiation therapy, surgery and nerve blocks may be necessary to help ease cancer pain.”

Nerve blocks

A nerve block involves a localized anesthetic, often coupled with a steroid, that is introduced by injection into a nerve or the region encircling the spinal cord. The American Cancer Society says this injection serves to obstruct pain signals. After this intervention, the nerve's capacity to transmit pain signals is impeded, bringing relief for a time.

It's important to note that a nerve block might lead to temporary muscle paralysis or a complete loss of sensation within the treated area. That said, nerve blocks are an effective means to relieve pain by targeting the nerve pathways involved.

Surgeries for cancer pain

The American Society of Clinical Oncology suggests that the key aim of palliative surgery is to offset cancer's adverse effects while enhancing your overall well-being. This surgical approach can:

• Alleviate nerve pain or reduce pressure on nerves
• Remove obstructions within the digestive system or other affected areas
• Stop internal bleeding
• Install a feeding tube or medication port
• Help reduce the risk of broken bones

Palliative surgery can be integrated into your cancer treatment journey at any stage, though it often plays a pivotal role in advanced cancer cases. It is a compassionate approach to pain management that aims to address sources of discomfort and enhance your quality of life.

Remember: Relief for cancer pain can be attained through various treatments tailored to your unique needs.

"It is best to work with your doctor to decide which treatments may be best for your particular situation," Bershadskiy said. "The goal should be to keep you comfortable. If you aren't comfortable, talk to your doctor, and together, continue searching for the best pain management options."

With many strategies ranging from medications and surgeries to complementary therapies, the road to comfort is paved by collaboration between you and your health care team.

Resources

Alexander Bershadskiy, MD, interim chief, hematology/oncology, Staten Island University Hospital, New York City

American Cancer Society Journals: Cancer Statistics, 2023

American Cancer Society: Other Medical Treatments for Cancer Pain

Cleveland Clinic: Cancer Pain

National Cancer Institute: Pain Management

National Cancer Institute: Cancer Pain (PDQ)–Patient Version

PubMed: Postoperative Acute Pain Challenges in Patients with Cancer

American Society of Clinical Oncology: What is Cancer Surgery?