Cancer Pain Management

Cancer and its treatments can be painful. Unfortunately, pain is a prevalent symptom of cancer, occurring in 55% of patients while receiving treatment and 66% of patients with advanced, metastatic disease. When you have cancer, related pain can feel like a condition in itself.

Cancer pain is often a manifestation of the cancer but can also be related to treatments, comorbidities or other factors as well. The intensity and frequency of the pain will depend on the type and location of the cancer, stage or extent of the cancer, and what treatments have been provided. Patients often experience pain from surgery; from tumors pressing on bones, nerves, or organs; and from chemotherapy and radiation. Each of these kinds of pain can be controlled and kept at a bearable level.

Causes of Cancer Pain

Cancer

Patients with cancer may experience pain from the disease and its progression and its impact on tissue, bones, nerves, and other organs.

Cancer Treatment

Injury/Damage/Trauma from cancer treatment may also cause pain. Pain may be induced by radiation, chemotherapy, or surgery.

Post Recovery

Even after cancer has been treated, pain from cancer and its treatment may persist. Nearly 35% of Cancer Survivors will experience pain.

Even after cancer has been treated, pain from cancer and its treatment may persist (e.g. neuropathy, phantom pain). Nearly 35% of Cancer Survivors will experience pain. It’s also important to know that pain might not be from the cancer and could come from an underlining chronic condition.

Symptoms of Cancer Pain

Pain from cancer can be Acute or Chronic. Acute Pain might occur after surgery, but the pain subsides when the damage or injury from the operation heals. Often pain from cancer is Chronic, meaning the pain persists for three months or longer. Breakthrough pain occurs when pain ‘breaks through’ any established pain relief, or when pain significantly worsens. This pain can be unpredictable, or it may be caused by an activity such as dressing or receiving radiation.

Nerve Pain

Nerve Pain, or neuropathic pain, is caused by pressure on the nerves or damage to the nerves. Cancer itself can compress the nerves or spinal cord and nerves can be damaged following surgery, chemotherapy, or radiation. This pain is often described as burning or shooting.
Bone Pain

Bone Pain, also referred to as Somatic Pain, is typically caused from bone metastases. This pain is often described as aching, throbbing, cramping, and gnawing.
Visceral Pain

Visceral pain results from damage to tissue or pressure on internal organs. This pain is often described as deep, throbbing, and squeezing.
Phantom Pain

Phantom Pain can occur when a part of the body has been removed. For example, following a mastectomy for a patient with breast cancer.
Referred Pain

Referred Pain is pain that initiates from one part of the body but is felt in an entirely different, usually due to where the nerve ends.

Treatments for Cancer Pain

At CPSC, we take a very mind, body, spirit approach to treating patients with cancer pain. We work with our patients to develop a unique pain management and rehabilitation plan based on their type of cancer no matter where they are in their journey.

Using a holistic care model, bringing together a team of healthcare providers, Center for Pain and Supportive Care facilitates the best possible quality of life by attending to a patient’s overall health and wellness.

Neuromodulation Devices - Chemical

Implantable pain pumps are used to deliver small amounts of medicine directly to your spinal cord bypassing the barriers encountered by oral medications

Neuromodulation Devices - Electrical

Dorsal Root Ganglion (DRG), Peripheral Nerve, and Spinal Cord Stimulation devices use electrical signals to treat conditions such as post-herpetic neuralgia, peripheral nerve injury, Complex Regional Pain Syndrome, foot/ankle/knee pain, low back and leg pain after surgery, and diabetic neuropathy

Neurolytic Blocks (Celiac Plexus, Splanchnic, Superior Hypogastric, and Ganglion Impar)

These procedures use alcohol or phenol to chemically destroy the nerves that supply pain signals from your cancer. Common indications include pancreatic, liver, small bowel, large bowel, kidney, pelvic, and rectal cancers

Osteocool (Palliative Tumor Ablation) and Kyphoplasty/Vertebroplasty

This procedure uses heat to treat painful metastatic bone tumors. This procedure has been shown to provide quick pain relief and to prevent fractures by using cement to harden the bone

Peripheral nerve block catheters

These devices can be used to treat localized cancer pain (e.g. bone tumors, nerve tumors). Ultrasound is used to place a catheter next to your nerve which is then connected to a pump that delivers numbing medicine

Medications

Opioid and non-opioid

Resources

A day in pain is a day lost

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