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RMC Bayonet Point
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Coping With Pain Related to Cancer and Chemotherapy

image for chemotherapy article Chemotherapy drugs can cause some side effects that are painful. The drugs can damage nerves, leading to burning, numbness, tingling, or shooting pain, most often in the fingers or toes. Some drugs can also cause mouth sores, headaches, muscle pains, and stomach pains.

Not everyone with cancer or who receives chemotherapy experiences pain from the disease or its treatment. But if you do, it can be relieved. First, keep a journal of your pain. It will help you and your family detect pain patterns, or possibly triggers that you may be able to avoid. Talk to your friends and family about how the pain makes you feel. This will help them to better understand the pain, and how and when to help you.

When you have pain, take note of the following:

  • Where you feel pain
  • What it feels like—sharp, dull, burning, throbbing, steady
  • How strong the pain feels
  • How long it lasts
  • What eases the pain
  • What makes the pain worse
  • What medications you are taking for the pain and how much relief you get from them

Stay in contact with members of your healthcare team. It should include doctors, nurses, pharmacists, and other healthcare professionals that can help you with your pain.

Using a pain scale is helpful in describing how much pain you are feeling. Try to assign a number from 0 to 10 to your pain level. If you have no pain, use a 0. As the numbers get higher, this means that your pain is getting worse. A 10 means the pain is as bad as it can be. You may wish to use your own pain scale using numbers from 0 to 5 or even 0 to 100. Be sure to let others know what pain scale you are using and use the same scale each time, for example, "My pain is 7 on a scale of 0 to 10."

Preventing and Treating Pain

The goal of pain control is to prevent pain that can be prevented, and treat the pain that can't. This is usually accomplished by taking a combination of long- and short-acting pain medications with a variety of co-analgesics (medications that have been traditionally used for conditions other than pain, but have been found to be effective for pain control). For example, some antidepressants and antiseizure medicationsmay be effective in treatment of cancer-induced nerve pain.

  • If you have persistent or chronic pain, take your pain medication on a regular schedule (by the clock) as prescribed.
  • Do not skip doses of your scheduled pain medication. Pain is harder to control if you wait to take pain medication only when you feel pain.
  • Try using relaxation exercises in addition to taking medication for the pain. This may help lessen tension, reduce anxiety, and manage pain.
  • Talk to your doctor about alternative treatments for cancer pain. For example, acupuncture may be effective in reducing your pain.
  • Some people with chronic or persistent pain that is usually controlled by medication can have breakthrough pain. This occurs when moderate to severe pain "breaks through" or is felt for a short time. It may be related to movement or happen at the end of the dosing interval. If you experience this pain, use a short-acting medication prescribed by your doctor. Don't wait for the pain to get worse. If you do, it may be harder to control.

Also, opioids may cause constipation. Make sure you drink plenty of water throughout the day and eat foods that contain fiber, such as fruits, vegetables, and whole grains. If you have problems, your doctor may recommend fiber supplements, stool softeners, or laxatives.

There are many different medications and methods available to control cancer pain. You should expect your doctor to seek all the information and resources necessary to make you as comfortable as possible. If you are in pain and your doctor has no further suggestions, ask to see a pain specialist or have your doctor consult with a pain specialist. A pain specialist may be an oncologist, anesthesiologist, neurologist, neurosurgeon, other doctor, nurse, or pharmacist. Many cancer centers have a pain specialist on staff.

  • American Cancer Society

    http://www.cancer.org

  • National Cancer Institute

    http://www.cancer.gov

  • BC Cancer Agency

    http://www.bccancer.bc.ca

  • Canadian Cancer Society

    http://www.cancer.ca

  • Buchanan A, Davies A. Breakthrough cancer pain: the current situation. Int J Palliat Nurs. 2014;20(1):6-8.

  • Cancer pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 7, 2015. Accessed December 8, 2015.

  • Chemotherapy and you. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/chemotherapy-and-you.pdf. Updated June 2011. Accessed December 8, 2015.

  • Opioids for chronic cancer pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 10, 2015. Accessed December 8, 2015.

  • Pain. American Cancer Society website. Available at: http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/dealingwithsymptomsathome/caring-for-the-patient-with-cancer-at-home-pain. Updated June 8, 2015. Accessed December 8, 2015.

  • 2/14/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Paley C, Johnson M, Tashani O, Bagnall A. Acupuncture for cancer pain in adults. Cochrane Database Syst Rev. 2011;(1):CD007753.