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Pain from Cancer

Pain is an unpleasant physical or emotional experience.  More than half of cancer patients will have pain at some point during their illness. It is important to treat your pain.

Patient handout (English): Pain from Cancer

Patient handout (Traditional Chinese): Pain from Cancer

Pain is an unpleasant physical or emotional experience.  More than half of cancer patients will have pain at some point during their illness.


Pain relief is an important part of your care.  Untreated pain can affect your sleep, eating and quality time with family and friends.

‎Cancer and cancer treatments can cause pain.  


People experience pain in many different ways. How you experience pain will affect how you ask for help with pain control.

‎Tell your health care team if you are having pain. You are the only one who can describe your pain in detail. We cannot tell by looking at you if you are having pain or not.


Be honest, open and clear. The more we know about your pain, the better we can treat it.

Call your health care team right away if you have any of these symptoms:
  • A sudden increase in your pain
  • A sudden pain that you cannot explain
  • Pain with a fever
  • Sudden change in the strength of your legs or if the sensation in your legs is not normal
  • Sudden loss of bowel or bladder control (you cannot hold your “pee” or “poop”).  

‎Medications for Pain

There are many different types of pain medications.  Your health care team will work with you to figure out the best medicines for you. You may need to try a few different medications to find the right one.

Each person is different. The amount (dose) of medication you need to take might be different than someone else in your situation. It is important that you take the dose your health care team has prescribed.  

Tell your health care team if you cannot afford to pay for your medications. There are benefits that can help. 

Non-opioids

Non-opioids are used to control mild to moderate pain. Examples of non-opioids:
  • Acetaminophen (Tylenol®)
  • Aspirin
  • Ibuprofen (Advil® or Motrin®)
  • Naproxen (Aleve®)
Non-opioids do not need a prescription but may be covered if you get a prescription for them.  

Talk to your health care team before taking a non-opioid. Some of these medications might interact with other medications or treatments you are taking.  

Some non-opioids can cause side effects, such as:
  • Upset stomach
  • Kidney damage
  • Problems with blood clotting

Opioids

Opioids are used to control moderate to severe pain. Examples of opioids:

  • Morphine
  • Fentanyl
  • Oxycodone
  • Methadone
  • Hydromorphone
  • Buprenorphine
There are two types of opioids:
  • Short-acting: relieve pain quickly and only last for a short time.
  • Long-acting: take longer to relieve pain but lasts for a longer time.  
These two types are usually used together.  

Opioids will work as long as they are needed. If your pain gets worse for any reason, we can give you a higher dose.  

You should not worry about becoming addicted to opioids. Addiction is very rare when opioids are taken correctly to control cancer pain.

Side effects of Opioids

Constipation 
Most patients taking opioids will get constipation (when you do not have a bowel movement – go “poop” – as often as is normal for you).  You cannot treat this type of constipation by changing what you eat or drink, eating more fiber, or exercising. 
It is important that you take a laxative every day. If your dose of opioid goes up, your laxative dose may also have to go up.

Read the BC Cancer handout “How to treat constipation caused by your opioid pain medications”.  Talk to your health care team about managing constipation.

Other Side Effects
Many patients taking opioids will feel a little sleepy and/or nauseated (feeling queasy, like you might throw up) after starting an opioid pain medicine.  These side-effects should go away after a few days. 

If you still feel sleepy or nauseated after three days, talk to your health care team. Your dose may need to be changed.


Medications for Nerve Pain

Nerve pain is different than other pain.  It is described as shooting, stabbing or pins and needles. We often treat nerve pain with medications that were originally made to treat something else.

Anti-depressants
Anti-depressants are used to treat depression.  Some types of anti-depressants are also good for treating nerve pain.  
Anti-depressants include nortriptyline, imipramine, and desipramine. Using these medications for pain does not mean anyone thinks you are depressed.  

Anti-seizure medications
Medications used to treat seizures can sometimes also help nerve pain. An example of this type of drug is gabapentin. 

Medical cannabis

Medical cannabis has been shown to help relieve some kinds of pain, but does not work for everyone.  Also, it is quite complicated. There are many kinds of medical cannabis and buying some safe and tested product legally is quite difficult. It is important to do it right if you are thinking of trying cannabis.


More medical cannabis information is on the BC Cancer website.


Talk to your health care team before taking medical cannabis.  


‎Prevent your pain from starting

The best way to treat pain is to predict when it will come and treat it before it starts.
  • Take your pain medications exactly as your health care team has told you to.
  • Do not wait until your pain comes back before taking your medication. Waiting can make your pain more difficult to control.
  • If you are going to do something that you expect to be painful, take a short-acting pain medication before the activity.  

Keep a pain journal 

Tracking your pain will help your health care team figure out how best to manage it:
  • Write down when your pain happens and how bad it is. Use this pain intensity scale to rate your pain:
pain-scale.jpg

  • Keep track of the medications you are taking and if they work to control your pain.
  • Write down any activities that make your pain worse or better.

Try complementary therapies

  • Relaxation and guided-imagery exercises can be helpful. Ask your health care team or the BC Cancer Library for more information.
  • Distract yourself with music, a movie or video game. 
  • Massage can help reduce muscle tension and relieve some kinds of pain. You may want to ask your family and friends for back rubs or massage of painful muscles. They may appreciate being able to help you feel better.
  • Heat, cold, and electrical skin stimulation (TENS)   machines can give relief for some patients. Ask your health care team before trying these.
  • Sharing your feelings. Support groups allow you to talk with others in your situation and learn what has helped them.

Revised February 2020


SOURCE: Pain from Cancer ( )
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