Cancer Pain

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What is Cancer Pain?

Cancer pain refers to the discomfort experienced by individuals diagnosed with cancer, either as a direct result of the disease itself or as a consequence of cancer treatments. It can manifest in various forms, ranging from localized pain related to tumor growth pressing on nerves, bones, or organs to generalized discomfort stemming from chemotherapy-induced side effects or surgical interventions. Cancer pain is highly individualized, influenced by factors such as the type and stage of cancer, treatment modalities utilized, and patients’ unique pain thresholds and sensitivities. Managing cancer pain effectively is crucial for enhancing patients’ quality of life, minimizing suffering, and optimizing their ability to cope with the physical and emotional challenges associated with the disease.

What Are The Causes of Cancer Pain?

Cancer pain can be related directly to the tumor, which may be pressing against bone, nerves, or other organs. Pain in particular areas of the body is associated with different types of cancer: lower back with colon or ovarian cancer; shoulder pain with lung cancer; and head with brain tumors (malignant and benign).

Cancer pain can also be caused by treatment procedures. Chemo headaches are common for two reasons: flu-like symptoms onset by biological therapies; the irritation in the lining of the brain and spinal column when therapies are given directly into the spinal fluid.

There is also referred pain, where pain feels like it is coming from a part of the body other than the one directly affected by the cancer. This usually occurs between an internal and an external body part. For example, a swollen liver can cause pain in the shoulder, since the liver presses against nerves that end in the shoulder.

Even after cancer is successfully treated, patients seek help. Chronic pain can be ongoing in the body, and Phantom pain can remain in a once-tumorous area. Treatment for cancer pain can be holistic or, if severe enough, pharmaceutical.

But what really drives patients to seek help is the chronic pain they experience long after the cancer has been treated.

  • Post-mastectomy pain
  • Post-radiation pain
  • Post-surgical pain
  • Chronic nerve pain

Doctors do not often talk to their patients about pain. It is its own area of treatment, stemming from targeting discomfort and addressing the pain directly. Emphasis should be placed on pain when dealing with cancer. Some Doctors don’t know enough about its treatment, when it should be addressed every visit. Pain specialists base their profession on it, and can play an essential role in the cancer patient’s treatment.

Cancer patients tend to be passive when it comes to the pain they are experiencing. They don’t want to “bother” their doctors, even if they fear that the pain means the cancer is worsening. Others are worried their doctors will think of them as complainers or drug-seekers.

What Are The Signs And Symptoms of Cancer Pain?

Cancer pain presents with various signs and symptoms depending on its origin and severity. Common indicators include persistent discomfort, localized pain in specific areas of the body corresponding to affected organs or tissues, worsening pain with movement or pressure, and referred pain where the sensation is felt in a different area than the source. Patients may also experience neuropathic pain, characterized by tingling, burning, or shooting sensations, and psychological distress such as anxiety or depression often accompanies chronic pain.

What Are The Risk Factors of Cancer Pain?

Several factors contribute to the development of cancer pain, including the type, stage, and location of the cancer, as well as the aggressiveness of treatment modalities like surgery, chemotherapy, and radiation therapy. Additionally, individual variations in pain perception, genetic predispositions, and pre-existing conditions such as neuropathy or chronic pain syndromes can influence the risk of experiencing cancer-related pain.

How is Cancer Pain Diagnosed?

The process of diagnosing pain related to cancer entails a thorough evaluation conducted by healthcare providers, which includes an extensive review of the individual’s medical background, a comprehensive physical examination, and various imaging techniques like X-rays, CT scans, or MRIs to pinpoint the root cause and gauge the extent of tissue damage or tumor expansion. Furthermore, nerve conduction assessments, blood analyses, and nerve blocks may be utilized to assess nerve functionality and precisely identify the origins of pain.

What Are Possible Treatments For Cancer Pain?

Due to current social concerns, the medical field has grown increasingly reluctant to prescribe opioid medications. Maintaining a close working relationship with your cancer specialists is essential for the proper use of these medications.

Fortunately, the risk of addiction for people who take opioid medications as directed for cancer pain is low (25%).

While opioids play a role in cancer pain management, other treatments complement them well or replace them altogether. Physical modalities target mechanical pain, and improve function and mobility. Injections may deliver a treatment directly to the source of pain, reducing the need for oral medications. Pain-psychology also plays a role in modulating fearful, pain-avoidance behaviors.

Opioid management is complex. It’s more than increasing the dose. It’s making sure you’re on the right medication and optimizing it for your specific needs. Discussion about side-effects, overdose, addiction, and safety around family members is part of the treatment.

You can develop a tolerance for your pain medication, which means you may need a higher dose to control your pain. Tolerance isn’t addiction. If your medication isn’t working as well as it once did, talk to your doctor about a higher dose, or a different medication. Don’t increase the dose on your own.

Patients are often fearful of the side-effects: consistent drowsiness, uncommunicative responses, erratic behavior, or self-consciousness of dependence. You might have these side effects when you start taking strong pain medications, but they should resolve once your doctors find the correct level of pain medications for you. Communication is a two-way road – even between a healthcare professional and a patient.

Are There Preventative Steps or Measures To Avoid Cancer Pain?

While it may not always be possible to prevent cancer-related pain entirely, certain strategies can help reduce its occurrence and severity. Early detection and treatment of cancer through regular screenings and prompt medical intervention can prevent tumor progression and alleviate associated pain. Moreover, adopting a healthy lifestyle, including regular exercise, balanced nutrition, and stress management, can enhance overall well-being and potentially mitigate the impact of cancer and its treatment on pain perception.

What Are The Risks If Cancer Pain Is Left Untreated?

Leaving cancer pain untreated can have detrimental effects on patients’ physical, emotional, and psychological well-being, leading to decreased quality of life, impaired functional ability, and increased morbidity and mortality rates. Untreated pain may also contribute to the development of chronic pain syndromes, opioid dependence, and mental health disorders such as depression and anxiety, further exacerbating patients’ suffering and compromising their ability to cope with their illness effectively.

Are There Other Related Conditions To Cancer Pain?

Several related conditions may coexist with cancer pain or contribute to its complexity, including neuropathic pain syndromes, musculoskeletal disorders, visceral pain from organ involvement, and psychological comorbidities such as depression, anxiety, and post-traumatic stress disorder (PTSD). Addressing these underlying conditions alongside cancer pain management is crucial for comprehensive care and optimizing patients’ overall outcomes and quality of life.

Key Takeaways About Cancer Pain (Top 3-5 points to remember from everything)

  1. Cancer pain can arise from various sources, including tumor infiltration, treatment-related complications, and neuropathic mechanisms, significantly impacting patients’ physical and emotional well-being.
  2. Early recognition and effective management of cancer pain are essential to alleviate suffering, optimize treatment outcomes, and improve patients’ quality of life.
  3. Multimodal approaches to cancer pain management, incorporating pharmacological interventions, physical therapies, psychological support, and complementary modalities, offer personalized and comprehensive care to address patients’ diverse needs.
  4. Open communication between patients and healthcare providers is paramount in navigating cancer pain management, ensuring treatment adherence, and addressing concerns regarding pain control, medication side effects, and psychosocial support.
  5. A holistic approach to cancer care, integrating pain management into overall treatment plans and fostering collaborative efforts among multidisciplinary teams, promotes patient-centered care and enhances therapeutic outcomes.

Recommended Next Steps

  1. Schedule a comprehensive assessment with a pain specialist at Manhattan Pain Medicine to evaluate your cancer-related pain and develop an individualized treatment plan tailored to your needs.
  2. Explore various pain management modalities and supportive services offered at Manhattan Pain Medicine, including pharmacotherapy, interventional procedures, physical therapy, psychotherapy, and integrative medicine approaches.
  3. Engage in open and honest communication with your healthcare providers regarding your pain experience, treatment preferences, and goals of care to optimize symptom control and enhance your overall well-being.
  4. Take proactive steps to prioritize self-care and well-being, including adopting healthy lifestyle habits, practicing relaxation techniques, and seeking social support from loved ones and support groups.
  5. Stay informed and empowered as an active participant in your pain management journey, advocating for your needs, asking questions, and collaborating with your healthcare team to achieve optimal pain relief and improve your quality of life.

Meet Manhattan Pain Medicne, PLLC

Jason W. Siefferman, MD is board-certified in Physical Medicine and Rehabilitation (PM&R) and Interventional Pain Medicine. He is trained to offer a comprehensive diagnostic evaluation and treatment for anyone experiencing pain or a disability. He has published articles, book chapters, and persuasive essays surrounding many... Learn More »