Managing Cancer Pain: Understanding Symptoms and Treatments
Effective Cancer Pain Management: Symptoms, Causes, and Top Relief Strategies
Understanding cancer pain and effective treatments
Cancer is often associated with physical pain, which can severely impact the quality of life for patients. Managing cancer pain effectively involves understanding its causes, symptoms, and the best treatment options available. This article delves deeply into the various types of cancer-related pain, their underlying causes, and both medical and alternative strategies for pain relief, ensuring comprehensive care for cancer patients.
Symptoms of Cancer Pain
Cancer pain varies widely in intensity, duration, and type. It can be sharp, dull, chronic, or intermittent. Recognizing these symptoms and their characteristics is crucial for developing an effective pain management plan.
Sharp and Sudden Pain
Sudden, sharp pain is often an indication of rapid changes in the body, such as tumor growth, nerve compression, or complications like cyst ruptures or fractures.
​
Shooting Pain in Breast
Shooting pain in the breast can be a symptom of nerve damage, often resulting from surgery, radiation, or tumor growth. This type of pain is usually localized and can feel like an electric shock, especially when triggered by movement or touch.
​
Pain Behind Left and Right Breasts
Pain that radiates behind the breasts can result from muscle strain, inflammation, or the spread of cancer to the ribs or spine. This type of pain is often mistaken for musculoskeletal issues but can indicate more serious underlying conditions like metastatic cancer.
Chronic and Dull Pain
Chronic pain is often a hallmark of advanced cancer. It tends to be persistent, making daily activities difficult and significantly impacting the patient’s quality of life.
​
Aching Pain in Left and Right Breasts
Aching pain in the breasts can be caused by hormonal changes, treatment side effects, or cancer progression. This type of pain is often dull and persistent, lasting for weeks or months, and may be managed with a combination of medications and supportive therapies.
Pain in Back of Head and Neck
​
Cancers affecting the brain, esophagus, or lymph nodes can cause pain that radiates to the back of the head and neck. This pain may be a result of tumor growth, inflammation, or nerve compression and can be exacerbated by movements like swallowing or turning the head.
​
Pain Underneath the Breast
Persistent pain underneath the breast may indicate cancer metastasis to the ribs, lungs, or chest wall. This pain may be sharp or dull, depending on the extent of the spread and the involvement of surrounding tissues.
Breakthrough Pain in Cancer Patients
Breakthrough pain is a sudden, intense flare of pain that occurs even when a patient is taking medication for ongoing pain. This type of pain often "breaks through" the background pain relief provided by regular medication and can be particularly distressing for cancer patients. Breakthrough pain may occur spontaneously or be triggered by specific activities, such as movement, coughing, or eating. Treatment typically involves adjusting the patient’s pain management plan, including the use of fast-acting pain relief medications.
Does this mean I have to hurt forever?
No! Book a consultation with our specialists today and get a pain management plan in place, including complementary therapies.
"Cancer brings difficult emotions… sadness, grief, despair, frustration, exhaustion, anger, feelings of being overwhelmed, and disbelief to name a few. Sometimes people experience persistent physical pain."
Katie Estridge
Physical Therapist
Types of cancer pain and their causes
Cancer pain can manifest in different ways depending on the type and location of the cancer, as well as how far it has progressed. Cancer pain is generally categorized into somatic pain (affecting bones, muscles, and soft tissues), visceral pain (involving internal organs), and neuropathic pain (resulting from nerve damage). The severity and nature of the pain can be influenced by tumor growth, cancer treatment, and other coexisting conditions.
Breast Pain and Cancer
Breast pain, while not a common early symptom of breast cancer, can occur due to a number of factors, including the cancer itself or treatments like surgery, chemotherapy, and radiation. Hormonal changes can also contribute to breast pain, especially during treatment or in the case of hormone-sensitive cancers. Breast Bone Pain When breast cancer metastasizes (spreads) to the bones, including the sternum (breastbone), patients may experience intense, aching pain. Bone metastasis is more common in advanced stages of breast cancer and can result in pain that radiates to nearby areas. Bone pain due to metastasis often worsens with movement and may be accompanied by fractures if the cancer weakens the bones. Pain in Left and Right Breasts Breast pain can be unilateral (in one breast) or bilateral (in both breasts). Pain in either the left or right breast is not always linked to breast cancer; however, persistent pain in one breast, especially when coupled with other symptoms like lumps, skin changes, or nipple discharge, should prompt further investigation. This pain can be localized or radiate to surrounding areas like the armpit, chest, or upper back. Menopause and Breast Pain Hormonal fluctuations during menopause, particularly decreases in estrogen levels, can cause breast pain. Although menopause-related breast pain is typically benign, it may become more pronounced in women undergoing cancer treatment, especially those taking hormone therapies like tamoxifen or aromatase inhibitors. These medications can cause breast pain as a side effect by blocking estrogen, which breast cancer cells often rely on to grow.
Ovarian and Uterine Pain
Cancer of the ovaries or uterus can lead to a range of symptoms, including significant pain in the pelvic region. Ovarian and uterine cancers can cause localized discomfort, as well as referred pain to the lower back or legs due to pressure on surrounding tissues and nerves. Ovarian Cyst Pain Ovarian cysts are fluid-filled sacs that form on the ovaries. While most cysts are benign and cause minimal discomfort, larger or more problematic cysts can cause sharp, stabbing pain in the lower abdomen or pelvic region. This pain may come and go, depending on the cyst's size and whether it is pressing on surrounding tissues. Ruptured Ovarian Cysts A ruptured ovarian cyst can cause sudden, severe pain, often described as sharp or stabbing, in the lower abdomen. This type of pain may be accompanied by internal bleeding, nausea, or vomiting and typically requires immediate medical intervention. Although most cyst ruptures are not life-threatening, they can cause significant pain and discomfort and may lead to complications such as infection or further damage to the ovary. Ovarian Pain During Menstruation For women with ovarian cancer, menstruation may exacerbate pelvic pain due to increased inflammation, hormonal changes, or pressure from the tumor. This pain can be dull and chronic, or it may come in waves, resembling menstrual cramps but more intense. Hormonal therapies, pain relievers, and even surgical interventions are often necessary to manage this type of pain.
Pain in the Lungs and Chest
Lung and chest pain related to cancer can occur when cancer spreads to or originates in the lungs, chest wall, or pleura (the lining surrounding the lungs). The pain may worsen during breathing, coughing, or moving. Pain Under Left and Right Breasts Pain beneath the breasts, whether on the left or right side, can be a sign of underlying issues such as lung cancer, pleural effusion (fluid buildup around the lungs), or the spread of cancer to the chest wall. It may feel sharp, aching, or like a deep pressure, and it can radiate to the ribs or shoulders. Lung Pain When Breathing When cancer affects the lungs or pleura, it can cause sharp pain that is exacerbated by breathing, known as pleuritic pain. Lung pain during breathing is often associated with lung cancer, pleural mesothelioma, or metastatic cancer that has spread to the lungs. The pain may also be accompanied by other symptoms like shortness of breath, coughing, or wheezing. Lung Pain in the Back Lung cancer that spreads to the bones of the spine can cause chronic, dull pain in the upper or lower back. This pain may be more intense at night or after long periods of lying down. Additionally, tumors pressing on nerves near the lungs can cause referred pain in the back, sometimes mistaken for musculoskeletal issues.
Rectal and Prostate Pain
Pain in the rectal or prostate region is often associated with cancers affecting these areas. Prostate cancer can cause discomfort in the pelvic area, while colorectal cancer may lead to rectal pain, especially during bowel movements. Prostate Pain and Cancer Prostate cancer typically causes pain in the pelvic region, but as the disease progresses, it can spread to the bones, particularly the spine, hips, and legs. Prostate cancer pain is often dull and aching but can become sharp and severe if the cancer compresses nerves or causes fractures in bones weakened by metastasis. Rectal Pain and Bowel Movement Issues Rectal pain, particularly during bowel movements, is a common symptom of colorectal cancer. The pain may be accompanied by other symptoms, such as a change in bowel habits, rectal bleeding, or a feeling of incomplete evacuation. In advanced stages, colorectal cancer can obstruct the bowel, causing intense cramping, bloating, and severe pain.
"According to the NIH, chronic pelvic pain continues to affect 4-16% of the population of women. These are people who live the majority of their days having pelvic pain. Physical therapy can help patients with chronic pelvic pain and with intermittent pelvic pain."
Katrina Health
Physical Therapist
Diagnosing cancer pain
Accurately diagnosing the source and type of cancer pain is essential for effective treatment. Doctors use a combination of physical exams and diagnostic imaging to assess the location and cause of the pain.
Physical Exams and Imaging Tests
Physical exams help doctors identify areas of tenderness, swelling, or abnormalities, such as lumps or masses. Imaging tests like X-rays, MRIs, CT scans, and PET scans provide detailed views of the internal structures, allowing doctors to detect tumors, metastases, or other sources of pain. In some cases, specialized tests like bone scans or nerve conduction studies may be required to pinpoint the cause of cancer-related pain.
Understanding Pain Radiation
Cancer pain often radiates from its source to nearby areas, making it difficult to localize. Understanding how pain travels can help in determining its origin.
​
Pain Radiation in Breast Cancer
Breast cancer pain can radiate to the arm, shoulder, or back, especially if the cancer has spread to the lymph nodes or bones. This referred pain may be sharp or dull, depending on the extent of nerve involvement.
​
How Pain Travels in Prostate Cancer
Prostate cancer pain often radiates to the lower back, hips, or legs, particularly when the cancer has spread to the bones or nerves. This pain is usually persistent and can worsen with movement or prolonged sitting.
Treatment options for cancer pain
Cancer pain management involves a multifaceted approach, combining medications, alternative therapies, and, in some cases, surgical interventions to provide relief and improve quality of life.
Medication and Pain Management
Prescription Painkillers for Cancer Pain For moderate to severe cancer pain, doctors often prescribe opioids like morphine, oxycodone, or fentanyl. These medications are highly effective at controlling pain but must be carefully monitored due to the risk of addiction and side effects such as constipation, drowsiness, and nausea. Over-the-Counter Medications Milder cancer pain can often be managed with over-the-counter medications like acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil). These medications are often used in conjunction with other treatments to reduce inflammation and provide pain relief.
Complementary Therapies for Pain Relief
Physical Therapy Physical therapy can help cancer patients manage pain by improving strength, flexibility, and mobility. Specific exercises may be designed to relieve pain, reduce stiffness, and prevent muscle wasting during cancer treatment. Acupuncture for Cancer Pain Acupuncture, a traditional Chinese medicine practice, involves inserting thin needles into specific points on the body to relieve pain. It has gained recognition as a complementary therapy for cancer pain, particularly for those experiencing neuropathic pain or side effects from chemotherapy.
Surgery and Other Medical Interventions
Pain Relief Through Surgery Surgical interventions, such as removing tumors that are pressing on nerves or organs, can provide significant pain relief. In some cases, palliative surgeries are performed not to cure cancer but to reduce pain and improve quality of life. Radiofrequency Ablation Radiofrequency ablation is a minimally invasive procedure that uses heat to destroy nerve tissue responsible for transmitting pain signals. It is particularly useful for treating pain caused by bone metastases or tumors that are inoperable.
Coping with cancer pain emotionally
Cancer pain management involves a multifaceted approach, combining medications, alternative therapies, and, in some cases, surgical interventions to provide relief and improve quality of life.
Psychological Support for Pain
Counseling and Support Groups
​
Psychological support, through counseling or participation in support groups, can help cancer patients cope with the emotional toll of chronic pain. Support groups provide a sense of community and shared experiences, while professional counseling can help patients develop coping mechanisms and address mental health concerns like depression or anxiety.
​
Coping with Anxiety Due to Pain
​
Chronic pain often leads to increased anxiety, which in turn can exacerbate the perception of pain. Cognitive-behavioral therapy (CBT) and relaxation techniques such as deep breathing, meditation, or guided imagery can help patients manage anxiety and improve their overall well-being.
When to seek medical help for cancer pain
While some degree of pain is common in cancer, certain warning signs indicate the need for immediate medical attention.
Warning Signs to Watch Out For
Persistent or Worsening Pain​
​
If pain persists or worsens despite ongoing treatment, it is crucial to consult a doctor. This could indicate cancer progression, treatment side effects, or new complications such as infections or fractures.​
​
​Unexplained Sharp or Stabbing Pain
​
Sudden, sharp, or stabbing pain that appears without any apparent cause may indicate serious complications like nerve damage, tumor growth, or organ dysfunction and requires immediate evaluation by a healthcare professional.
​
In conclusion, managing cancer pain is a vital component of cancer care, involving a combination of medications, therapies, and emotional support. By recognizing the different types and causes of pain and seeking timely medical interventions, patients can improve their quality of life during their cancer journey.