Cancer Pain Syndromes
Condition
Definition
About one-third of people with cancer have pain. Cancer pain can be affected by:
- The cancer getting worse
- Where cancer is in the body
- A person's physical condition
Most cancer pain can be managed with treatment.
Causes
Cancer pain may be caused by:
- Tumors pressing on bone, nerves, or an organ.
- Cancer treatment, such as chemotherapy, radiation therapy, and surgery
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Risk Factors
Having cancer is the main risk factor for cancer pain.
Symptoms
Cancer pain will vary from person to person. The pain may be:
- Near or far from the tumor
- Mild, moderate, or severe
- Regular and long lasting, or it may come and go
- Felt as pressure, sharp, dull, throbbing, burning, stabbing, or achy
Diagnosis
The doctor will ask about symptoms and past health. A physical exam will be done. Tests may also be done to find possible causes of the pain. They may include:
Imaging tests such as:
Nerve tests, such as:
- Electromyography (EMG)
- Nerve conduction velocity (NCV)
Treatment
Treatment depends on the type of pain. It also depends on how the cancer has been treated. The goal is to manage pain. Options may be:
Counseling and support groups may also be advised—to help with coping.
Prevention
Cancer pain usually cannot be prevented.
Medicine
- Non-opioids—to treat mild-to-moderate cancer pain:
- Acetaminophen
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Opioids—often used to treat moderate-to-severe cancer pain
- Medicines to treat nerve pain:
- Antidepressants
- Anticonvulsants
- Steroids
- Medicines to treat bone pain:
- Bisphosphonates
- Denosumab
Medicine
- Non-opioids—to treat mild-to-moderate cancer pain:
- Acetaminophen
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Opioids—often used to treat moderate-to-severe cancer pain
- Medicines to treat nerve pain:
- Antidepressants
- Anticonvulsants
- Steroids
- Medicines to treat bone pain:
- Bisphosphonates
- Denosumab
Radiation Therapy
Radiation therapy can help to shrink tumors and ease:
- Bone pain
- Pain caused by tumors pressing on other structures
Alternative Treatments
Alternative treatments to ease pain may include:
- Acupuncture
- Hypnotherapy
- Massage therapy
- Mindfulness
- Music
- Creative arts therapy
Procedures
Procedures are sometimes used to ease cancer pain. Options may be:
- Ablation—using cold or heat to destroy cancer cells
- Injection of a numbing drug and steroid into the spinal cord area
- Spinal cord stimulation—an implanted device sends impulses to the spinal cord
- An implanted pump—to deliver numbing medicine
American Cancer Society
National Cancer Institute
CANADIAN RESOURCES:
Canadian Cancer Society
Provincial Health Services Authority
American Cancer Society
National Cancer Institute
CANADIAN RESOURCES:
Canadian Cancer Society
Provincial Health Services Authority
References
- Cancer pain. American Cancer Society website. Available at: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/pain.html.
- Cancer pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cancer-pain.
- Deng G. Integrative medicine therapies for pain management in cancer patients. Cancer J. 2019;25(5):343-348.
- General information about cancer pain. National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/pain/pain-pdq.
Contributors
- Mohei Abouzied, MD, FACP
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