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Coping With Pain Related to Cancer and Chemotherapy

image for chemotherapy articleChemotherapy 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 family and friends so they can describe the pain if you are unable to do so. Stay in contact with members of your care team. Your team should include doctors, nurses, pharmacists, and other healthcare professionals that can help you with your pain.

When you have pain, take note of the following:

  • Where you feel pain
  • What it feels like—sharp, dull, 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

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    TOP

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, gabapentin is a antiseizure medication that has been used effectively in treatment of cancer-induced neuropathies.

  • 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.

RESOURCES:

American Cancer Society
http://www.cancer.org
National Cancer Institute
http://www.cancer.gov

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca

References:

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:
...(Click grey area to select URL)
Updated November 27, 2013. Accessed February 5, 2014.
Caring for the patient with cancer at home. American Cancer Society website. Available at:
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Updated November 5, 2013. Accessed February 5, 2014.
Chemotherapy and you. National Cancer Institute website. Available at:
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Updated June 2011. Accessed February 5, 2014.
Opioids for chronic cancer pain. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated January 11, 2014. Accessed February 5, 2014.
2/14/2011 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Paley C, Johnson M, Tashani O, Bagnall A. Acupuncture for cancer pain in adults. Cochrane Database Syst Rev. 2011;(1):CD007753.
Last reviewed February 2014 by Michael Woods, MD
Last Updated: 02/05/2014