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

Chemotherapy Affects the Whole Body
Chemotherapy

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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:

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:

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:

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

Counseling and support groups may also be advised—to help with coping.

Prevention

Cancer pain usually cannot be prevented.

RESOURCES:

American Cancer Society
https://www.cancer.org

National Cancer Institute
https://www.cancer.gov

CANADIAN RESOURCES:

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

Provincial Health Services Authority
http://www.bccancer.bc.ca

REFERENCES:

Cancer pain. American Cancer Society website. Available at: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/pain.html. Accessed September 22, 2021.

Cancer pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cancer-pain. Accessed September 22, 2021.

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. Accessed September 22, 2021.

Last reviewed July 2021 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP  Last Updated: 9/22/2021