Cancer: Controlling Cancer Pain

Sometimes people try to live with their pain because they believe these common myths:

Myth #1: Pain is just part of cancer.

Truth: Pain can almost always be controlled if you work with your doctor to create a treatment plan that is right for you.

Myth #2: It is best to wait as long as possible between doses of pain medicine.

Truth: Pain medicine works best when you stay on top of your pain. That means not holding off treatment until the pain becomes bad. If you let the pain get bad, it may be harder to get it under control.

Myth #3: Pain medicines work the same for everyone.

Truth: There are many kinds of pain medicines. They are given in different amounts to different people. And they are given in different ways (for example, as pills you swallow or as a patch taped to your skin). Your doctor will work with you to find a plan that helps control your pain.

Myth #4: Doctors are so busy. I should not bother my doctor with my pain problems.

Truth: There is a reason you are having pain, and your doctor needs to know about it. Talking to your doctor about your pain and what treatment works or does not work is an important part of your treatment plan. It is also important for your well-being.

Myth #5: If I whine about pain, it means I am weak. My doctor and family won't respect me if I am not tough.

Truth: Telling your doctor about your pain does not mean you are weak. It means you are being honest with your doctor. You are giving your doctor important information. No two people feel the same when they have cancer. Do not compare yourself to others.

Myth #6: If I take strong drugs like morphine, I will become addicted.

Truth: Addiction to pain medicine is rare if you have not had a problem with addiction in the past and you take your medicine as directed under your doctor's care. When you no longer need these medicines, your doctor will slowly lower the amount you are taking until your body no longer needs the medicine.

Myth #7: If I take strong pain medicine before I really need to, it might not help me when my pain gets worse.

Truth: It is much better to treat your pain when you first notice it, before it gets bad. Although you may gradually need more medicine, this is rarely a problem.

Cancer pain can lower your quality of life if it is not treated. Untreated pain may cause you to feel:

• Tired or depressed.
• Unable to cope.
• Isolated or lonely.
• Stressed.
• Unable to sleep.
• Worried or angry.
• Uninterested in food.

Controlling your cancer pain can help you to:

• Be active.
• Sleep.
• Cope more effectively with cancer and its treatment.
• Enjoy family and friends.
• Eat with pleasure.

Keep track of your pain and your treatments

Your doctor needs all the information you can give about what your pain feels like. Your doctor needs to know how your treatment is working or not working. It may be easier to give your doctor information if you write it down. Use a daily diary to Reference rate your pain Opens New Window. Write down what drugs you are taking and how well they are working. Write down any other methods you are using to control your pain.

Pay attention to the details of your pain so you can tell your doctor. Is it burning? Throbbing? Steady? How long does it last? Take your written information and your questions with you when you see your doctor.

Use a calendar or a pain control diary (What is a Reference PDF Opens New Window document?) to keep track of your treatment. Write down how strong your pain is and when it comes and goes. Most doctors use a "0 to 10" scale to measure pain. On this scale, "0" means no pain and "10" means the worst possible pain.

It is easy to get confused about medicines when you are in pain and are looking for something to help you feel better. You may have prescriptions from more than one doctor. Keeping a written medicine record (What is a Reference PDF Opens New Window document?) can help you and your doctors work together.

Stay on top of your pain

Your pain will be harder to control if you let it get worse before you take your medicine. Make the most of your pain medicines by following these rules:

• Take them on time (by the clock).
• Do not skip a dose or wait until you think you need it.
• Be prepared for breakthrough pain. You may find that taking your medicine works most of the time, but your pain flares up during extra activity or even for no clear reason. This is called breakthrough pain. Your doctor can give you a prescription for fast-acting medicines that you can take for breakthrough pain.
• Ask one of your doctors to be your team leader. It is best to have one doctor in charge of all your medicines. If more than one doctor prescribes pain medicine, make sure they talk to each other about it.

Manage the side effects

Pain medicines may cause side effects. For example, opiate pain relievers may cause drowsiness, constipation, nausea, and vomiting. Some anti-inflammatory drugs, including aspirin, may cause stomach upset or bleeding. Before you start taking a drug, ask your doctor about the possible side effects.

There are things you can do to manage some side effects.

• Reference Home treatment for nausea or vomiting includes eating clear soups, mild foods, and liquids if you feel nauseated. Watch for and treat early signs of dehydration. Older adults can quickly become dehydrated from vomiting.
• Reference Home treatment for constipation includes making sure that you drink enough fluids and include fruits, vegetables, and fiber in your diet each day. Do not use a laxative without first talking to your doctor.

Try complementary medicine

Complementary medicine is the term for a wide variety of health care practices that may be used along with or in place of standard medical treatment. If you use one or more of these practices, you may be able to take a lower dose of pain medicines.

Most of these therapies have not been subjected to the same degree of rigorous scientific testing for safety and effectiveness that standard medical treatments must go through before they are approved in the United States. Be sure to talk with your doctor about which therapies might be best for you.

Behavioral therapies

• Reference Biofeedback is a method of consciously controlling a body function that is normally controlled unconsciously, such as skin temperature, muscle tension, heart rate, or blood pressure.
• Reference Cognitive-behavioral therapy is a type of counseling that can help you cope with pain by modifying certain thought and behavior patterns.
• Reference Relaxation exercises, Reference music therapy, Reference humor therapy, and Reference prayer may reduce tension, help you feel relaxed, and reduce stress.
• Reference Guided imagery is a series of thoughts and suggestions that direct your imagination toward a relaxed, focused state. You can use an instructor, tapes, or scripts to guide you through this process.
• Reference Hypnosis is a state of focused concentration that allows you to become less aware of your surroundings.

Physical therapies

• Reference Exercise helps you keep your strength, flexibility, and mobility.
• Reference Heat and cold treatments relieve sore muscles and decrease pain.
• Reference Massage helps reduce tension and pain, improves circulation, and encourages relaxation.
• Reference Transcutaneous electrical nerve stimulation (TENS) uses electrical current delivered through electrodes to the skin for pain relief.

Other therapies

• Reference Acupuncture Opens New Window is a form of traditional Chinese medicine. It is done by inserting very thin needles into the skin at certain points on the body. Acupuncture may help relieve pain.^{Reference 2}
• Reference Aromatherapy is the therapeutic use of aroma-producing oils (essential oils) extracted from a plant's flowers, leaves, stalks, bark, rind, or roots. These oils are mixed with another substance, such as oil, alcohol, or lotion, and then applied to the skin, sprayed in the air, or inhaled.
• Reference Healing touch is the conscious influence of one person on another, without physical means of intervention, to benefit the recipient's physical or emotional well-being.
• Reference Meditation is the practice of focusing your attention to alter your state of consciousness, usually directed toward feeling calm and having a clear awareness about your life.
• Reference Yoga is a meditation program that includes exercises to help improve flexibility and breathing, decrease stress, and maintain health.

For more information on these therapies, see the topic Reference Complementary Medicine.

Discuss your pain and your feelings about having cancer with your doctor. He or she can address your concerns and refer you, as needed, to organizations that can offer support and information. You may also contact your local chapter of the American Cancer Society to help you find a support group. Talking with other people who have cancer and may have similar feelings can be helpful.

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