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."
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,
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,
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.
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Chemotherapy and you. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/coping/chemotherapy-and-you.pdf. Updated June 2011. Accessed February 5, 2014.
Opioids for chronic cancer pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 11, 2014. Accessed February 5, 2014.
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http://www.ebscohost.com/dynamed: Paley C, Johnson M, Tashani O, Bagnall A. Acupuncture for cancer pain in adults.
Cochrane Database Syst Rev.
Last reviewed February 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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