Causes and types of cancer pain

Cancer pain has many different causes and there are different types. You can have pain control and get support to help you manage any pain you might have.

Causes of cancer pain

Most cancer pain is caused by the tumour pressing on bones, nerves or other organs in the body.

Sometimes pain is due to your cancer treatment. For example, some chemotherapy drugs can cause numbness and tingling in your hands and feet. Or they might cause a burning sensation at the spot where you have the drug injection.

Radiotherapy can cause skin redness and irritation.

Remember that some pain might have nothing to do with your cancer. You could have the general aches and pains that everyone gets from time to time.

Acute and chronic pain

Cancer pain can be acute or chronic.

Acute pain

Acute pain is due to damage caused by an injury and tends to only last a short time. For example, having an operation can cause acute pain. The pain goes when the wound heals. In the meantime, painkillers will usually keep it under control.

Chronic pain

Chronic pain can be due to changes to the nerves. Nerve changes may be due to cancer pressing on nerves or due to chemicals produced by a tumour. It can also be caused by nerve changes due to cancer treatment. Chronic pain continues long after the injury or treatment is over and can range from mild to severe. It can be there all the time.

Sometimes pain can come on quickly, for example when you have a dressing changed or you move around and change position. This type of pain is called incidental pain.

Chronic pain is also called persistent pain.

Types of cancer pain

It is extremely important for your doctor to find out the type and cause of your pain. Then they can treat it in the right way. Different types of pain need different treatment. 

Nerve pain is also called neuropathic pain. It's caused by pressure on nerves or the spinal cord, or by damage to the nerves.

People often describe nerve pain as burning, shooting, tingling or a feeling of crawling under their skin. It can be difficult to describe exactly how it feels. Nerve pain can sometimes be more difficult to treat than other types of pain.

Some people have long term nerve pain after surgery. Nerves are cut during surgery and they take a long time to heal because they grow very slowly. In time the nerves heal, and the pain does usually go.

Nerve pain can also happen after other cancer treatments, such as radiotherapy or chemotherapy.

Cancer can spread into the bone and cause pain by damaging the bone tissue. The cancer can affect one specific area of bone or several areas.

You might also hear bone pain called somatic pain. People often describe this type of pain as aching, dull or throbbing.

Soft tissue pain means pain from a body organ or muscle. For example, you might have pain in your back caused by tissue damage to the kidney.

You can't always pinpoint this pain, but it is usually described as sharp, cramping, aching, or throbbing. Soft tissue pain is also called visceral pain.

Phantom pain means pain in a part of the body that has been removed. An example is pain in the breast area after removal of the breast (mastectomy).

Phantom pain is very real and people sometimes describe it as unbearable.

Doctors are still trying to understand why phantom pain happens. One theory is that your brain's thinking section knows that part of your body has gone but your brain's feeling section can't understand this. Other possible causes are poor pain control at the time of surgery.

  • Over 50 out of 100 people (over 50%) who have surgery to remove an arm or leg feel phantom pain.
  • About one third of women (about 1 in 3 women) who have surgery to remove a breast feel phantom breast pain.

In most people the pain goes away after a few months, or gets less after the first year. But some people can still feel phantom pain after a year or more.

It’s important to tell your doctor or specialist nurse about phantom pain, because they can control it with painkillers.

Sometimes people can feel pain from an organ in the body but in a different part of their body. This is called referred pain.

For example, a swollen liver may cause pain in the right shoulder, even though the liver is under the ribs on the right. This is because the liver presses on nerves that end in the shoulder.

How much pain you might have

The amount of pain you have with cancer depends on:

  • the type of cancer you have
  • where it is
  • the stage of your cancer
  • whether the cancer or treatment has damaged any nerves

Other factors can also affect how you feel pain, such as fear, anxiety, depression and a lack of sleep.

It’s very important to let your medical team know straight away if you have pain. Don’t try to put up with it. This can cause nerve changes that could make the pain harder to control in the future.

Controlling chronic pain

Chronic pain is also called persistent pain. It can be difficult to treat, but often painkillers or other pain control methods can successfully control it.

Pain that is not well controlled can develop into chronic pain. So it is important to take the painkillers that the doctor prescribes for you. Trying to put up with the pain can make it harder to control in the future.

People with chronic cancer pain might have times when their medicines do not control the pain all the time. This is called breakthrough pain.

Tell your doctor or nurse if you’re taking regular painkillers but still get pain at times. They can prescribe extra doses of painkillers for you to take when you need them.

Getting support with cancer pain

Pain can greatly affect your quality of life. Chronic pain can make it hard for you to do everyday things such as bathing, shopping, cooking, sleeping and eating.

This can be hard for your close friends and relatives to understand. You might need support to deal with how pain can affect you and your loved ones.

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