Cancer pain management
Managing Cancer Pain:
More Options Than Medication
For patients with cancer and their families, pain is often one of the
greatest fears. The truth we want everyone to know is this:
most cancer pain can be controlled, using a stepwise
approach tailored to each patient. Enduring pain does not make cancer
treatment more effective. On the contrary, well-controlled pain helps
patients eat, sleep, keep their strength for treatment, and spend quality
time with the people they love.
Where does cancer pain come from?
Pain in cancer patients arises through several mechanisms: the tumor
itself pressing on or invading tissue, bone, or nerves; the treatments —
surgery, chemotherapy, or radiation; and other coexisting conditions such
as pressure sores or stiff joints. One patient may have several types of
pain at once. A careful assessment of exactly what is causing each pain
is the most important first step of treatment.
Pain medication: using it correctly is the foundation
The World Health Organization describes a stepladder approach to
cancer pain medication — from basic analgesics for mild pain, up to
opioids such as morphine for moderate to severe pain, alongside adjuvant
medicines for nerve pain. Used under a physician’s supervision, these
medications are safe and effective.
Common misunderstandings about morphine
- “Starting morphine means the end is near.” —
Not true. Morphine is a standard pain medication usable at any stage
of disease, whenever pain is moderate to severe. - “I will become addicted.” — When used for pain
relief under medical supervision, addiction is very uncommon, and
your physician monitors and adjusts the dose throughout. - “I should tough it out and save the strong medicine for
when I really need it.” — Please don’t. Pain medication has
no “quota” that runs out. Controlling pain early works better than
waiting until pain becomes severe.
When medication alone is not enough: interventional procedures
Some patients remain in significant pain despite fully optimized
medication, or suffer side effects that make higher doses intolerable.
These patients may benefit from specialized interventional procedures,
such as:
- Neurolysis — such as celiac plexus neurolysis for
pancreatic and upper abdominal cancers, providing months of relief and
allowing lower medication doses - Targeted nerve blocks — for localized pain, such as
chest-wall or rib pain - Intrathecal (spinal) drug delivery — in selected
patients, achieving pain control with far smaller drug doses
Importantly, these procedures need not be “saved as a last resort.”
In some diseases — pancreatic cancer, for example — performing the
procedure early in the course of pain gives better results than waiting.
A pain specialist can help judge the right timing.
Caring for the whole person
Cancer pain is never purely physical. Worry, sadness, and the
uncertainty of the disease can all intensify how pain is felt. Good care
therefore combines control of physical symptoms with emotional support
for both patient and family — with the pain team working closely
alongside oncology and palliative care. Our shared goal is for every
patient to have the best possible quality of life at every stage of the
disease.
diagnosis or advice. If you or a loved one has poorly controlled cancer
pain, please talk to your treating physician or contact our pain clinic.
Cancer pain can be controlled
Talk to our team about the options that fit you or your loved one.