Pain Medication and Cancer: What You Need to Know

October 2, 2020

Cancer and its treatment can result in pain for some patients. While this can be difficult, there are many different ways to treat and manage pain with the help of your care team.

“Each person is unique in their pain experiences, and management plans can be tailored to each patient,” says Dan Gorman, NP, a nurse practitioner in Adult Palliative Care, a division of Dana-Farber’s Department of Psychological Oncology and Palliative Care. Gorman and his colleagues provide symptom management support for patients with all diagnoses and all stages during their treatment.

Why does cancer or its treatments cause pain?

Pain can be caused by a patient’s cancer itself due to a variety of factors. These include:

  • The location of a tumor
  • The tumor spreading to another area, such as the bones
  • A tumor putting pressure on nerves in the body

Therapies that are used to treat cancer — including chemotherapy, radiation, or surgery — can also cause pain. For example, surgery always leaves incisions, which can be painful after surgery and during the healing process. Chemotherapy and radiation can also result in a variety of side effects, with pain often being one of them.

How can I manage pain?

Generally, over-the-counter medications such as acetaminophen (e.g. Tylenol) or ibuprofen (e.g. Advil) can be used to manage pain if the pain is not too severe.

Pain caused by the position or spread of the tumor can be relieved by the removal of the tumor, if possible. When chemotherapy, radiation, or other cancer treatments are causing pain, your oncologist can refer you to palliative care specialists to determine a plan that can manage your pain, if over-the-counter medications are no longer working.

There are many options for pain management during your cancer treatment, including:

  • Palliative radiation
  • Pain medications
  • Nerve blocks
  • Epidural catheter placement
  • Steroid injections

It is best to talk with your care team to figure out the best method to keep your pain under control.

Could I become addicted to pain medication?

Some patients need opioid medications to manage pain. Gorman says that many people are concerned that they may become dependent on these medications. He suggests communicating with your care team and your clinician can determine the best way to support you.

“Patients should not hesitate to bring up concerns with their provider,” Gorman says. Patients who are concerned about addiction may ask how long they are going to be on the medication, and shouldn’t be embarrassed to share any history with addiction.

What should I expect at my first appointment with a palliative care provider?

“When someone comes in for their first appointment, we’ll obtain a thorough history, which includes a full assessment of the patient’s pain, what their primary experience has been, if they’ve used pain medication in the past, and if they’ve ever had problems with pain medication before,” Gorman explains.

Palliative care clinicians will also take into account the medications patients are taking to treat their cancer, and will often consult with the patient’s oncologists and palliative pharmacists. Some pain medication can cause adverse reactions and side effects when combined with certain cancer treatment protocols; with the full picture, palliative care clinicians can develop a more appropriate plan. On the other hand, some medications may be able to treat both pain and other cancer side effects, such as neuropathy.

Palliative care clinicians will also consider how both pain and medications may affect patients’ daily function and psychological well-being, and will take into account how their quality of life may change with certain prescriptions.