​Pain management

Why does cancer cause pain?

According to the National Cancer Institute, as many as 50 percent of cancer patients experience pain. And in 80 percent of patients with advanced-stage cancer, this pain may be moderate to severe.

Cancer-related pain may be chronic and last after treatment ends or after scans show no evidence of disease. Younger people are more likely to experience cancer pain than older people. The severity of the pain often depends on:

• The type of cancer 
• The cancer’s stage
• Where the cancer is located
• The patient’s tolerance for pain

Cancer pain may also cause emotional distress.

Cancer-related pain may stem from:

• The cancer itself if it spreads to the bones or presses on nerves or organs
• Diagnostic tests
• The treatment (especially surgery, chemotherapy, radiation therapy, targeted therapy)
• A combination of these factors

The good news is that most patients may find relief with pain management therapies.

Our services

Pain management is a medical field dedicated to controlling pain with a variety of tools. Cancer-related pain is often caused by the actual tumor, especially when the tumor is pushing on nerves, organs and bones. Pain may also result from surgery, chemotherapy, radiation and other treatments.

At City of Hope, pain management physicians use the science of medicine to guide patients in finding comfort and improving their quality of life. City of Hope pain management clinicians are part of a team of health care professionals, including physicians and nurses who focus on evaluating, treating and managing acute (short-term) or chronic (long-term) pain.

Our clinicians use a combination of pain-control methods, including pharmacological approaches, such as prescription medications, and non-pharmacological approaches. Pharmacological approaches use analgesics and/or other drugs, while non-pharmacological approaches involve therapies, including behavioral, neurological or psychological interventions.

The pain management team at City of Hope focuses on treating patients with cancer-related pain, so they can focus on healing and completing everyday tasks. Our pain management clinicians are part of a wider supportive care team, led by a medical oncologist and coordinated by a care manager.

Because each patient may experience pain differently, we tailor pain management therapies to each individual patient. The team approach at City of Hope is designed to put patients in the middle of their care, treating the disease and managing side effects so they can get back to their lives.

Pain management may be used to manage a number of cancer-related symptoms and side effects, including:

Digestive issues: Stomach cancer may cause stomach pain and or digestive issues. Diarrhea, constipation and/or nausea may be caused by the cancer, its treatment or even diet changes related to cancer treatment. Over-the-counter stool softeners or fiber supplements may ease constipation, and drinking enough fluid may help prevent dehydration from diarrhea.

Eating difficulties: Chemotherapy, radiation therapy or surgery may affect the ability to chew or swallow food. A dietitian may recommend foods and beverages that are easier to consume.

Headaches: Certain cancer treatments may cause headaches. Stress, fatigue, anxiety and sleeping problems—which may occur with a cancer diagnosis—may also cause headaches. Medication, lifestyle changes and supportive care services such as relaxation techniques may help relieve cancer-related head pain.

Immobility: Cancer and its treatments may cause joint and muscle pain that may make it harder to move around. Physical and occupational therapists may help.

Lymphedema: Lymphedema develops when lymph fluid doesn’t drain properly, causing a build up of fluid in the tissues that triggers pain and swelling. This condition may occur if the cancer is blocking part of the lymphatic system, following surgery to remove lymph nodes or after radiation therapy. Lymphedema typically affects the arms or legs. Compression garments, exercise and (or in conjunction with) a type of specialized massage called manual lymph drainage from a certified lymphedema therapist may make a difference in lymphedema-related pain.

Mucositis and mouth sores: Chemotherapy and radiation therapy kill rapidly dividing cells—including healthy cells, such as those in the mouth. As a result, patients may develop painful mouth sores and ulcers (oral mucositis). Good oral hygiene and dietary changes could help relieve pain from mucositis and mouth sores.

Numbness: Numbness in the hands and feet may occur if a tumor is pressing on a nerve, and some cancer treatments, like chemotherapy, may damage nerves. Changes to treatment regimens and physical or occupational therapy may help.

Pain: Pain from cancer may be caused by a tumor pressing on nerves, bones or organs—or by cancer treatments, including surgery, chemotherapy and radiation therapy. Identifying the cause of the pain will help guide treatment choices. In terms of spinal cord compression pain or bone pain, the following may explain causes and possible treatments:

• Spinal cord compression pain: If the spinal cord is compressed by a tumor, it may cause pain, weakness, numbness or other symptoms.Treatment typically involves radiation therapy and steroids to shrink the tumor or possibly surgery to remove the tumor, followed by radiation therapy to kill remaining cancer cells.
• Bone pain: When cancer spreads to the bones, it may be painful. Treatment options include radiation drugs (to help strengthen bones) and pain medications.
  

Peripheral neuropathy: Tingling or pain in the hands and feet may occur if a tumor is pressing or growing into a nerve. Other causes include chemotherapy drugs (especially in high doses), radiation therapy, certain cancer surgeries and immune system reactions. Medications may be prescribed to help relieve nerve pain and other symptoms of peripheral neuropathy.

Radiation burns: Radiation may burn the skin. Symptoms may be reduced by taking good care of skin and taking a lukewarm shower or bath. Some creams may help relieve this pain.