Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. In people with cancer, pain may be caused by the tumour itself, cancer treatments, or other medical conditions unrelated to cancer.

Pain may occur:

  • As a result of tumour compression or invasion of nerves, organs or bones.
  • Following surgery.
  • After chemotherapy (for example, peripheral neuropathy).
  • Following radiotherapy.
  • Due to inflammation, infection or treatment-related complications.

The experience of pain is different for every person. Physical, emotional, social and spiritual factors can all influence how pain is perceived and experienced.

Types of Pain

Identifying the type of pain helps healthcare professionals select the most appropriate treatment.

Acute Pain

  • Develops suddenly.
  • Usually lasts for a limited period.
  • May be related to surgery, medical procedures or recent injuries.

Chronic or Persistent Pain

  • Persists for weeks or months.
  • May require ongoing treatment.

Nociceptive Pain

This type of pain is caused by tissue injury or inflammation.

Somatic Pain

  • Affects bones, muscles or joints.
  • Can usually be localised easily.

Visceral Pain

  • Originates from internal organs.
  • May feel like pressure, stretching or cramping.
  • Can sometimes be difficult to pinpoint.

Neuropathic Pain

Neuropathic pain results from damage to or dysfunction of the nerves.

It may be described as:

  • Burning.
  • Cramping.
  • Electric shock-like sensations.
  • Tingling.
  • Stabbing or pinprick sensations.

Breakthrough Pain

Breakthrough pain is a temporary episode of severe pain that occurs despite the background pain being reasonably well controlled. It requires specific assessment and may sometimes require rescue medication.

Pain Assessment

Your healthcare team may ask you to rate your pain using a numerical scale:

  • 0 = no pain.
  • 10 = the worst pain imaginable.

It is also helpful to explain:

  • Where the pain is located.
  • When it occurs.
  • What the pain feels like.
  • What makes it worse.
  • What relieves it.
  • How it affects your daily life.

Keeping a pain diary can help optimise treatment.

Non-Pharmacological Treatments

International guidelines recommend combining medication with non-pharmacological measures whenever possible.

These may include:

  • Adapted exercise programmes.
  • Physiotherapy.
  • Cognitive Behavioural Therapy (CBT).
  • Relaxation techniques.
  • Mindfulness and meditation.
  • Therapeutic massage.
  • Psychological support.

These interventions complement medical treatment but should not replace it.

Simple measures that may also help include:

  • Finding comfortable positions.
  • Using supportive cushions or pillows.
  • Maintaining appropriate physical activity.
  • Applying heat or cold when recommended by your healthcare team.
  • Listening to music or engaging in enjoyable activities.
  • Maintaining contact with family and friends.
  • Practising breathing exercises or relaxation techniques.

When Should You Seek Urgent Medical Advice?

Contact your healthcare team promptly if:

  • Your pain suddenly becomes worse.
  • Your pain medication is no longer effective.
  • You develop significant treatment-related side effects.
  • Pain prevents you from sleeping, eating or moving.
  • You develop weakness, loss of sensation, or loss of bladder or bowel control.
  • You experience severe new pain.