Key Points

  • When pain is controlled, the quality of life improves dramatically.
  • Pain can be acute or persistent.
  • Cancer pain can be managed, often with relatively simple treatments.
  • Many of the common fears people have about cancer pain management are often unfounded.
  • In addition to opiods, many complementary therapies can also be remarkably helpful in controlling pain.

Pain, which can range from mild to severe, is the most common symptom leading people to seek medical attention. Both our experience and research tell us that when pain is controlled, quality of life improves dramatically. Uncontrolled pain, on the other hand, creates unnecessary suffering, "not only by causing immediate physical suffering, but also by increasing the anxiety level and the fear about the future and future problems."1 Pain may even shorten life.

Types of Pain

Pain can be acute or persistent:

  • Acute pain is short-term and usually ends after the source of the pain is addressed and the painful area heals—for example, incision pain after surgery.
  • Persistent pain is present frequently or constantly most of the day and persists beyond the period of time when the painful area is expected to heal. In persistent pain, the cause of the pain may not be able to be addressed.

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Reporting Pain

A critical step is reporting pain to your doctor. To learn how to talk with your doctor about pain, see NCI’s booklet: Pain Control. If your doctor is not trained in cancer pain management and is unable to help you relieve your pain satisfactorily, consider asking for a referral to a healthcare professional trained in managing cancer-related pain. These professionals often have a point of view that pain is an “emergency”, encouraging patients to report unmanaged pain promptly. In addition to medical oncologists (who are usually very knowledgeable about cancer pain management), doctors and nurses trained in palliative care are experts in helping people manage symptoms related to chronic illnesses such as cancer. These palliative care specialists often work in hospice or palliative care programs.

Our fears are masks of old hurts and not necessarily premonitions about the future.

Benjamin Shield 

Myths and Truths about Pain

Fears about pain and pain treatment are common. Perhaps your fears come from experience with someone with cancer whose pain caused suffering, and you are afraid that will happen to you. Many people are also afraid that if they take opiates such as morphine, they will become addicted or will be confused, incoherent or “out of it” all the time. Many may fear that if they take an opiate now, it won’t work later if the pain gets worse.

Addiction Risk Factors

As with other diseases, risk factors are associated with higher likelihood of addiction:2

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A realistic goal is to manage the pain so that it is tolerable and frees you up to achieve your own goals of living well.

Managing Pain

Clinical Practice Guidelines

The 2016 American Society of Clinical Oncology clinical practice guideline for management of chronic pain in survivors of adult cancers makes these recommendations regarding complementary approaches:3

Therapy Recommendation
An individualized exercise program
  • Based on intermediate quality evidence
  • Benefits outweigh harms
  • Strength of recommendation: moderate
Acupuncture, massage or music therapy
  • Based on low quality evidence
  • Benefits outweigh harms
  • Strength of recommendation: weak
Cognitive behavioral therapy, mindfulness, relaxation, distraction, or guided imagery
  • Based on intermediate quality evidence
  • Benefits outweigh harms
  • Strength of recommendation: moderate

Pain and Suffering

Unrelieved physical pain can cause unnecessary suffering. In addition to physical pain, people also experience emotional, mental, social and spiritual pain. These types of pain may also lead to suffering.

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Conventional Approaches

Opiates are currently the mainstay of treating moderate to severe cancer pain. We can often further manage pain with other kinds of medication, such as anti-inflammatories, anticonvulsants and antidepressants. Sometimes, chemotherapy, surgery or radiation therapy may also be part of your pain-treatment plan.

Complementary Approaches

Many non-drug techniques—complementary therapies—can also be remarkably helpful in controlling your pain. Persistent pain often is best managed with an integrative approach, combining conventional medications and treatments with complementary approaches. The Society for Integrative Oncology clinical practice guidelines list integrative therapies with evidence for addressing pain:5

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Integrative Programs, Protocols and Medical Systems

For more information about programs and protocols, see our Integrative Programs and Protocols page.

Written by Laura Pole, RN, MSN, OCNS, and reviewed by Nancy Hepp, MS; most recent update on April 19, 2018.

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