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 opioids, many complementary therapies can also be remarkably helpful in controlling pain.

ALaura Poleuthor

Laura Pole, RN, MSN, OCNS, BCCT Senior Researcher

Read more


Nancy Hepp, MS, BCCT Project Manager

Read more

Last updated August 31, 2021

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. Reported pain in a group of ovarian cancer survivors was associated with markers of inflammation, a known driver of cancer and other diseases.2

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.

Read more

Reporting Pain

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

Benjamin Shield

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.

Myths and Truths about Pain

For Health Professionals

Addiction Risk Factors

As with other diseases, risk factors are associated with higher likelihood of addiction:3

Expand list

Nonmedical Opioid Use

Among cancer patients receiving long-term opioid treatment for pain, 19 percent developed behaviors of nonmedical opioid use (NMOU) within a median duration of 8 weeks, researchers reported.4

Read more

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.

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.

Read more

Managing Pain

Helpsy Health

Even when people are getting the best of cancer treatment, they often feel like they need more help with organizing their care and managing symptoms and side effects. Helpsy empowers members to take control of their health through a real-time virtual nurse support service. This service is available via mobile devices, a Helpsy website and automated phone calls.

Read more

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:10

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.

Read more

Conventional Approaches

Opiates are currently the mainstay of treating moderate to severe cancer pain. The non-opioid analgesic acetaminophen/paracetamol (brand name Tylenol in the US) can be effective against mild to moderate pain. Non-steroidal anti-inflammatory drugs (NSAIDs) including aspirin can reduce pain caused by inflammation. Your doctor may prescribe both acetaminophen and an NSAID for mild to moderate pain if inflammation is involved. Advil Dual Action combines analgesic and anti-inflammatory effects in one pill, but a similar effect can be achieved by alternating an analgesic (acetaminophen/paracetamol) with an NSAID, with the added benefit of tailoring the NSAID to your specific needs and condition (see Aspirin and Other Non-steroidal Anti-inflammatory Drugs (NSAIDs) for cautions related to each type of NSAID). Because each type of pain reliever carries risks of adverse reactions and interactions with other therapies, we encourage you to consult your physician before use.

We can often further manage pain with other kinds of medication, such as anticonvulsants and antidepressants. Chemotherapy, surgery or radiation therapy may also be part of your pain-treatment plan.

Pharmacologic treatment of pain does not always meet patients’ needs and may produce difficult side effects.

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:12

Read more

Smoking and Pain

A 2020 study found that daily smokers and former daily smokers "reported higher levels of bodily pain compared with never daily smokers at all ages."21 The reason or mechanism for this association is still unknown.

Research shows that mind-body interventions can reduce or relieve pain in cancer patients, whether from the disease itself or from side effects of treatments, and allow patients to participate in their own care.22

Earlier bedtimes (before midnight) were also associated with less pain than later bedtimes in a group of ovarian cancer survivors.23

Integrative Programs, Protocols and Medical Systems

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

View All References

More Information

Enter your comments or questions below.

Comments (0)

Allowed tags: <b><i><br>Add a new comment: