Pain is a sensation that hurts. It may cause discomfort,
distress or agony. It may be steady or throbbing. It may be
stabbing, aching, or pinching. However you feel pain, only you can
describe it or define it. Because pain is so individual, your pain
cannot be "checked out" by anyone else.
Pain may be acute or chronic. Acute pain is severe and lasts a
relatively short time. It is usually a signal that body tissue is
being injured in some way, and the pain generally disappears when
the injury heals. Chronic pain may range from mild to severe, and
it is present to some degree for long periods of time.
What Causes Pain People With Cancer?
Cancer patients may have pain for a variety of reasons. It may
be due to the effects of the cancer itself, or it could result from
treatment methods. For example, after surgery a person feels pain
as a result of the operation itself. Or the pain could be unrelated
to the cancer-a muscle sprain, a toothache, or a headache.
Remember that not all people with cancer have pain. And those
who do are not in pain all the time.
Cancer pain may depend on the type of cancer, the
(extent) of the disease, and your
(or tolerance for pain). Cancer pain that
lasts a few days or longer may result from:
The tumor causing pressure on organs, nerves, or bone.
Poor blood circulation because the cancer has blocked blood
Blockage of an organ or tube in the body.
--cancer cells that have spread to other sites in
Psychological responses to illness such as tension, depression,
Whatever the cause, pain can be relieved.
What Can Be Done for Cancer Pain?
The best way to manage pain is to treat its cause. Whenever
possible, the cause of the pain is treated by removing the tumor or
decreasing its size. To do this, your doctor may recommend surgery,
radiation therapy, or chemotherapy. When none of these procedures
can be done, or when the cause of the pain is not known,
pain-relief methods are used.
This booklet describes many methods for controlling pain. They
include pain medicines, operations on nerves,
nerve blocks, physical therapy
, and techniques such as
. Only you and your doctor and nurse-who know where
your pain is, how bad it is, the kind of cancer you have, and your
general health-can decide which methods might be best for you.
What Do I Tell Those Caring For Me About My Pain?
If you are feeling pain, you need to be able to describe it to
those who are trained to help you. Some people find pain very hard
to explain. Try to use words that will help others understand what
you are feeling. Your doctor and others who are caring for you need
Where do you feel your pain?
When did it begin?
What does it feel like? Sharp? Dull? Throbbing? Steady?
How bad is it?
Does it prevent you from doing your daily activities? Which
What relieves your pain?
What makes it worse?
What have you tried for pain relief? What helped? What did not
What have you done in the past to relieve other kinds of
Is your pain constant? If not, how many times a day (or week)
does it occur?
How long does it last each time?
Pain has different effects on different people. Be sure that
those who are caring for you know about the effects.
Don't hesitate to talk about your pain to those who can help
you. You have a right to the best pain control you can get.
Relieving your pain means you can continue to do the everyday
things that are important to you. Remember, only you know what you
: work, recreation, interpersonal
relationships, ability to get around, self-care activities
How Can I Describe How Bad or Intense the Pain Is?
Understanding how bad your pain is helps your doctor decide how
to treat it. You can rate how much pain you are feeling by using a
pain scale like the one below. Try to assign a number from 0 to 5
to your pain level. If you have no pain, use a 0. A 5 means the
pain is as bad as it can be. As the numbers get larger, they stand
for pain that is gradually getting worse.
You may wish to make up your own pain scale using numbers from
0 to 10 or even 0 to 100. Be sure to let others know what pain
scale you are using: for example, "My pain is a 7 on a scale of 0
You can use a rating scale to answer:
How bad is your pain at its worst?
How bad is your pain most of the time?
How bad is your pain at its least?
How does your pain change with treatment?
How Can I Remember All the Details
About the Pain I Have, and What I Do To Relieve It?
You may find it helpful to keep a record or a diary about your
pain and what you try for pain relief. The record helps you and
those who are caring for you understand more about your pain, the
effects it has on you, and what works best to ease your pain. Items
that should be included are:
The number from your rating scale that describes your pain
before and after using a pain-relief measure.
The time you take pain medicine.
Any activity that seems to be affected by the pain or that
increases or decreases the pain.
Any activity that you cannot do because of the pain.
The name of the pain medicine you take and the dose.
No, but these feelings can make the pain seem worse. People
often have an emotional reaction to pain. You may feel worried,
depressed, or easily discouraged when you are in pain. Some people
feel hopeless or helpless. Others feel alone or embarrassed,
inadequate or angry, frightened or frantic.
People with cancer have many reasons for feeling anxious or
depressed even when they are not in pain. Try to talk about your
feelings with your doctors, nurses, family members, friends, a
member of the clergy, or other cancer patients. Talking with family
members is often helpful, even though this might be hard for you to
do at first.
In some communities, cancer patients meet informally to talk
about their feelings and share how they have coped with this
disease. Just understanding that others feel the same way as you do
might help you deal with having cancer. For information about
support services in your area contact your local Unit of the
American Cancer Society, the Visiting Nurses Association, the
Cancer Information Service at 1-800 4 CANCER (1-800422-6237), or
someone from a hospice, if one is located in your area.
If you feel that these informal ways to lessen your anxiety or
depression are not helpful, you may wish to talk with a counselor,
a mental health professional who is skilled at dealing with such
problems. Your doctor or nurse may be able to help you find a
counselor who is specially trained to help people with chronic
illnesses. The social services department at your local hospital is
another source of information about people who can help you deal
with anxiety and depression.
Another option is to ask your doctor about medication.
Sometimes, medicine such as
can be helpful. Some of these medicines
relieve pain in addition to their antidepressant effects.
How Does Fatigue Affect My Pain?
Fatigue can make it harder for you to deal with pain. When you
are tired, you may not be able to cope with the pain as well as
when you are rested. Many people notice that pain seems to get
worse as they get tired. Lack of sleep can increase your pain. Be
sure to tell your doctor or nurse if you have not been sleeping
well because of pain or worry.
What Is Phantom Limb Pain?
If you have had an arm or leg removed by surgery, you may still
feel pain or other unpleasant sensations as if they were coming
from the absent limb. Doctors are not sure why it occurs, but
phantom limb pain is real; it is not imaginary. This also can occur
if you have had a breast removed-you may have a sensation of pain
in the missing breast.
No single pain-relief method controls phantom limb pain in all
patients all the time. Many methods have been used to treat this
type of pain, including pain medicine, physical therapy, and nerve
stimulation. If you are having phantom pain, ask your doctor,
nurse, or pharmacist about how you might relieve it.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a