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Pharmacological Management of Cancer Pain


What do I need to know about cancer pain? Some people who have cancer experience pain. The pain may be short-term or long-term. It may come and go. Pain management is an important part of cancer care.

What causes cancer pain?

  • As the tumor grows and becomes larger, it may damage, block, or put pressure on tissues, nerves, and blood vessels.

  • Some cancer cells may produce chemicals that cause pain.

  • Chemotherapy, radiation therapy, or surgery may cause pain.

How is cancer pain diagnosed? You may need the following to check how much pain you have or find its cause:

  • Physical examination: Your caregiver will examine you and look for painful areas. He may touch or press different places on your body.

  • Pain diary: Write down what makes your pain better and worse. Also include when your pain begins and ends.

  • Pain scales: These may help measure how much pain you feel. There are many pain scales that include numbers or faces. Your caregiver may ask you to rate the pain on a scale of 0 to 10.

  • Imaging tests: You may need imaging tests to look for the cause of your cancer pain. These may include x-rays, a CT scan, and a MRI test. You may be given dye to help the pictures show up better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body.

  • Stimulation tests: These may help to find which nerves or muscles are affected by pain. These tests may include electromyography (EMG), nerve conduction studies, and evoked potential (EP) studies.

How is cancer pain treated? Caregivers will try to treat the cause of your cancer pain. This may include treating infections or cancer. You may need the following:

  • Acetaminophen: This medicine decreases pain. You can buy acetaminophen without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.

  • NSAIDs: These medicines decrease swelling and pain. You can buy NSAIDs without a doctor's order. Ask your caregiver which medicine is right for you, and how much to take. Take as directed. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly.

  • Narcotic analgesics: These medicines are used for moderate to severe pain. They may be used to control cancer pain or after surgery and other procedures.

  • Anesthetics: These may be injected in or around a nerve to block pain signals from the nerves.

What other medicines are used to treat cancer pain?

  • Antidepressants: These medicines may be used to help decrease or prevent the symptoms of depression or anxiety. They are also used to treat nerve pain.

  • Antianxiety medicine: This medicine may help you feel calm and relaxed. It may also decrease pain and help you sleep.

  • Muscle relaxers help decrease pain and muscle spasms.

  • Steroids: This medicine may be given to decrease inflammation that causes pain.

  • Radiopharmaceuticals and biphosphonates: Radiopharmaceuticals and biphosphonates help decrease cancer growth, pain, and inflammation that happens when cancer gets inside bones.

  • Anticonvulsant medicine: This medicine is given to control seizures. It may also be used to decrease chronic pain.

What are the risks of cancer pain? Cancer pain can make it hard for you to eat and sleep. You may lack energy or the ability to do things. It can also affect your mood and your relationships with others.

Where can I find support and more information?

  • National Cancer Institute
    6116 Executive Boulevard, Suite 300
    Bethesda , MD 20892-8322
    Phone: 1- 800 - 422-6237
    Web Address:

When should I contact my caregiver? Contact your caregiver if:

  • You have a fever.

  • You have chills, a cough, or feel weak and achy.

  • You have nausea or vomiting.

  • Your skin is itchy, swollen, or has a rash.

  • You have questions or concerns about your condition or care.

When should I seek immediate care? Seek care immediately or call 911 if:

  • You feel more pain even after you take your pain medicine.

  • You feel so depressed that you cannot cope with your disease.

  • You feel very anxious or irritable after you take your medicines.

  • You have problems thinking clearly.

  • You cannot control when you urinate or have a bowel movement.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

  • You suddenly feel lightheaded and short of breath.

  • You have chest pain when you take a deep breath or cough. You may cough up blood.


You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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