Cancer pain: Relief is possible

Learn about what causes cancer pain, how it's treated, and what barriers might stand in the way of adequate cancer pain relief.

By Mayo Clinic Staff

Not everyone with cancer has cancer pain, but some do. If you have cancer that's spread or recurred, your chance of having pain is higher.

Cancer pain takes many forms. It can be dull, achy, sharp or burning. It can be constant, intermittent, mild, moderate or severe. How much pain you feel depends on a number of factors, including the type of cancer you have, how advanced it is, where it's situated and your pain tolerance.

Most cancer pain is manageable, and controlling your pain is an essential part of your treatment.

What causes cancer pain?

Pain can be caused by the cancer itself. Pain could happen if the cancer grows into or destroys nearby tissue. As a tumor grows, it can press on nerves, bones or organs. The tumor can also release chemicals that can cause pain.

Treatment of the cancer can help the pain in these situations. However, cancer treatments, including surgery, radiation and chemotherapy, also can cause pain.

How do you treat cancer pain?

A number of treatments are available for cancer pain. Your options may depend on what's causing your cancer pain and the intensity of the pain you're feeling. You may need a combination of pain treatments to find the most relief.

Options include:

  • Over-the-counter pain relievers. For mild and moderate levels of pain, pain relievers that don't require a prescription may help. Examples include aspirin, acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others).
  • Medications derived from opium (opioids). Opioids are prescription medications used to treat moderate to severe pain. Examples of opioids include morphine (Kadian, Ms Contin, others) and oxycodone (Oxycontin, Roxicodone, others).

    Some opioids are short-acting medicines, so pain relief comes quickly but you may need to take them more often. Other opioid drugs are long-acting medicines, so pain relief takes longer but the medicine doesn't need to be taken as often. Sometimes short-acting and long-acting opioids are used together.

  • Other prescription medicines. Other types of medicine can help relieve pain, including antidepressants, anti-seizure drugs and steroids.
  • Procedures to block pain signals. A nerve block procedure can be used to stop pain signals from being sent to the brain. In this procedure, a numbing medicine is injected around or into a nerve.
  • Integrative therapies. Some people find some pain relief through acupuncture, massage, physical therapy, relaxation exercises, meditation and hypnosis.

Other treatments may be available for your particular situation. In some places, it may be legal to use medical marijuana for cancer pain.

All pain medicines have side effects. Work with your doctor to understand the benefits and risks of each pain treatment and how to manage the side effects. Together you can decide which treatments may be best for you.

What are some reasons for not receiving adequate treatment for cancer pain?

Unfortunately cancer pain is often undertreated. Many factors can contribute to that, some of which include:

  • Reluctance of doctors to ask about pain or offer treatments. Health care professionals should ask people with cancer about pain at every visit. Some doctors don't know enough about pain treatment. In that case, request a referral to a palliative care or pain specialist.

    Given current concerns about opioid use and abuse, many doctors might be reluctant to prescribe these medications. Maintaining a close working relationship with your cancer specialists is essential to proper use of these medications.

  • Reluctance of people to mention their pain. Some people don't want to "bother" their doctors, or they fear that the pain means the cancer is worsening. Others are worried their doctors will think of them as complainers or that they can't afford pain medications.
  • Fear of addiction to opioids. The risk of addiction for people with advanced cancer who take pain medications as directed for cancer pain is low.

    You might develop a tolerance for your pain medication, which means you might need a higher dose to control your pain. Tolerance isn't addiction. If your medication isn't working as well as it once did, talk to your doctor about a higher dose or a different drug. Don't increase the dose on your own.

  • Fear of side effects. Some people fear being sleepy, being unable to communicate, acting strangely or being seen as dependent on medications. You might have these side effects when you start taking strong pain medications, but they often resolve once your doctors find the correct level of pain medications for you and once you achieve a steady level of pain medicine in your body.

How can you help your doctor understand your cancer pain?

If the pain interferes with your life or is persistent, report it. It might help to keep track of your pain by jotting down:

  • How severe the pain is
  • What type of pain (stabbing, dull, achy) you have
  • Where you feel the pain
  • What brings on the pain
  • What makes the pain worse or better
  • What pain relief measures you use, such as medication, massage, and hot or cold packs, how they help and any side effects they cause

Using a pain-rating scale from 0 to 10 — with 0 being no pain and 10 being the worst pain imaginable — might help you to report your pain to your doctor.

What steps can you take to ensure you're receiving adequate cancer pain treatment?

First, talk to your doctor or health care provider about your pain.

Second, you and your doctor can set a goal for pain management and monitor the success of the treatment. Your doctor should track the pain with a pain scale, assessing how strong it is. The goal should be to keep you comfortable. If you aren't comfortable, talk to your doctor.

If you're not getting the answers you need, request a referral to a facility skilled in the care of pain. All major cancer centers have pain management programs. The medications and treatment for pain are generally covered by standard insurance.

Get the latest health information from Mayo Clinic’s experts.

Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Feb. 12, 2021 See more In-depth

See also

  1. Adjuvant therapy for cancer
  2. After a flood, are food and medicines safe to use?
  3. Alternative cancer treatments: 10 options to consider
  4. Atypical cells: Are they cancer?
  5. Biological therapy for cancer
  6. Biopsy procedures
  7. Blood Basics
  8. Bone marrow transplant
  9. Bone scan
  10. Cancer
  11. Cancer blood tests
  12. Myths about cancer causes
  13. Infographic: Cancer Clinical Trials Offer Many Benefits
  14. Cancer diagnosis: 11 tips for coping
  15. Cancer diagnosis? Advice for dealing with what comes next
  16. Cancer-related fatigue
  17. Cancer-prevention strategies
  18. Cancer risk: What the numbers mean
  19. Cancer surgery
  20. Cancer survival rate
  21. Cancer survivors: Care for your body after treatment
  22. Cancer survivors: Late effects of cancer treatment
  23. Cancer survivors: Managing your emotions after cancer treatment
  24. Cancer survivors: Reconnecting with loved ones after treatment
  25. Cancer treatment decisions: 5 steps to help you decide
  26. Cancer treatment for men: Possible sexual side effects
  27. Cancer treatment for women: Possible sexual side effects
  28. Cancer treatment myths
  29. Cancer Vaccine Research
  30. Cellphones and cancer
  31. Chemo Targets
  32. Chemoembolization
  33. Chemotherapy
  34. Chemotherapy and hair loss: What to expect during treatment
  35. Chemotherapy and sex: Is sexual activity OK during treatment?
  36. Chemotherapy nausea and vomiting: Prevention is best defense
  37. Chemotherapy side effects: A cause of heart disease?
  38. Complete blood count (CBC)
  39. Cough
  40. CT scan
  41. CT scans: Are they safe?
  42. Curcumin: Can it slow cancer growth?
  43. Cancer-related diarrhea
  44. Eating during cancer treatment: Tips to make food tastier
  45. Fatigue
  46. Fertility preservation
  47. Get ready for possible side effects of chemotherapy
  48. Ginger for nausea: Does it work?
  49. Heart cancer: Is there such a thing?
  50. High-dose vitamin C: Can it kill cancer cells?
  51. Honey: An effective cough remedy?
  52. How plant-based food helps fight cancer
  53. Infographic: CAR-T Cell Therapy
  54. Intrathecal chemotherapy
  55. Joint pain
  56. Joint pain: Rheumatoid arthritis or parvovirus?
  57. Low blood counts
  58. Magic mouthwash
  59. Medical marijuana
  60. Mediterranean diet recipes
  61. Mindfulness exercises
  62. Minimally invasive cancer surgery
  63. Monoclonal antibody drugs
  64. Mort Crim and Cancer
  65. Mouth sores caused by cancer treatment: How to cope
  66. MRI
  67. Muscle pain
  68. Night sweats
  69. No appetite? How to get nutrition during cancer treatment
  70. Palliative care
  71. PALS (Pets Are Loving Support)
  72. Pelvic exenteration
  73. PET/MRI scan
  74. Pet therapy
  75. Radiation therapy
  76. Infographic: Scalp Cooling Therapy for Cancer
  77. Secondhand smoke
  78. Seeing inside the heart with MRI
  79. Self-Image During Cancer
  80. Sentinel lymph node mapping
  81. Sisters' Bone Marrow Transplant
  82. Sleep tips
  83. Mediterranean diet
  84. Radiation simulation
  85. Small cell, large cell cancer: What this means
  86. Stem Cells 101
  87. Stem cells: What they are and what they do
  88. Thalidomide: Research advances in cancer and other conditions
  89. Treating pain: When is an opioid the right choice?
  90. Tumor vs. cyst: What's the difference?
  91. TVEC (Talimogene laherparepvec) injection
  92. Ultrasound
  93. Unexplained weight loss
  94. Stem cell transplant
  95. How cancer spreads
  96. MRI
  97. PICC line placement
  98. Compassionate use
  99. When cancer returns: How to cope with cancer recurrence
  100. Wide local skin excision
  101. X-ray
  102. Your secret weapon during cancer treatment? Exercise!