NCI cancer pain entry updated

Longtermsurvivor · March 2016

Cancer itself and the side effects of cancer treatment can sometimes cause pain. Pain is not something that you have to "put up with." Controlling pain is an important part of your cancer treatment plan. Pain can suppress the immune system, increase the time it takes your body to heal, interfere with sleep, and affect your mood.

Talk with your health care team about pain, especially if:

the pain isn't getting better or going away with pain medicine

the pain comes on quickly

the pain makes it hard to eat, sleep, or perform your normal activities

you feel new pain

you have side effects from the pain medicine such as sleepiness, nausea, or constipation

Your doctor will work with you to develop a pain control plan that is based on your description of the pain. Taking pain medicine is an important part of the plan. Your doctor will talk with you about using drugs to control pain and prescribe medicine (including opioids and nonopioid medicines) to treat the pain.

Ways to Treat or Lessen Pain

Here are some steps you can take, as you work with your health care team to prevent, treat, or lessen pain:

Keep track of your pain levels. Each day, write about any pain you feel. Writing down answers to the questions below will help you describe the pain to your doctor or nurse.

What part of your body feels painful?

What does the pain feel like (is it sharp, burning, shooting, or throbbing) and where do you feel the pain?

When does the pain start? How long does the pain last?

What activities (such as eating, sleeping, or other activities) does pain interfere with?

What makes the pain feel better or worse? For example, do ice packs, heating pads, or exercises help? Does pain medicine help? How much do you take? How often do you take it?

How bad is the pain, on a scale of 1 to 10, where "10" is the most pain and "1" is the least pain?

Take the prescribed pain medicine. Take the right amount of medicine at the right time. Do not wait until your pain gets too bad before taking pain medicine. Waiting to take your medicine could make it take longer for the pain to go away or increase the amount of medicine needed to lower pain. Do not stop taking the pain medicine unless your doctor advises you to. Tell your doctor or nurse if the medicine no longer lowers the pain, or if you are in pain, but it's not yet time to take the pain medicine.

Meet with a pain specialist. Specialists who treat pain often work together as part of a pain or palliative care team. These specialists may include a neurologist, surgeon, physiatrist, psychiatrist, psychologist, or pharmacist. Talk with your health care team to find a pain specialist.

Ask about integrative medicine. Treatments such as acupuncture, biofeedback, hypnosis, massage therapy and physical therapy may also be used to treat pain.

Talking With Your Health Care Team

Prepare for your visit by making a list of questions to ask. Consider adding these questions to your list:

What problems or levels of pain should I call you about?

What is most likely causing the pain?

What can I do to lessen the pain?

What medicine should I take? If the pain doesn't go away, how much more medicine can I take, and when can I take it?

What are the side effects of this pain medicine? How long will they last?

Is there a pain specialist I could meet with to get more support to lower my pain?

Learning to Relax

Many people with cancer have found that doing relaxation or imagery exercises has helped them cope with pain and stress.

Take the time to learn helpful relaxation skills, such as the ones below, and practice them when you can. You can also take a class, buy a relaxation DVD or CD, or find other exercises online.

Getting Started

For each exercise, find a quiet place where you can rest undisturbed. Let others know you need time for yourself. Make the setting peaceful for you. For example, dim the lights and find a comfortable chair or couch.

You may find that your mind wanders, which is normal. When you notice yourself thinking of something else, gently direct your attention back to your body. Be sure to maintain your deep breathing.

Some people like to listen to slow, familiar music while they practice these exercises.

Breathing and Muscle Tensing

Get into a comfortable position where you can relax your muscles. Close your eyes and clear your mind of distractions. You can sit up or lie down. If you're lying down, you may want to put a small pillow under your neck and knees.
Breathe deeply, at a slow and relaxing pace. Concentrate on breathing deeply and slowly, raising your belly with each breath, rather than just your chest.
Next, go through each of your major muscle groups, tensing (squeezing) them for a few seconds and then letting go. Start at the top of your head and work your way down. Tense and relax your face and jaws, then shoulders and arms.
Continue tensing and relaxing each muscle group as you go down (chest, lower back, buttocks, legs), ending with your feet. Focus completely on releasing all the tension from your muscles and notice the differences you feel when they are relaxed.
When you are done, focus on the pleasant feeling of relaxation for as long as you like.

Slow Rhythmic Breathing

Stare at an object or shut your eyes and think of a peaceful scene. Take a slow, deep breath.
As you breathe in, tense your muscles. As you breathe out, relax your muscles and feel the tension leaving.
Remain relaxed and begin breathing slowly and comfortably, taking about 9 to 12 breaths a minute. To maintain a slow, even rhythm, you can silently say to yourself, "In, one, two. Out, one, two."
If you ever feel out of breath, take a deep breath, and continue the slow breathing.
Each time you breathe out, feel yourself relaxing and going limp. Continue the slow, rhythmic breathing for up to 10 minutes.
To end the session, count silently and slowly from one to three. Open your eyes. Say to yourself, "I feel alert and relaxed." Begin moving slowly.

Imagery

Imagery usually works best with your eyes closed. To begin, create an image in your mind. For example, you may want to think of a place or activity that made you happy in the past. Explore this place or activity. Notice how calm you feel.

If you have severe pain, you may imagine yourself as a person without pain. In your image, cut the wires that send pain signals from one part of your body to another. Or you may want to imagine a ball of healing energy. Others have found the following exercise to be very helpful:

Close your eyes and breathe slowly. As you breathe in, say silently and slowly to yourself, "In, one, two," and as you breathe out, say "Out, one, two." Do this for a few minutes.
Imagine a ball of healing energy forming in your lungs or on your chest. Imagine it forming and taking shape.
When you're ready, imagine that the air you breathe in blows this ball of energy to the area where you feel pain. Once there, the ball heals and relaxes you. You may imagine that the ball gets bigger and bigger as it takes away more of your discomfort.
As you breathe out, imagine the air blowing the ball away from your body. As it floats away, all of your pain goes with it.
Repeat the last two steps each time you breathe in and out.

To end the imagery, count slowly to three, breathe in deeply, open your eyes, and say silently to yourself, "I feel alert and relaxed."

Posted: February 29, 2016