About cancer pain

Pain is usually a sign that something is wrong. It is a sign that you have an illness or an injury. When there is damage to any part of your body, your nervous system sends a message along nerves to your brain. When your brain receives these messages, you feel pain. This includes pain caused by cancer.

What pain means

Having a lot of pain can be frightening. It can make you think that your cancer must be growing. But how much pain you have isn’t necessarily connected to a cancer’s growth. A very small cancer that’s pressing on a nerve or your spinal cord can be extremely painful. Yet a very large cancer somewhere else in the body might not cause you any pain at all.

Having pain after successful treatment doesn't necessarily mean that your cancer has come back. Some people get pain after cancer treatments like surgery or radiotherapy. Or, it might be a long term side effect of chemotherapy.

Post treatment pain can start or get worse, months or even years after treatment has finished. This is due to the nervous system rewiring itself after some nerves have been damaged. These damaged nerves then send pain signals to the brain.

Often, this type of pain doesn't respond to ordinary painkillers. Your cancer specialist will then use other ways of treating pain. This includes using other medicines.

Remember that pain might not be related to your cancer. It’s completely understandable to worry about this. But sometimes pain can just be due to everyday things like arthritis, headaches, constipation or digestive problems.

Not all cancers cause pain

Many people with cancer do not have pain. This is because cancers don't have any nerves of their own. The pain comes from a tumour pressing on nerves nearby.

Researchers estimate that 38 and of 100 people with cancer (38%) have moderate to severe pain. Pain is more likely with advanced cancer. Advanced cancer means the cancer has spread or come back since it was first treated. Around 65 out of 100 people with advanced cancer (around 65%) have pain.

It is possible to relieve all pain to some extent with the right treatment. With good pain control, most people should be able to be free of pain when they are lying down or sitting.

The best way of controlling pain depends on what's causing it. The first step is to tell your doctor or specialist nurse that you have pain.

How pain affects you

Pain can affect you physically and emotionally. It's a very personal experience that feels different for everyone. What is painful and disturbing for one person might not affect someone else in the same way.

Everyone needs different pain treatment. What works for you might not help someone else. So having an individual treatment plan to control your pain is very important.

Try to write down as much detail as possible about your pain. For example, you could use a pain diary. Include when it comes on, what it feels like and what helps. This will help your cancer specialist to find out what’s causing the pain and work out the best way of treating it.

Things to write down:

  • Where it is – in one place, or spread around an area.
  • What it feels like – for example, stabbing, aching or burning.
  • What relieves it – for example, heat, cold, changing position, massage.
  • How often you have it – always or it comes and goes.
  • How it comes on - suddenly or gradually.

Getting help with cancer pain

Don't be afraid to tell your doctor or nurse that you have pain, however mild or severe it feels to you. The earlier you get treatment for pain, the easier it is to get it under control. 

At any stage of your cancer you have a lot to deal with. Having pain too can make things harder for you, both emotionally and physically.

Many people with cancer are scared that they will become addicted to painkillers. So they don’t ask for help. But it’s very rare for people taking painkillers for cancer pain to become addicted to them. And it is important that the pain is controlled.

Some painkillers can have side effects. Tell your doctor or specialist nurse if you have any side effects, so they can help you through them.

  • Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines

    M Fallon and others

    Annals of Oncology, 2018. Volume 29, Supplement 4

  • Cancer Pain Management

    The British Pain Society, 2010 (Updated 2014)

  • Cancer and its management (7th edition)

    J Tobias and D Hochhauser, 2015

  • Oxford Textbook of Palliative Medicine 

    NI Cherny and others (Editors)

    Oxford University Press, 2015

  • Update on Prevalence of Pain in Patients With Cancer: Systematic Review and Meta-Analysis
    MHJ van den Beuken-van Everdingen and others
    Journal of Pain Symptom Management, 2016. Volume 51, Issue 6, Pages 1070 - 1090

Last reviewed: 
20 Oct 2020
Next review due: 
20 Oct 2023

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