Causes of Cancer Pain

• Not everyone who has cancer has pain
• For those who do have pain, there are many different causes:
• The cancer itself causes about 65%-80% of cancer pain
• Pressure of the tumor on an organ (liver, lungs), bone or nerves
• Cancer growth into bone, nerves or an organ

• The cancer treatments cause about 15%-25% of pain
• Chemotherapy
  • Mouth sores
  • Numb fingers, feet
  • Bone or joint pain

• Surgery
  • Cutting across a nerve during surgery
  • Pain from incision

• Radiation therapy
  • Nerve ending sensitivity
  • Skin irritation
  • Procedures for treatment, evaluation or diagnosis (cause about 5%-10% of pain)

• Biopsy (cutting out the cancer or a a piece of the cancer to make a diagnosis)
• Blood draws (using a needle to remove blood from a vein)
• Placing a needle into the spine area (back bone) to give medication (called a lumbar puncture) also could be used to give pain medication
• Not related to cancer or cancer treatment
  • Other diseases (diabetes, heart problems, arthritis)
  • Injury (car accidents)

The different causes for pain in people with cancer.

• Physical from the cancer or the treatment
• Intellectual - knowledge, memory loss, self-control, review of life issues
  • Emotional pain anxiety, fear, grief
  • Interpersonal pain burden, physical needs, overprotection
  • Financial pain costs, loss of job
  • Spiritual pain facing death, questions of faith, feelings
  • Bureaucratic pain - more doctors, tests, questions

  Types of physical pain:

  • Acute Pain
  • Related to a specific event (surgery, injury)
  • Short lasting, as recover from the surgery, the pain at the incision goes away
  • Your need for pain medicine is short. You rapidly go from taking strong medicine (a narcotic) to less strong medicine (Tylenol® or Advil®) to no need for pain medicine

  Chronic Pain

  • Can last months to years even if cause of pain has healed (surgery) or been removed (chemo done)
  • If untreated, pain signals continue and becomes remembered (feelings of pain continue) in your brain even after the pain is gone.
  • This is real pain and is not just in your mind.
  • Affects your sense of well-being and quality of life.
  • Requires the use of pain medicine(s) for longer periods of time, possibly the rest of your life.

  Phantom (Limb) Pain

  • Feeling that the limb or breast is still there even after it has been removed
  • May ache, throb or otherwise give you an unpleasant or hurting feeling
  • The pain is real even though providers do not know why it happens

  Neuropathic Pain (involves nerve endings): Nerve damage by tumor or cancer treatment

  • The nerve is injured or squeezed by the cancer or cancer treatment.
  • Pain may be felt as burning, shooting, stabbing, or numbness. Some say it feels like pins and needles.
  • Sometimes called peripheral neuropathy.

  Breakthrough Pain

  • Unexpected pain that occurs between doses of pain medicine (called a pain flare).
  • Pain gets very bad in 3-5 minutes
  • Pain flares may last about 30 minutes
  • Pain flares are not always the same each time you have one
  • Usually treated with a pain medicine that acts very quickly and doesnt last for long
  • Usually means pain medicine needs to be adjusted (may need more medicine)
  • Pain Flares can be caused by:
    • Doing something like moving, gardening
    • Pain medicine does not last as long or relieve your pain as it should (You have pain before your next dose of pain medicine is due).
    • Sometimes there is no obvious cause; the pain flare just happens

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