Guide for People With Cancer & Their Families

What do I need to know about pain control?

Having cancer does not always mean having pain. But for people who do have pain, there are many different kinds of medicines, different ways to take the medicines and non-drug methods that can help relieve pain. You should never accept pain as a normal part of having cancer. All pain can be treated, and most pain can be controlled or relieved. When your pain is controlled, you can sleep and eat better, enjoy being with family and friends, and continue with your work and hobbies.

Only you know how much pain you are in. Telling your doctor and nurse when you are in pain is very important because pain is easier to treat when it first starts. It can also be an early warning sign of the side effects of your cancer treatment or some other problem. Together — you, your nurse, and your doctor — can talk about how to treat your pain. You have a right to pain relief, and you should insist on it.

Facts about cancer pain treatment

Cancer pain can almost always be relieved or lessened.

There are many medicines and methods that can be used to control cancer pain. You should expect your health care team to work with you to keep you as comfortable as possible. Controlling your cancer pain is part of your cancer treatment. Your doctor wants and needs to hear about what works for your pain and what does not. Knowing about the pain will help your doctor know more about how the cancer and the treatment are affecting your body. Talking about pain will not distract your doctor from treating the cancer.

Keeping pain from starting and keeping it from getting worse are the best ways to control it.

Pain is best relieved when treated early. You may hear some people refer to this as “staying on top” of the pain. Do not try to hold off as long as possible between doses. Pain may get worse if you wait. Then it may take longer, or you may need larger doses, for your medicine to give you relief.

You have a right to ask for pain relief.

Talking about your pain is not a sign of weakness. Not everyone feels pain in the same way. There is no need to “rough it out” or be “brave” if you seem to have more pain than other people with the same kind of cancer. In fact, as soon as you have any pain you should speak up. Remember, it is easier to control pain right when it starts rather than waiting until after it becomes severe.

People who take cancer pain medicines the way the doctor or nurse tells them to rarely become addicted to them.

Addiction is a common fear of people taking pain medicine. Such fear may even keep people from taking the medicine. Or it may cause family members to encourage you to hold off as long as you can between doses. Addiction is defined as uncontrollable drug craving, seeking, and continued use. When opioids (also known as narcotics) — the strongest pain relievers available — are taken for pain, they rarely cause addiction as defined here. When you are ready to stop taking opioids, the doctor will lower the amount of medicine you are taking over a few days or weeks. By the time you stop using it completely, your body has had time to adjust. Talk to your doctor, nurse, or pharmacist about how to take pain medicines safely and about any concerns you have about addiction.

Most people do not get “high” or lose control when they take cancer pain medicines the way they are told to.

Some pain medicines can cause you to feel sleepy when you first start taking them. This feeling usually goes away within a few days. Sometimes you become drowsy because now that the pain is under control, you are able to catch up on the much-needed sleep you missed when you were in pain. Sometimes, people get dizzy or feel confused when they take pain medicines. Tell your doctor or nurse if this happens to you. Changing your dose or type of medicine can often solve these problems.

Side effects from pain medicines can be managed and often even prevented.

Some medicines can cause nausea and vomiting, itching, constipation, or drowsiness. Your doctor or nurse can help you manage these side effects. But some of these problems go away after a few days of taking the medicine. And many side effects can be managed by changing the medicine, the dose, or the times when the medicine is taken. Others, like constipation, can often be prevented with stool softeners and other measures.

Your body does not become immune to pain medicine.

Pain should be treated early, and stronger medicines should not be saved for later. It is important to take whatever medicine is needed when it is needed. Your body may get used to the medicine you are taking then the medicine may not relieve the pain as well as it once did. This is called tolerance. Tolerance is seldom a problem with cancer pain treatment because your doctor can increase the amount of medicine you are taking or add other medicines. Some people are alarmed by this because they are afraid it means they are addicted, but it is not the same thing. It only means that the body has learned to adjust to the drug in your system over time.

When pain is not relieved, you may feel:

• tired
• depressed
• angry
• worried
• lonely
• stressed

When cancer pain is relieved, you are able to:

• enjoy being active
• sleep better
• enjoy family and friends
• eat better
• enjoy sexual intimacy
• prevent depression

So, conquer pain the right away!