Unfortunately, moderate-to-severe pain is a common problem experienced by patients with cancer. Cancer pain is incapacitating and affects patients’ physical and emotional well-being. Although analgesic drugs can help manage cancer pain, adverse side effects are common, and some analgesic drugs are addictive. Therefore, it’s worth considering non-pharmacologic treatments that may ease cancer pain without negative side effects. However, pain management for cancer patients will likely require pharmacologic and non-pharmacologic approaches.

This article covers the following strategies of pain management for cancer patients:

Pharmacological solutions, including patient-controlled analgesia (PCA).
Complementary medicine.
Other non-pharmacologic interventions.
Targeted radiofrequency ablation (t-RFA).

Types of cancer pain.

Every cancer patient’s pain is a personal experience – your pain may be completely different than other patients with a similar diagnosis and treatment plan. Importantly, what’s painful for you may not be painful for another person.

Types of cancer pain include:

Bone pain can feel like a dull ache or throbbing pain.
Nerve pain occurs if a cancerous tumor puts pressure on your nerves or spinal cord. Additionally, you can feel nerve pain if cancer treatment damages your nerves. Nerve pain may feel like a burning sensation, shooting pain or tingling. Unfortunately, nerve pain can be hard to manage.
Soft tissue pain feels sharp, cramping, or throbbing. This can occur when cancer affects your organs or soft tissues (these parts of your body help connect, support or surround your bones and internal organs, including tendons, muscles, skin and fat).
Phantom pain is pain in a part of your body that’s been surgically removed to eliminate a cancerous tumor. For example, after a mastectomy, you may feel pain where your breast was.
Referred pain occurs when pain in one area of your body is caused by cancer in another area of your body. For example, cancer in your liver may make it swell and press on nerves that cause right shoulder pain.

Pharmacological approaches to pain management for cancer patients.

Doctors commonly prescribe medications to cancer patients to relieve pain. You may take pain medications orally, or by other means, including nasal spray, infusion or injection.

For mild pain.

If you have mild pain, you may get acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID).

Side effects of NSAIDs include stomach, kidney, heart, and blood problems.

For moderate to severe pain.

If you experience moderate to severe pain, your doctor may prescribe opioids. Although these medications can alleviate serious pain, they can lead to dangerous, life-threatening addictions.

Additionally, some patients develop a tolerance to the medication which means their bodies stop responding. This tolerance is a physical dependence, which is not the same as an addiction, which is a psychological dependence.

To avoid issues, make sure you follow your doctor’s instructions for the safe use, storage, and disposal of opioids.

Common side effects caused by opioids include:

Nausea.
Drowsiness.
Constipation.

Other side effects of opioid treatment include:

Dry mouth.
Vomiting.
Low blood pressure.
Dizziness.
Trouble sleeping.
Trouble thinking clearly.
Sedation.
Delirium or hallucinations.
Muscle jerks.
Seizures
Breathing problems
Severe itching.
Depression.

Patient-controlled analgesia (PCA).

With PCA, you determine when to give yourself a dose of pain medication through an infusion pump. The approach, which can be used at home or in the hospital, has many advantages:

You don’t have to wait for a nurse – you get prompt pain relief.
You can get small doses of medication more often.
IV infusions are helpful if you can’t swallow medication.

PCA use is relatively safe. Importantly, your healthcare provider will program the pump for the dosages you will receive each time you press the button. Additionally, he/she will set the time between doses and the total amount of medication you can receive over a certain period of time to prevent an overdose.

Certainly, patients who are confused, disoriented, or unresponsive should not use PCA.

Complementary medicine.

Complementary medicine treatments, such as acupuncture and yoga) can be used in conjunction with standard medical treatments (such as drugs and surgery) to manage pain for cancer patients. When you receive both types of treatments, it’s called integrative medicine.

Risks of complementary therapies.

Importantly, complementary treatments are not substitutes for conventional medical care. They should be used along with standard medical treatment.

Additionally, not all complementary therapies and products are recommended for certain conditions or people. And some therapies are considered potentially dangerous and should not be used at all. Talk to your oncologist before starting any complementary treatment. And visit the National Center for Complementary and Integrative Health’s website for more information on specific complementary treatments.

The following complementary therapies – generally considered safe – may be used as part of pain management plan for cancer patients:

1. Acupuncture

Acupuncture. a Chinese medical technique during which trained acupuncturists insert thin needles into specific body points, can help with pain management for cancer patients. For instance, acupuncture releases endorphins, often referred to as the body’s natural painkiller. Additionally, acupuncture can induce neuroplastic changes in the brain which can reduce pain. And acupuncture increases blood circulation and helps reduce inflammation, which can reduce pain.

Simply put, acupuncture is a non-invasive, low-risk treatment that can significantly ease cancer pain.

Types of acupuncture for cancer pain.

There are 3 types of acupuncture that could be used for cancer pain:

Traditional acupuncture – inserting thin needles at predetermined points around the body.
Electroacupuncture – attaching electrodes to the needles.
Auricular (ear) acupuncture – placing needles in parts of the outer ear that correspond to different body parts.

Success in reducing pain for cancer patients undergoing treatment.

Doctors use aromatase inhibitors to treat hormone receptor-positive breast cancer that relies on estrogen to grow. Unfortunately, aromatase inhibitors often cause musculoskeletal pain, which can be so bad that many patients discontinue the treatment.

A randomized clinical trial conducted at 11 US academic centers and clinical sites evaluated pain levels among postmenopausal women with early-stage breast cancer receiving aromatase inhibitors. Participants received either true acupuncture, sham (fake) acupuncture, or no interventions (a control group).

Excitingly, the research found a statistically significant reduction in joint pain 6 weeks after treatment, indicating that acupuncture may decrease aromatase inhibitor-related joint symptoms.

Success in reducing pain for cancer survivors.

In a large clinical trial, cancer survivors reported modest improvements in pain after receiving acupuncture treatments. Note that the participants in this study had no current evidence of cancer, but reported musculoskeletal pain for at least 3 months prior to receiving acupuncture,

Participants in this trial received either electroacupuncture, auricular acupuncture, or usual care. Note – there was no group receiving a placebo version of acupuncture, which makes it impossible to rule out the placebo effect among those receiving acupuncture.

Study participants who received electroacupuncture reported modestly better pain control than those treated with auricular acupuncture, but both types of acupuncture were superior to usual care. However, it’s important to note that participants who received the auricular acupuncture were more likely to report ear pain and other side effects, leading to a 10% discontinuation of treatment among those receiving auricular acupuncture.

Importantly, the decrease in pain lasted well beyond the last acupuncture session, in some cases the reduction of pain lasted up to 4 months.

2. Massage therapy.

Massage therapy – the manual manipulation of soft tissues – reduces muscle soreness and spasms, enhances circulation, and induces relaxation. Moreover, massage therapy supports recovery and healing, while reducing pain, as well as anxiety and depression, for cancer patients.

Oncology massage, a specialized branch of massage, focuses on providing safe and effective massages for people with cancer. Oncology therapists receive advanced education and training so they can meet the unique needs of cancer patients.

Studies show massage is non-invasive, low-risk treatment that can ease cancer pain.

For instance, studies show that massage therapy can relieve cancer pain in patients with hematological (blood-related) malignancies, breast cancer, and digestive system cancers.

Additionally, several other studies show that massage therapy reduces perceived pain in cancer patients receiving palliative care.

To find an oncology trained massage therapist in your area, ask your doctor or use the search tool on the Society For Oncology Massage’s website.

3. Mindfulness meditation.

During mindfulness meditation you to focus on the “now”, by slowing down racing thoughts, letting go of negativity, and calming both your mind and body. Although techniques can vary, mindfulness meditation generally involves deep breathing and awareness of body and mind.

Research indicates that mindfulness meditation may help patients manage pain by drawing their attention away from their pain. In other words, when patients practice mindfulness meditation, they become less focused on their pain, which leads to an increase in pain tolerance.

As with the other integrative techniques, mindful meditation is a low-risk and non-invasive tool that can aid in pain management for cancer patients.

4. Clinical hypnosis (hypnotherapy).

Hypnotherapy, or clinical hypnosis, is a mind-body therapy that involves a deeply relaxed state, during which your mind is focused and receptive to therapeutic suggestion. In hypnotherapy, you learn how to use the power of your mind to help make positive changes, including transforming the perception of pain. And you’re in control – you won’t leave treatment sessions barking or meowing!

Research shows that hypnosis can reduce chronic and procedural-related pain in oncology. For instance, a study of breast cancer patients found that those who underwent hypnosis reported significantly less pain. Additionally, a study of advanced-stage cancer patients with malignant bone disease found that those receiving hypnosis had a significant overall decrease in pain.

And a review of clinical trials evaluating hypnosis for procedural-related pain in pediatric oncology found that hypnosis helped with pain management.

To summarize, clinical hypnosis is a low-risk, non-invasive option that can help cancer patients manage pain. Learn more about hypnotherapy by reading Pros and Cons of Hypnosis.

To find a certified hypnotherapist, ask your doctor or use the search tool on the American Society of Clinical Hypnosis (ASCH)’s website.

5. Yoga.

Yoga involves a combination of physical postures, breathing exercises, and meditation techniques that work together to create a sense of unity between the body, mind, and spirit.

Studies show yoga can reduce inflammation, which causes cancer-related pain and other symptoms.

Importantly, evidence suggests that yoga can reduce inflammation across a multitude of conditions, including cancer. Through the combination of gentle postures, deep breathing exercises, and mindful meditation, yoga stimulates the parasympathetic nervous system, which helps reduce inflammation.

For more information, read Yoga Can Help Cancer Patients.

6. Music therapy.

Music therapy is the clinical use of music to address physical, emotional, social, and spiritual needs of individuals. For cancer patients, music therapy can reduce pain (and can improve other physical and emotional issues well).

Interestingly, in one study, cancer patients who listened to music reported significantly less pain than patients who didn’t listen to music. Similarly, in a small study, music therapy caused a statistically significant reduction in pain score for cancer patients.

In may even lead to a reduction in the amount of pain medication you need.

Clearly, music therapy is very safe and has no side effects!

Some cancer centers and hospitals have board-certified music therapists, so if you’re interested, ask your doctor or call hospitals in your area.

Other non-pharmacological interventions.

In addition to medical treatments, various non-pharmacological therapies can help with pain management for cancer patients, including the following:

1. Physical therapy.

The aim of physical therapy (PT), also known as physiotherapy, is to relieve pain, improve mobility, and/or strengthen weakened muscles. PT may include exercises, massages, and various other treatments including heat, cold, electrical stimulation, and ultrasound.

PT can decrease the intensity and frequency of pain related to your cancer and your cancer treatments, by:

Improving drainage of the lymphatic system to prevent or improve lymphedema.
Improving nerve function to alleviate neuropathy.
Increasing cardiovascular functioning to ease the strain on your body from treatment.
Improving mobility, balance, and coordination.
Minimizing scarring and skin tightness from surgical incisions.
Elevating mood and reducing symptoms of depression.

If you want or need PT, look for an oncology physical therapist. These specially trained professionals understand how cancer and cancer treatments can affect your body and can create a plan based on your side effects. Ask your doctor for a referral.

2. Virtual reality (VR) therapy.

Virtual reality (VR) used hardware and software to generate sensations of real experiences. When using VR, patients can focus on pleasurable experiences while being distracted from their pain.

Importantly, virtual reality (VR) therapy is a non-invasive, safe treatment that can reduce cancer-related pain and can help patients tolerate painful procedures.

For instance, researchers evaluated pain among hospitalized adult patients with moderate-severe pain related to cancer and cancer therapies. The study found that VR therapy provided a significant reduction in pain, compared to a control group. Moreover, participants who had VR therapy had sustained improvement in pain 24 hours later.

Similarly, a small study of women with metastatic breast cancer also found the VR therapy reduced their pain.

Radiofrequency ablation.

To reduce pain via radiofrequency ablation (RFA), doctors insert a needle-like probe into nerve tissue, using guidance from an ultrasound or other imaging techniques. After the probe is in place, radiofrequency waves are sent through the probe into the tissue, causing nearby cells to die. The subsequent nerve damage prevents the pain signal from reaching the brain, which leads to a reduction in pain. If successful, the reduction of pain can last for months or years.

Advantages of radiofrequency ablation include:

It’s minimally invasive.
Pain relief.
Avoiding more invasive surgery.
Little to no recovery time.
Decreased need for pain medications.
Improved function.

Importantly, RFA can help patients with the pain associated with metastatic spinal tumors. RFA can shrink or destroy spinal tumors, relieving the intense pain caused by the tumor leaning against spinal nerves. This treatment often eliminates the need for narcotics and greatly improves a person’s quality of life.

Conclusion.

If you are dealing with cancer-related pain, talk to your doctor to create a pain management plan. Ideally, you and your doctor should coordinate with pain specialists, integrative medicine practitioners, and mental health professionals to create an individualized plan tailored to your unique needs.

Learn more…

It’s emotionally and physically stressful to have cancer. These posts will help you manage this difficulty journey:

I wrote this article in collaboration with Ahsan Habib, a passionate healthcare enthusiast dedicated to exploring innovations in medical research and patient care. Currently, as a research intern at Chattagram Metropolitan Hospital Limited, he contributes to studies aimed at improving healthcare practices and patient outcomes.

Pain Management for Cancer Patients

Types of cancer pain.