Are Certain Cancers More Painful Than Others?


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Pain is a common cancer symptom. In fact, it’s estimated that approximately 66 percent of people with cancer will experience pain as a symptom at some point.

Cancer pain can have several causes. These can include the cancer itself or the effects of various treatments or surgeries that are used to treat the cancer.

While all cancers can cause pain, some, such as those affecting the bones or pancreas, are more frequently associated with pain. Regardless of the type of cancer, it’s important that remember that cancer pain can often be treated.

Continue reading below to learn more about cancer and pain, how this pain can be managed, and more.

Cancer and pain

All cancers have the potential to cause pain. The amount of cancer pain you may experience can depend on many different factors, including:

  • the type of cancer
  • the stage of cancer and whether or not it has spread, or metastasized
  • your individual pain tolerance
  • other health conditions that you may have
  • the types of treatments and therapies you’re receiving

According to the National Cancer Institute, younger individuals are more likely to experience cancer pain and people with advanced cancer tend to experience more severe pain.

When the cancer itself causes pain, it’s often due to a tumor that’s pressing on other organs, bones, or nerves. Tumors can also spread to other areas, such as the spinal cord and bones, leading to pain as well.

Below, we’ll discuss some types of cancer that are commonly associated with pain and why the pain may occur. As we do so, it’s important to keep in mind that even severe cancer pain can be treated.

Bone cancer

Bone cancer is when cancer occurs in your bones. Cancer that originates in the bone, which is called primary bone cancer, is actually quite rare in adults. In fact, it makes up only 0.2 percent of all cancers.

Many times, when someone has bone cancer, it’s actually due to cancer that’s spread to the bones from another location in the body. This can happen with many types of cancer, such as those of the breast, lung, and prostate.

Pain is one of the main symptoms of cancer in the bones. The presence of cancer cells can interfere with the normal maintenance of bone tissue, making your bones weaker. A growing tumor may also press on nerves around the bone.

The pain from bone cancer often begins as a dull pain that comes and goes and is typically worse at night. Eventually, the pain can become constant. Because bone tissue has become weak, it’s also prone to breaking.

Pancreatic cancer

Pancreatic cancer is cancer that develops in your pancreas. The pancreas is an organ that produces enzymes that are important for digestion. It also helps to regulate your blood sugar.

In its early stages, pancreatic cancer can be asymptomatic. Because of this, about 80 percent of pancreatic tumors are detected at more advanced stages. When symptoms are present, they can include abdominal or back pain, jaundice, and weight loss.

Pain from pancreatic cancer can be severe. It can be due to a tumor that presses on surrounding nerves, the spine, or organs in your abdomen like your liver or intestines.

Head and neck cancers

Head and neck cancers are those that start in your:

  • lips and mouth
  • throat
  • voice box (larynx)
  • nose and sinuses
  • salivary glands

The symptoms of head and neck cancer can depend on their specific location but often include pain. Like other types of cancer, pain is often due to a tumor that presses on surrounding nerves and structures.

Cancer pain can be exacerbated in the head and neck because the area has a high number of nerves. Additionally, your head and neck contain many structures that are situated within a relatively small space.

A tumor in your head or neck can also cause discomfort by interfering with various body functions. These can include things like eating, swallowing, or breathing.

Brain and spinal cord cancers

Your brain and spinal cord make up your central nervous system (CNS). The CNS collects, processes, and responds to sensory information collected from your body and your environment. Think of it as your body’s control center.

Tumors around your brain or spinal cord can put pressure on the surrounding nerves and structures, leading to pain. This can also cause other symptoms like seizures, trouble with movement, and sensory problems.

The most common symptom of a brain tumor in adults is headache. These headaches often become more frequent and severe as time passes.

Pain from a tumor affecting the spinal cord can be characterized as burning, sharp, or tingling. It can happen at a specific location and may also radiate out to other areas of the body. It can be severe and may become constant as time passes.

Lung cancer

Lung cancer is cancer that starts in your lungs. It’s one of the most common cancers in the world.

Similar to pancreatic cancer, lung cancer has few symptoms in its early stages. Because of this, many times it isn’t diagnosed until more advanced stages.

As lung cancer grows and spreads, it can put pressure on your lungs and chest wall. This can lead to chest pain that gets worse when you breathe, cough, or laugh.

Additionally, tumors may partially or completely block some airways. This can also lead to discomfort and can cause distressing symptoms like shortness of breath and wheezing.

Managing pain

There are many different ways to help manage cancer pain. Let’s take a deeper dive into some of them below.

Medications

Many times, medications are prescribed to help ease cancer pain. Your doctor will select a medication based on whether your pain levels are mild, moderate, or severe.

Some examples of medications that can be given for cancer pain are:

  • Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs). Generally, acetaminophen and NSAIDs are prescribed when pain is mild. However, NSAIDs can also be used along with opioids for moderate to severe pain. Some examples of NSAIDs used for cancer pain include:

    • celecoxib
    • diclofenac
    • ibuprofen
    • ketoprofen
    • ketorolac
  • Opioids. If you have moderate or severe pain, you may be prescribed opioids. These are strong pain medications and can potentially lead to tolerance or addiction, so their use must be carefully monitored. Opioids used for cancer pain are:

    • buprenorphine
    • codeine
    • diamorphine
    • fentanyl
    • hydrocodone
    • hydromorphone
    • methadone
    • morphine
    • oxycodone
    • oxymorphone
    • tapentadol
    • tramadol
  • Other medications. Depending on the type of pain you’re having, it’s possible that other types of drugs may be used as a part of your pain management plan. Some examples include:

    • antiseizure medications like gabapentin and pregabalin
    • antidepressants like tricyclic antidepressants (TCAs) and certain types of serotonin and norepinephrine reuptake inhibitors (SNRIs)
    • corticosteroids
    • medications for when cancer has spread to the bones, including bisphosphonates and denosumab

Additional treatments for cancer pain

In addition to medications, there are other ways to help manage cancer pain. These can include:

  • Nerve blocks. Nerve blocks are an injection of an anesthetic or other drug that blocks nerve pain.
  • Nerve stimulation. This can include transcutaneous electric nerve stimulation (TENS) or the implanting of a device in the body. Both work by stimulating nerves with a mild electrical current, helping to alleviate pain.
  • Cordotomy. This is a type of surgery in which pain is eased by cutting specific nerves near the spinal cord. This procedure is less common.
  • Alternative therapies. Various alternative therapies may be used along with standard treatments for help with cancer pain. Some examples include acupuncture, hypnosis, and relaxation techniques.

Treatments

In addition to pain that’s caused from the cancer itself, the various types of cancer treatments can also potentially lead to pain. Let’s explore this further.

Surgery

Surgery may be used to remove a tumor from your body. If you have surgery for cancer, it’s normal to experience postoperative pain in the days or weeks after your procedure.

Pain from surgery is typically treated using medications. It’s possible you’ll need to use stronger pain medications right after your surgery and then switch to less strong medications in the following days.

In some cases, you may experience phantom pain following surgery. This is pain or discomfort that feels like it’s coming from an area of your body that’s been removed. It may happen if you’ve had a breast or limb surgically removed.

There are several treatment methods that may work for phantom pain. These include medications, TENS, or physical therapy.

Chemotherapy

Chemotherapy uses strong medications to kill cancer cells. However, it can also lead to side effects that can be painful. One of these is chemotherapy-induced peripheral neuropathy (CIPN), which can cause pain, numbness, and tingling.

According to the National Cancer Institute, studies on medications and natural products to help relieve pain due to CIPN have had mixed results. Some examples of medications that may be used include:

  • topical numbing medications
  • short-term steroids
  • antiseizure medications
  • antidepressants
  • opioids

Alterative treatment methods for CIPN are also being explored. Some examples of these include acupuncture and relaxation therapy.

Mouth and throat sores may also develop as a side effect of chemotherapy. While these often go away on their own eventually, you can ease discomfort by applying a topical pain medication and avoiding foods that may irritate the sores.

Radiation therapy

Radiation therapy utilizes high amounts of radiation to kill cancer cells. Like chemotherapy, it may also cause painful side effects. These can include:

  • Dermatitis, which is skin irritation and inflammation in areas that were treated with radiation.
  • Mucositis, which is an inflammation of mucus membranes due to radiation treatment.
  • Radiation pneumonitis, which is inflammation of the lungs that can happen when the chest is treated with radiation.
  • Radiation cystitis, which happens when radiation damages the bladder’s lining.
  • Brachial plexopathy, which is damage to the nerves in the arm.

Treatment for the side effects of radiation therapy can depend on the symptoms you’re experiencing. They may include pain medications, steroids for inflammation, or antiseizure medications for nerve pain.

Other cancer treatments

Other types of cancer treatments, such as immunotherapy and targeted therapy may cause pain as a side effect as well.

  • Immunotherapy. Immunotherapy helps your immune system fight the cancer. Pain from this type of treatment can include pain at the needle site and body aches and pains.
  • Targeted therapy. Targeted therapy includes antibodies and small molecules that specifically target cancer cells. Some people that are being treated with targeted therapy may develop mouth sores.

Medications are used to help ease these side effects as you receive treatment. Side effects typically go away once your treatment ends.

When to talk with your doctor

Cancer pain can be effectively managed using a variety of methods, helping to ease this symptom and improve your quality of life. Because of this, talk with your doctor if you have cancer and experience pain that:

  • is new or happens at a different location
  • doesn’t go away
  • occurs between medication doses
  • isn’t eased by your current pain medications
  • interferes with your daily life by affecting your movement, your sleep, or your ability to do daily activities

When you see your doctor, be sure to tell them:

  • where the pain is
  • what the pain feels like
  • how severe the pain is
  • how long the pain lasts
  • when the pain first began
  • if the pain happens at a specific time
  • if the pain occurs with specific movements or activities
  • the things that make the pain feel better or worse

It’s likely that you’ll be asked to rate your pain on a scale. For example, this may be done on scale of 1 to 10, where 1 would mean that you’re experiencing little pain and 10 would mean that you’re experiencing very severe pain.

Your doctor and care team can use this information as well as your medical history to help develop a plan to better manage your pain.

Support and resources

If you’ve recently been diagnosed with cancer, you may feel scared or worried. There are resources that can help you to cope with these feelings.

One of these resources is support groups. Support groups are made up of people whose lives have been touched by cancer. These can include other people with cancer, their loved ones, and cancer survivors.

In these groups, you can discuss your experience with cancer, learn about new treatments, and receive support and encouragement from others. Some resources for finding a support group near you are:

  • Your hospital or treatment center. Many hospitals and treatment centers have cancer support groups. You can contact yours to learn more.
  • The American Cancer Society. The American Cancer Society has a search tool that you can use to find support programs that are available in your area.
  • Cancer Support Community. Cancer Support Community is a nonprofit organization that offers a support network to those affected by cancer. Visit their site to learn how you can connect with others by phone, online, or in person.

It’s also possible that you may not be ready to talk about your feelings in a group setting. This is completely normal.

If you’re feeling distressed, anxious, or depressed about your diagnosis, it may be beneficial to speak to a mental health professional like a psychologist or psychiatrist. Your doctor can recommend one near you that has experience working with people with cancer.

The bottom line

Pain is a common symptom of cancer. It can be caused by the cancer itself, by the methods used to treat cancer, or both.

Some cancers are associated with more pain than others. These can include those of the bones, pancreas, and head and neck. However, pain can happen with all cancers.

It’s always important to keep in mind that cancer pain is treatable. In fact, there are many methods that may be used to manage cancer pain.

Speak to your doctor if you have new pain, pain that doesn’t go away, or pain that happens even when you take your current pain medications. They can work with you to adjust your pain management plan to help alleviate cancer pain.


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