Having cancer does not always mean having pain. For those with pain, there are many different kinds of medicines, ways to receive the medicine, and non-medicine methods that can relieve the pain you may have. You should not accept pain as a normal part of having cancer. When you are free of pain, you can sleep and eat better, enjoy the company of family and friends, and continue with your work and hobbies.

Only you know how much pain you have. Telling your doctor and nurse when you have pain is important. Not only is pain easier to treat when you first have it, but pain can be an early warning sign of the side effects of the cancer or the cancer treatment. Together — you, your nurse, and doctor — can talk about how to treat your pain. You have a right to pain relief, and you should insist on it.

Here are some facts about cancer pain that may help answer some of your questions.

Relief for cancer pain

There are many different medicines and methods available to control cancer pain. You should expect your doctor to seek all the information and resources necessary to make you as comfortable as possible. However, no one doctor can know everything about all medical problems. If you are in pain and your doctor suggests no other options, ask to see a pain specialist or have your doctor consult with a pain specialist. Pain specialists may be oncologists, anesthesiologists, neurologists, or neurosurgeons, other doctors, nurses, or pharmacists. A pain control team may also include psychologists and social workers.

If you have trouble locating a pain program or specialist, contact a cancer center, a hospice, or the oncology department at your local hospital or medical center. The National Cancer Institute’s (NCI) Cancer Information Service (CIS) and other organizations can give you a list of pain management facilities. The American Cancer Society (ACS) and other organizations may also be able to provide names of pain specialists, pain clinics, or programs in your area.

Preventing pain

Your doctor wants and needs to hear about what works and what doesn’t work for your pain. Knowing about the pain will help your doctor better understand how the cancer and the treatment are affecting your body. Discussions about pain will not distract your doctor from treating the cancer.

Preventing pain from starting or getting worse is the best way 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, and it may take longer, or require larger doses, for your medicine to give you relief.

Ask for pain relief when you need it

Not everyone feels pain in the same way. There is no need to be “stoic” or “brave” if you have more pain than others with the same kind of cancer. In fact, as soon as you have any pain you should speak up. Telling the doctor or nurse about pain is not a sign of weakness. Remember, it is easier to control pain when it just starts rather than waiting until after it becomes severe.

Risk of addiction

Addiction is a common fear of people taking pain medicine. It is also important to remember that not everyone who takes opioids becomes addicted. However, it is important to be aware of the risks and to take steps to avoid addiction. Talk to your doctor; they can assess your risk of addiction and help you develop a plan to avoid it.

Take opioids only as prescribed. Do not take more opioids than prescribed, and do not take them for longer than prescribed.

When you are ready to stop taking opioids, the doctor gradually lowers the amount of medicine you are taking. By the time you stop using them completely, the body has had time to adjust. Talk to your doctor, nurse, or pharmacist about how to use pain medicines safely and about any concerns you have about addiction.

Possible side effects

Some pain medicines can cause you to feel sleepy when you first take them. This feeling usually goes away within a few days. Sometimes you become drowsy because, with the relief of the pain, you are now able to catch up on the much needed sleep you missed when you were in pain. On occasion, 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 usually solve the problem.

Side effects can be managed or prevented.

Some medicines can cause constipation, nausea and vomiting, or drowsiness. Your doctor or nurse can help you manage these side effects. These problems usually go away after a few days of taking the medicine. Many side effects can be managed by changing the medicine or the dose or times when the medicine is taken.

Your body does not become immune to pain medicine.

Pain should be treated early. It is important to take whatever medicine is needed at the time. You do not need to save the stronger medicines for later. If your body gets used to the medicine you are taking, your medicine may not relieve the pain as well as it once did. This is called tolerance. Tolerance is not usually a problem with cancer pain treatment because the amount of medicine can be changed or other medicines can be added.

When pain is not treated properly, you may be:

• Tired
• Depressed
• Angry
• Worried
• Lonely
• Stressed

When cancer pain is managed properly, you can:

• Enjoy being active
• Sleep better
• Enjoy family and friends
• Improve your appetite
• Enjoy sexual intimacy
• Prevent depression