Not all forms of cancer are associated with pain. However, recurrent cancer or cancer that has spread is more likely to be associated with pain. Cancer pain can vary in its presentation depending on the type of cancer and where it is situated.
Most cases of cancer pain stem from the pressure of the cancerous growth or tumors on adjacent bones, nerves and other body tissues. Tumors growing within organs can stretch them, causing pain. Some forms of chemotherapy can result in numbness and tingling in the extremities. Radiation therapy can irritate the skin enough to be painful.
Symptoms of cancer pain are related to where the cancer is in the body and how much it has infiltrated nearby tissues such as bone or nerves. It can be dull, achy, sharp or burning. The pain can come and go or be constant. The intensity can vary from being very mild to being severe.
There is a significant variety in how cancer pain can present. Diagnosing cancer pain involves carefully assessing all the signs and symptoms. Symptoms can be broadly classified into those that are acute and those that are chronic. Diagnostic or therapeutic procedures are following by acute pain syndromes. Chronic pain syndromes result directly from the cancer or tumor itself.
Over-the-counter pain relievers such as Tylenol (acetaminophen) and non-steroidal anti-inflammatory drugs (aspirin, advil/motrin) are appropriate for mild to moderate cancer pain. Moderate to severe pain can be treated with opioid pain relievers such as morphine, codeine, hydrocodone, hydromorphone, oxycodone and tramadol. Neuropathic pain can be managed with antidepressants such as amitriptyline, nortriptyline and duloxetine. Anticonvulsants such as gabapentin and carbamazepine can also be used to treat neuropathic pain. Steroids may be prescribed when swelling is a source of cancer pain.
Other treatment modalities include physical therapy, biofeedback and relaxation techniques. Interventional pain management techniques such as nerve blocks and implantable pain pumps can be beneficial depending on the type of cancer pain. Surgery can relieve mechanical pressure by removing all or part of a tumor. Radiation therapy may have a similar effect by shrinking a tumor.