Cancer doesn't always cause pain. But if you have pain, don't try to tough it out. Cancer pain can be treated, and in most cases it can be relieved or at least greatly reduced. Treating the pain can help you stay active, sleep better and ward off depression.

Here are some facts you should know about cancer pain and its treatment:

• Pain management is part of your cancer treatment. Your doctor wants to know if you're in pain and will do his or her best to help you get it under control.
• Pain is easier to control if it's treated right away. Don't put off treating pain or it's likely to get worse and be harder to control.
• Don't worry about becoming addicted to pain medications. Fear of addiction prevents many people from taking strong pain medicines. But if you take the medication as prescribed by your doctor, you're very unlikely to become addicted.
• You're unlikely to get "high" if you take pain medicines as prescribed. You might feel drowsy or sleepy at first, and this might help you on missed sleep. Tell your doctor if the medications make you feel dizzy or confused.
• Your body won't become immune to pain medicine. Take the medicine you need when you need it. If it becomes less effective than it was at first, your doctor can change the dose or add another medication.

What causes cancer pain?

Most pain is caused by the cancer itself. It often occurs because a tumor is pressing on nerves, organs or bones. How severe the pain is may depend on the type and extent of the cancer and your pain tolerance.

Cancer treatments can also cause pain. For example, pain is common after surgery. It may last for a few days or a few weeks, depending on the extent of the surgery. Sometimes people who have an arm, leg or breast removed have "phantom pain," which seems to come from the missing body part. Doctors aren't sure what causes it, but the pain is real.

Chemotherapy and radiation treatment can sometimes cause painful side effects, such as mouth sores or scarring. Like other types of pain, these can be treated.

How is cancer pain diagnosed?

Pain is a very individual experience. You will need to tell your doctor about your pain and how severe it is. Doctors use a pain rating scale of 0 to 10, with 0 being no pain and 10 being the worst pain you can imagine. Using the pain scale will help your doctor determine the right treatment.

Your doctor may ask you to keep a pain journal. This is a record of what your pain is like, when it occurs and how well treatment works to relieve it. This can help your doctor figure out the best method of pain control for you.

How is cancer pain treated?

Cancer pain can usually be treated effectively with medication. Which type of medication is best will depend on what type of pain you have, what's causing it and how severe it is.

Three main types of medication are used to treat cancer pain:

• Non-opioids are often effective for mild to moderate pain. These include acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. Many of these can be bought without a prescription. But check with your doctor before taking these medications.
• Opioids (also called narcotics) may be prescribed for moderate to severe pain. These include morphine, hydrocodone, hydromorphone, oxycodone, fentanyl and codeine. A non-opioid may sometimes be used along with an opioid for better pain control.
• Other medications may be used to treat different types of pain. Antidepressants and anticonvulsants can help relieve tingling or burning pain from nerve damage. Steroids can help ease pain caused by swelling.

These medications can cause side effects. Be sure to discuss them with your doctor. There may be ways to reduce or avoid the side effects.

If medications don't relieve your pain, your doctor may suggest other options, such as:

• Radiation therapy. Radiation can sometimes ease pain by shrinking a tumor.
• Surgery. Cutting certain nerves can prevent pain signals from reaching the brain.
• Nerve block. Injecting a numbing drug in or around a nerve or the spine can block some kinds of pain.

Are there other ways to treat cancer pain?

There is a wide variety of complementary treatments that you may want to explore. They can be used along with medical treatments. Some people find that these treatments reduce their pain and help them cope with the stress having with cancer.

Complementary treatments include:

• Acupuncture. This is an ancient Chinese technique that is a proven method of pain relief. It involves inserting very thin needles at various points on the body. Acupuncture should be performed only by a licensed acupuncturist.
• Relaxation. This can include deep breathing, massage and listening to music or relaxation tapes. Relaxation can help relieve pain, reduce tension and anxiety, and help other pain relief methods work better.
• Biofeedback. A licensed biofeedback technician uses a machine to teach you how to control certain body functions such as heart rate, blood pressure and muscle tension. Biofeedback may help you relax and cope with pain.
• Hypnosis. Hypnosis can be used to block the awareness of pain and try to change the sensation to one that is not painful. Choose a person trained in hypnosis, usually a psychologist or psychiatrist.
• Meditation. Meditation can help relax the body and quiet the mind. It may help relieve pain and reduce stress.

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