Causes and Types of Cancer Pain
Causes and Types of Cancer Pain

Causes of Cancer Pain

  • Not everyone who has cancer has pain
  • For those who do have pain, there are many different causes:
    • The cancer itself causes about 65%-80% of cancer pain
    • Pressure of the tumor on an organ (liver, lungs), bone or nerves
    • Cancer growth into bone, nerves or an organ
  • The cancer treatments cause about 15%-25% of pain
  • Chemotherapy
    • Mouth sores
    • Numb fingers, feet
    • Bone or joint pain
  • Surgery
    • Cutting across a nerve during surgery
    • Pain from incision
  • Radiation therapy
    • Nerve ending sensitivity
    • Skin irritation
    • Procedures for treatment, evaluation or diagnosis (cause about 5%-10% of pain)
  • Biopsy (cutting out the cancer or a a piece of the cancer to make a diagnosis)
  • Blood draws (using a needle to remove blood from a vein)
  • Placing a needle into the spine area (back bone) to give medication (called a lumbar puncture) also could be used to give pain medication
  • Not related to cancer or cancer treatment
    • Other diseases (diabetes, heart problems, arthritis)
    • Injury (car accidents)

The different causes for pain in people with cancer.

  • Physical from the cancer or the treatment
  • Intellectual - knowledge, memory loss, self-control, review of life issues
    • Emotional pain anxiety, fear, grief
    • Interpersonal pain burden, physical needs, overprotection
    • Financial pain costs, loss of job
    • Spiritual pain facing death, questions of faith, feelings
    • Bureaucratic pain - more doctors, tests, questions

    Types of physical pain:

    • Acute Pain
      • Related to a specific event (surgery, injury)
      • Short lasting, as recover from the surgery, the pain at the incision goes away
      • Your need for pain medicine is short. You rapidly go from taking strong medicine (a narcotic) to less strong medicine (Tylenol® or Advil®) to no need for pain medicine

    Chronic Pain

    • Can last months to years even if cause of pain has healed (surgery) or been removed (chemo done)
    • If untreated, pain signals continue and becomes remembered (feelings of pain continue) in your brain even after the pain is gone.
    • This is real pain and is not just in your mind.
    • Affects your sense of well-being and quality of life.
    • Requires the use of pain medicine(s) for longer periods of time, possibly the rest of your life.

    Phantom (Limb) Pain

    • Feeling that the limb or breast is still there even after it has been removed
    • May ache, throb or otherwise give you an unpleasant or hurting feeling
    • The pain is real even though providers do not know why it happens

    Neuropathic Pain (involves nerve endings): Nerve damage by tumor or cancer treatment

    • The nerve is injured or squeezed by the cancer or cancer treatment.
    • Pain may be felt as burning, shooting, stabbing, or numbness. Some say it feels like pins and needles.
    • Sometimes called peripheral neuropathy.

    Breakthrough Pain

    • Unexpected pain that occurs between doses of pain medicine (called a pain flare).
    • Pain gets very bad in 3-5 minutes
    • Pain flares may last about 30 minutes
    • Pain flares are not always the same each time you have one
    • Usually treated with a pain medicine that acts very quickly and doesnt last for long
    • Usually means pain medicine needs to be adjusted (may need more medicine)
    • Pain Flares can be caused by:
      • Doing something like moving, gardening
      • Pain medicine does not last as long or relieve your pain as it should (You have pain before your next dose of pain medicine is due).
      • Sometimes there is no obvious cause; the pain flare just happens

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