Not everyone with cancer will suffer pain. According to the World Health Organisation, about 30% of people with metastatic cancer do not experience any pain at all. For those women who do experience pain, improvements in drugs and a better understanding of the causes of pain mean that there is rarely any need, at any stage, to continue to experience pain.
Cancer pain can be effectively controlled. Pain management aims to relieve your pain during the night and the day, and both at rest and on movement. It can involve drug and non-drug treatments.
The main causes of pain
Pain in women with metastatic breast cancer may occur for many reasons, including:
- Cancer in any part of the body, including the bones, lungs, liver or brain if the cancer presses on nerves or soft tissue
- A side effect of treatments such as surgery or medical tests
- A bone fracture
- An infection
- A blood clot caused by cancer or its treatment
- Obstruction of the bowel caused by cancer
- Any other illnesses or problems you had before your diagnosis or developed after your diagnosis that have nothing to do with the cancer
Key messages about cancer pain
Every woman’s experience of pain will be different. The amount or type of pain that one woman experiences may not be the same as that experienced by another woman who has the same cancer.
- Pain does not always gets worse. The level of pain experienced may remain unchanged, or may increase or decrease. In any situation medication can be adjusted to ensure pain relief.
- Pain is not related to the extent of the cancer. Experiencing pain does not necessarily mean that the cancer is more serious than if you had no pain.
- Take action as soon as the pain starts. Take pain relief when you first start to feel uncomfortable. It is harder to ease pain once it has taken hold. Taking medication for pain relief when the pain is bearable will not make the medication less effective later. The aim is to prevent pain. If you wait until the pain comes back you will suffer from unnecessary pain.
- When pain relief is taken regularly or ‘by the clock’ (such as every 4 hours), there is little danger that you will become addicted to these drugs. Addiction to pain killers is very rare in women with metastatic breast cancer. The dose can be tailored to your needs. Doses are increased or decreased according to the severity of your pain.
- Drugs for pain do not usually make you feel drowsy after the first or second day. Drowsiness can occur with strong pain relief drugs like morphine. However, the drowsiness usually passes in one or two days. People vary in how the medication affects them. You should ask your general practitioner about whether you can drive or work with machinery, and the effect of drinking alcohol with your medication.
- If one drug does not effectively help your pain, many other drugs or combinations of drugs can be used to give you pain relief. There is a large range of effective drugs for pain of all types and severity. It may take time, in consultation with your doctor, to establish the drug or drug combination that is right for you.
- Any pain can be difficult to cope with. However, pain is more difficult to cope with if you are also experiencing anxiety or depression. Also, being in pain can make you more likely to be depressed or anxious. If you are concerned by the feelings you are experiencing, it is important that you talk to your doctor as soon as possible.
