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Pain

Pain is a common complaint for cancer patients. It may be mild, moderate or severe, and it may happen from time to time, or it may be constant.

Uncontrolled pain can affect your ability to work, participate in family activities, sleep and may lead to feelings of hopelessness. Your pain can be well controlled when you work closely with your health care team.

Pain can almost always be controlled with proper use of a narcotic and other pain relieving medications.

Pain treatment is specific to each person, and may need to change over time as the pain changes. To get the best pain control, you must take your pain medication on a regular schedule, instead of waiting for the pain to come back. Pain can be worse if you feel depressed. A positive attitude is sometimes hard to keep, but it can help reduce the feeling of pain.

For more information talk to a member of your health care team.

Will I become addicted to narcotic pain medications?

Narcotic pain relievers are very useful for many patients. When you take these medications, you will not become addicted to them if you take them as prescribed by your doctor.

If the pain is reduced by other treatments, such as radiation therapy or chemotherapy, the pain reliever may often be reduced as well, under your doctor's supervision.

You should try to take the full amount of pain reliever needed. If you need higher doses to get enough pain control, do not be afraid to take enough medication. Holding back on pain relievers will not change the cancer’s course.

Ask a member of your health care team for more information about pain medications.

What side effects can I expect from the medications?

Drowsiness, nausea and vomiting, and constipation are common side effects that may occur while taking pain medication such as morphine or hydromorphine.

Drowsiness should not last more than a few days while your body adjusts to the medicine.

Nausea and vomiting, or upset stomach may occur while you are taking the medicine. This will usually lessen as your body adjusts to the medicine. Your doctor may prescribe another medicine to treat the nausea and vomiting if it bothers you or lasts more than a few days.

Constipation is a common side effect and is easily managed with a stool softener and a laxative. It is best to take the stool softeners and laxatives at regular times as soon as you start taking the narcotic pain medicines. This will help prevent constipation.

Some signs of pain:

• Loss of pain control with no change in medication
• Pain that gets worse before the next dose is due
• Episodes of pain that break through your usual level of pain control
• Feelings of depression, trouble sleeping, or lack of interest in things that used to interest you
• Trouble with constipation, confusion, nausea or sleepiness that lasts more than 1 or 2 days after a change in dose
• Any new symptoms that go along with the pain such as trouble walking or urinating, numbness or a tingling sensation
• Trouble swallowing pain medications by mouth, or other problems taking your medication
• Trouble sleeping

What should I do if I notice any of these symptoms?

Do:

• Take your pain medications as they are ordered. If the medications are ordered around-the-clock, you should take them on schedule.
• Make sure you have a few days' supply of pain medications on hand. Many narcotic pain relievers cannot be ordered over the telephone, and there can be delays to get your prescription filled.
• As your pain comes under control, try to increase your activity level.
• Use laxatives and diet to keep regular bowel movements. It is easier to prevent constipation than to treat uncomfortable or severe constipation.
• Spend time with family and friends doing activities that you enjoy and talking about things other than the pain. Try to think about something other than pain.

Do not:

• Suddenly stop taking all narcotic or other pain medications; if your doctor advises you to reduce your pain medications, do so gradually.
• Fear the regular use of pain relievers.

Pain is a complex problem that is different for each person. Your doctor and nurse will help you deal with your pain problems. For more information about specific drugs, speak with the LRCP Pharmacist, your doctor or your nurse.

Helpful Links:

Managing Pain - Canadian Cancer Society