Cancer pain is not the same for everyone.

Some people feel a constant ache in one part of the body. Others experience burning, shooting or nerve-like pain. There may be pain after surgery, during chemotherapy or radiotherapy, or because a tumour is pressing on a nearby nerve, bone or organ.

And sometimes, more than one type of pain is present at the same time.

This is why cancer pain needs to be looked at individually. The goal is not simply to prescribe a stronger painkiller. The first step is to understand where the pain is coming from, what is causing it, how severe it is, and how it is affecting the person’s daily life.

Cancer pain can often be managed with a combination of medicines, treatment of the underlying cancer, supportive care and, in selected cases, interventional pain procedures.

What Is Cancer Pain?

Cancer pain refers to pain associated with cancer or its treatment.

It can happen at different stages of the illness. Some patients experience pain when the cancer itself affects tissues, bones or nerves. Others develop pain as a result of surgery, chemotherapy, radiotherapy or other procedures used during cancer care.

The nature of the pain can provide important clues.

For example, pain caused by irritation of a nerve may feel burning, tingling or like an electric shock. Pain involving the bones may feel deeper and more persistent. Pain related to an internal organ can feel dull, aching or difficult to pinpoint.

There is no single description that fits every patient.

What Causes Cancer Pain?

There can be several reasons behind cancer-related pain.

The cancer itself

A tumour can grow into surrounding tissues or put pressure on nearby structures. If a nerve is affected, the pain may have a sharp or burning quality. If bones are involved, the pain may feel deep and persistent.

Cancer spread to the bones

Some cancers can spread to the bones. This can cause ongoing pain and may make movement uncomfortable. Bone metastases are one of the situations in which cancer- directed treatment and pain treatment may need to work together.

Nerve-related pain

Cancer or cancer treatment can affect nerves. Chemotherapy, for example, can cause peripheral neuropathy, which may produce pain, tingling or numbness, particularly in the hands and feet.

Pain after surgery

Surgical treatment can naturally cause pain during recovery. In some people, pain can persist for longer and may need separate assessment.

Chemotherapy and radiotherapy

Some cancer treatments can themselves contribute to pain or nerve problems. The type of pain depends on the treatment and the area affected.

Because the cause matters, new pain during cancer treatment should be discussed with the treating medical team rather than automatically being assumed to be a normal side effect.

What Does Cancer Pain Feel Like?

Cancer pain can be:

• Dull and aching
• Sharp or stabbing
• Burning
• Shooting or electric-like
• Throbbing
• Constant
• Intermittent
• Worse with movement
• Associated with numbness or tingling

Some patients have a continuous background pain with occasional episodes when the pain suddenly becomes much stronger. These episodes are often referred to as breakthrough pain.

The important thing is to tell your doctor exactly what the pain feels like. “It hurts” is useful, but describing the location, pattern and triggers can make the assessment much more informative.

How Is Cancer Pain Diagnosed?

There is no single test for cancer pain.

A doctor usually starts by talking to the patient about the pain and examining the affected area. The assessment may include questions such as:

• When did the pain begin?
• Where exactly do you feel it?
• Is it always present?
• How severe is it?
• What makes it better or worse?
• Does it disturb your sleep?
• Does it affect walking or other daily activities?
• Is there numbness, weakness or tingling?
• What medicines are you currently taking?
• Have you recently had surgery, chemotherapy or radiotherapy?

Pain is often rated on a 0–10 scale, but the number alone does not tell the whole story. Two people with the same pain score may be affected very differently. NCI recommends assessing pain regularly and looking at its location, intensity, quality and impact on the person’s life.

Depending on the symptoms and the type of cancer, existing scans and reports may also be reviewed. Additional imaging or investigations may be required when there is a new or unexplained change in pain.

Cancer Pain Treatment in Gurgaon

Treatment depends on the source and severity of the pain. A patient with mild pain after a procedure will not necessarily need the same treatment as someone with advanced cancer and severe bone or nerve pain.

Medicines for Cancer Pain

Pain medicines remain an important part of cancer pain management.

Depending on the situation, doctors may use non-opioid medicines, anti-inflammatory medicines, opioid medicines or other drugs that specifically help with certain types of pain. Medicines may also be combined when more than one mechanism is contributing to the pain.

For moderate to severe cancer pain, opioids such as morphine may have an important role. They need to be prescribed and monitored carefully, particularly because side effects and individual medical factors have to be considered.

Patients should not increase, reduce or stop prescribed pain medicines on their own.

Managing Nerve Pain

Nerve pain often behaves differently from other types of pain.

Burning, tingling, numbness and shooting sensations may suggest neuropathic pain. Depending on the cause, medicines specifically used for nerve pain may be added to the treatment plan.

For example, chemotherapy-induced peripheral neuropathy may continue even after chemotherapy has finished, so it is worth reporting these symptoms rather than assuming they will automatically disappear.

Managing Bone Pain

When cancer has spread to the bones, treating the underlying cancer may itself help reduce pain.

Radiotherapy can also be used in selected patients to relieve pain associated with bone metastases. WHO includes radiotherapy and other approaches among the options for managing cancer-related bone pain.

The oncology team and pain specialist may therefore need to coordinate care rather than treating the pain in isolation.

What Is Breakthrough Cancer Pain?

Sometimes a patient has reasonably controlled background pain but suddenly experiences a severe flare.

This is called breakthrough pain.

It may happen spontaneously or be triggered by something such as movement. The treatment plan may need to account for these episodes separately from the patient’s regular pain control. NCI recognises breakthrough pain and other pain flares as important parts of cancer pain assessment.

If these episodes are happening frequently, tell your doctor. It may mean that the existing pain-management plan needs to be reviewed.