Pain and Chemotherapy

The side effects of chemotherapy (chemo) depend on the type of chemo and the amount given. Being ready for and managing side effects can help you better cope with them.

Just as each person is different, so is their reaction to treatment. Side effects may be severe or mild. Or you might not have any. Talk with your cancer care team about possible side effects of your treatment so you know what to watch for.

How does chemo cause pain?

Some chemo medicines can cause painful side effects. For instance, if they cause nerve damage, you may have burning, numbness, tingling, or shooting pain in your fingers or toes. This is called neuropathy. Some chemo medicines can cause mouth sores, headaches, muscle aches, and stomach pains.

Managing pain

The goal of pain control is to prevent pain and control pain that can't be prevented. You may not have pain from chemo. But if you do, you can take steps to relieve it. The first step is to talk with your healthcare provider about your pain.

Contact your healthcare provider at the first signs or symptoms of pain. Side effects like neuropathy may depend on the dose or duration of treatment. So, the pain can worsen as treatment goes on. 

Give your healthcare provider as many details as possible. You may want to describe your pain to your family and friends, too. This way, they can help communicate with your treatment team if you're too tired or in too much pain to talk to them yourself. Be ready to share the following:

• Where it hurts. In what part or parts of your body are you having the most pain?

• How it feels. Describe what the pain feels like. Is it sharp or dull, throbbing or steady, burning, shooting?

• How strong it is. Use a scale to rate your pain, with 0 being no pain and 10 being the worst pain.

• What its duration is. How long does the pain last?

• What helps. Does anything make the pain better or worse? Do certain activities or positions help or make it worse?

• When you have it. What are your ideas about what is causing the pain?

• What medicines you're using. List the names of the medicines you're taking and how well they work.

Taking pain medicine

Chronic pain means the pain is ongoing and has been present for a while. To treat this kind of pain, you may do better taking pain medicines on a regular schedule (by the clock) as directed by your healthcare provider. Don't skip doses, even if you don't have pain when a dose is due. If you wait until you feel pain, it may be harder to get it under control. To lessen tension and reduce anxiety, it may also help to use relaxation exercises when you take your medicines.

You may find that your usual pain can be controlled by medicine. But sometimes a more severe pain will break through for a short time. If this is happening, your provider may give you a short-acting medicine to use when it happens. Take it as directed.

Many different medicines and methods can be used to control cancer pain. There are different medicines that work better for different kinds of pain. If you are in pain and your healthcare provider has no further suggestions, ask to see a pain or palliative care specialist. A pain specialist may be an oncologist, anesthesiologist, neurologist, neurosurgeon, another healthcare provider, or pharmacist. This provider specializes in treating pain. Palliative care specialists can help relieve symptoms for people with serious illnesses.

If you have pain, don't give up until you get the relief you need. You may need to try different treatments and see different providers. But good pain control is part of good cancer care.

Questions to ask your healthcare team about pain medicine

• What side effects can the medicine cause? How can I prevent or treat them?

• Should I take the medicine with food or liquid?

• Is it safe to take this pain medicine with other medicines?

• Do I need to stay away from drinking alcohol, driving, or other activities when taking this medicine?

• What can I do if my pain doesn't get better after taking the medicine?

• How long does it take for the medicine to start reducing my pain? How long does it last?

• Can I split or crush the pill?

Other ways to treat pain

You may be interested in other methods to treat pain. Your healthcare provider may advise these in addition to pain medicines. These methods may include acupuncture, massage, meditation, physical therapy, or relaxation methods. Talk to your healthcare team about which options may be right for you.