Other ways of treating cancer pain
As well as painkillers, there are other ways to help control cancer pain and this page tells you about them. There is information about
Cancer treatments can help to reduce pain by shrinking a tumour and reducing pressure on nerves or surrounding tissues. This is called palliative treatment. It won't cure the cancer, but can get rid of symptoms. Treatments used in this way include
There is a great deal of information about these treatments in the main sections of CancerHelp UK. Use the links above to find information about each treatment.
You may have some side effects from palliative cancer treatments. But the aim is to make you feel better, so your cancer specialist will try to choose treatments that have as few side effects as possible.
You may be able to cut down on your painkillers after cancer treatments. But the treatments can take a while to work. It can take several weeks to get the full benefit. So you will need to carry on taking your painkillers in the meantime.
Chemotherapy can shrink many types of cancer to reduce symptoms such as pain. Hormone treatments can shrink some types of advanced cancer such as breast cancer, prostate cancer, womb cancer and kidney cancer. Biological therapies are newer treatments but doctors may sometimes use them to shrink cancers and control symptoms.
Radiotherapy can give very good long lasting pain control for certain types of cancer pain such as bone pain. The treatment kills the cancer cells, so the tumour shrinks. The affected bone then begins to heal and strengthen itself. The pain may ease to some extent or may go altogether. When treated with radiotherapy, about 3 out of 10 people with pain from cancer spread to the bones will have no pain within a month. More than another 4 out of 10 will have pain that is half as bad as it was. Radiotherapy is often used to treat bones that have fractured because they have been weakened by cancer. This is called pathological fracture. Radiotherapy can also reduce pain caused by spinal cord compression
In some situations surgery can be used to control pain. A surgeon may carry out an operation to take away as much of a tumour as possible. This is called ‘debulking’. It can relieve pain by relieving pressure. It may also prevent complications developing, such as a blocked bowel.
This may be called an epidural, intrathecal or spinal anaesthetic. To give painkillers in this way a small tube (called a catheter) is put into your back and into the area around the spinal cord. The painkiller is continuously injected through the tube into your spine. If you are having a big operation for your cancer this may be the best way to control your pain. It will give good pain control for up to 24 hours after your surgery.
This is not a first choice to treat non-surgical cancer pain, but can help some people whose pain is not controlled by other ways of giving painkillers, such as tablets or injections. This method can give excellent pain control but it needs a highly experienced doctor (anaesthetist) to do the procedure and to watch you very closely afterwards. Not all hospitals, hospices or pain clinics are able to provide this service.
Sometimes a small pump is put into the fluid around the spinal cord. It is in your back area just below the waist. Painkillers can be injected into the pump every few weeks. This type of treatment is usually used where other methods of pain control have not worked. You can stay at home with this type of pain relief. It is called an implanted intrathecal pump.
If you have pain that is difficult to treat, your doctor may suggest a nerve block. This is a way of killing or deadening a nerve to stop it causing pain. There are not usually many side effects to nerve blocks. You may have low blood pressure afterwards. This can make you feel light headed if you stand up too quickly. But this usually gets better over a few days. There are different types of nerve block, named after the nerves that are treated.
The coeliac plexus (pronounced seel-ee-ak pleck-sus) is a complicated web of nerves at the back of the abdomen. It can be responsible for ongoing pain in people with pancreatic cancer and some other types of cancer. To block the pain, the doctor injects alcohol into the coeliac plexus. You will have a small injection of local anaesthetic first to numb your skin. You may then have a CT scan or ultrasound scan so that your doctor can check that the needle is in exactly the right place. Then a long needle is put in through your chest to the coeliac plexus. Or you may have the needle put into the nerves through the stomach wall during an endoscopy.
Some research has shown that up to 9 out of 10 people with abdominal cancers can get short and long term pain relief with a coeliac nerve block. A very small number of people have severe, ongoing diarrhoea after this treatment.
Your doctor may think it is better to cut the nerves causing the pain, rather than just inject them. This is a small operation and you may have it done during other surgery (for example bypass surgery). You may have a medicine to make you drowsy. You then have a local anaesthetic and the anaesthetist pushes a thin needle into the nerve. The needle has a laser or radiofrequency probe at the tip, which cuts the nerve. The anaesthetist may use ultrasound or a CT scan during the procedure, to make sure the needle is in the right place.
Pressure on the splanchnic nerves can cause continuing pain in some types of cancer. The splanchnic nerves send signals from the spinal cord to the organs in the chest and abdomen. Cutting the splanchnic nerve is called 'splanchnicectomy' (pronounced splank-nik-ectomy). It can reduce pain for many people.
Another type of nerve block is called thoracoscopic sympathectomy. This means the doctor uses a thoracoscope to reach the nerves in the chest. This is a tube with a camera, eyepiece and light that enables the surgeon to look inside the body. It is similar to an endoscope. You will have either a general anaesthetic or a sedative. You have a few small cuts (incisions) made between your neck and breastbone. The surgeon uses the thoracoscope to look inside your body and find nerves that are part of a chain called the sympathetic nerve chain. The surgeon then uses a laser or radiofrequency probe at the tip of the thorascope to block this chain of nerves.
TENS stands for Transcutaneous Electrical Nerve Stimulation. It may temporarily help pain that is in one area of the body. Small pads are stuck onto the skin and they release a small electrical charge. This causes a tingling feeling in the skin. By stimulating the nerves that run up the spine to the brain, it blocks the nerves carrying the pain messages. TENS can be worth trying, simply because it is very easy, doesn't do any harm and has no side effects.
Some research studies have shown that acupuncture can reduce muscle pain or bone pain for some people. It makes the body release pain relieving chemicals. It can work very well when cancer pain is causing muscle spasms that make the pain worse. We have a page about acupuncture in our complementary therapy section.
There are many ways you and your family can help to control your pain. You may have noticed that your pain seems worse if you are anxious or worried. It often seems worse at night if you cannot sleep and there is nothing else to distract you. Here are some things to try that can help relieve your pain
- Change your position at least every two hours to prevent stiffness and sore skin
- Hot or cold packs can help relieve pain (wrap them in a soft towel to prevent them damaging your skin)
- Watching TV, reading or chatting can help to take your mind off your aches and pains
- Relaxation - use tapes or listen to some calming music and think of somewhere beautiful you would like to be
- Breathing - try to breathe slowly and deeply when you are tense
- Massage - ask your family or friends to give gentle massage to your back, hands or feet or treat yourself to a professional massage. Be sure to check that your masseur is fully qualified and let them know that you have cancer.
- Aromatherapy, hypnotherapy, acupuncture and reflexology can all help -some cancer support groups can tell you where to find these services in your area
- Talking to someone about your pain, perhaps a counsellor, can help relieve stress and tension and make it easier to cope
These are not magic cures. But they can all help you to take some control over your pain and make it seem better for a time. If you can't sleep, learning relaxation exercises can be very helpful. Remember not to get too tired. Visitors are a wonderful distraction but it is often better to see people for short periods of time when you are not well.
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