Cancer Pain
Medications
Many different drugs are used to treat cancer pain. If you are already taking pain medicine for another problem, tell your doctor how often you are taking it and how well it works.
The key to controlling cancer pain is to take your medicine on a regular schedule. Do not wait until your pain gets bad. Pain is easier to control when you treat it just after it starts. Painkilling drugs work to control cancer pain in most people.2
Non-prescription drugs
Drugs you can buy without a prescription may be enough to relieve your pain at times. Acetaminophen, such as Tylenol or Panadol, relieves pain. Anti-inflammatory drugs, such as ibuprofen, relieve pain and also decrease swelling.
Know how to be careful with these drugs. If you have had kidney or liver disease, gastrointestinal bleeding, or a stomach ulcer, talk to your doctor before you take any of these drugs.
Prescription drugs
People with cancer pain often need stronger drugs that their doctors prescribe. Be sure to follow your doctor's orders when you take these stronger drugs. If you still have pain, call your doctor.
Prescription drugs may be used alone or with other drugs. Depending on your pain, some of these drugs work better than others. Prescription drugs include:
- Anti-inflammatory drugs and corticosteroids (for example, prednisone or dexamethasone). Corticosteroids used to treat cancer and cancer pain are not the same as steroids used by body builders.
- Narcotic painkillers, such as hydrocodone (for example, Hycodan), oxycodone (for example, Percocet), morphine, methadone, and fentanyl.
- Bisphosphonates, such as pamidronate and zoledronic acid. These are used to treat bone pain. Cancer cells that have spread to the bone upset the normal activity of your bone cells. These drugs slow the bone changes related to cancer. This relieves pain and helps keep your bones from breaking.
- Calcitonin may help with certain types of pain, such as phantom pain.2 Phantom pain is a feeling of pain or other uncomfortable sensations in body parts that are no longer there, such as after an amputation. Although the limb is gone, the nerve endings at the site of the amputation continue to send pain signals to the brain that make the brain think the limb is still there. Women who have had a breast removed because of breast cancer may also feel phantom pain.
- Mouthwashes to relieve pain from mouth sores (mucositis).
- Antidepressants, to relieve pain and help you sleep.
- Anticonvulsants, to help control nerve pain like burning and tingling.
- Skin creams, such as capsaicin cream or lidocaine, to help relieve pain in the skin and surrounding tissues.
- Chemotherapy, to shrink the cancer that is causing pain. The type of chemotherapy that you receive depends on your cancer diagnosis, the area of your body affected, and your previous use of chemotherapy drugs.
For more information, see:
What to think about
Drugs that are used to treat cancer pain rarely cause addiction. Many people worry that they will become addicted to painkillers or that they will become immune to them. Their fears stop them from taking their medicine. As a result, their cancer pain goes needlessly untreated.
If narcotic painkillers are used for longer than a week or so, they can cause your body to keep expecting the medicine. This is called a drug dependency. Dependency is not the same as addiction. Addiction is a behavioural disorder in which a person has a craving for the drug. This craving may not even be related to the level of pain.
Addiction to pain medicine is rare if you have not had a problem with addiction in the past and you take your medicine as directed under your doctor’s care. If you are worried about addiction or anything else, talk to your doctor.
Pain medicine works best when it is used at the time it is needed in the dose prescribed. If you know that your pain will be worse at a certain time, such as with activity, you can take your pain medicine in advance.
Some people may be able to use a patient-controlled analgesia (PCA) pump to control their pain medicines. A PCA pump is a computerized machine that contains your medicine. You press a button whenever you feel pain or are uncomfortable, and the machine gives you more medicine.
Drugs that are used to treat cancer pain can be very expensive. Talk to your doctor if financial concerns prevent you from taking your medicine as often as you need it. Schedule an appointment with someone in patient and financial support services at your cancer treatment centre. Many organizations provide resources to help you with the cost of your medicine. Often a less expensive drug will work as well as a more expensive one. For more information, contact your local chapter of the Canadian Cancer Society or call 1-888-939-3333.
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| Author: | Shannon Erstad, MBA/MPH Ralph Poore | Last Updated: February 12, 2008 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Michael Seth Rabin, MD - Medical Oncology Douglas A. Stewart, MD - Medical Oncology | |
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