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What is cancer pain?

Medical studies have shown that over a third of all patients suffering with cancer experience moderate to severe pain; this rises to 66% in patients who have advanced stage disease.

Cancer pain is usually caused by the presence of tumours (abnormal growths of tissues) that can press on surrounding organs, nerves or bones.

If the tumours grow, this can increase the pressure on the surrounding structures and make the pain worse.

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There are a number of approaches that can be used to treat cancer pain and greatly improve quality of life:

Reducing the size of the tumour

This can be achieved by surgery (removing of all or part of the tumour), chemotherapy, radiotherapy, or hormonal-targeted treatment, depending on the size, type and location of the tumour.

Even though this may or may not cure the cancer itself, reducing the tumour’s size (or removing it completely), can relieve the pressure on the surrounding structures and ease pain.

Pain management

This can be achieved through a number of methods including:

  • Painkilling medications that either provide long-acting pain relief for chronic pain, or faster-acting pain relief for ‘breakthrough’ cancer pain (a sudden increase in pain)
  • Other medications such as antibiotics that are used to treat concurrent infections, steroids to reduce swelling and relieve pressure, and some types of anti-depressants can also treat nerve pain caused by compression or damage
  • Radiotherapy can help reduce pain originating from tumours. It provides pain relief in an average of two to three weeks for 60% of patients. High energy X-rays are targeted to the disease site, causing DNA damage and cell death
  • Nerve block procedures that target specific nerves with injections or anaesthetic to stop them sending pain signals
  • Neuromodulation procedures, such as spinal cord stimulation or peripheral nerve stimulation, which use electrodes to block pain signals sent by the nerves
  • Lesional procedures, such as cingulotomy (a neurosurgical treatment to the part of the brain associated with feeling chronic pain) or cordotomy (surgery to the selected pain-conducting tracts in the spinal cord). These involve using small wires (electrodes) to deliberately destroy parts of the brain or spinal cord carrying pain signals to reduce awareness of pain.

How effective are these procedures?

The mainstay of most cancer pain treatment is the use of opioid-type painkilling medications (like morphine or similar). These can be very effective at managing pain.

However, they do have some side effects such as drowsiness, constipation, nausea and dependence. People can also build up tolerance to them, meaning that they need increasing doses to get the same pain relief over time.

The most effective cancer pain treatment procedure is likely to depend on the type, location and stage of cancer, as well as other general health factors.

For example, neuromodulation is effective in treating pain caused by nerve damage (also known as neuropathic pain).

Pain caused by tumours or metastases (areas of cancer spread) in bones can be best treated using medications called ‘bisphosphonates’ (that help to strengthen the bones) and targeted radiotherapy.

If the pain is caused by a tumour pressing on a nearby organ, then surgery to remove all or part of the tumour can help.

What are the risks associated with cancer pain procedures?

All of the treatments for cancer pain can have side effects. For example:

  • Opioid-type medications can often make people feel drowsy, nauseous and constipated
  • Radiotherapy can make people feel nauseous and tired, as well as cause some soreness in the skin over the target site (similar to sunburn)
  • Any surgical procedure will come with its own risks and side effects that must be weighed up beforehand. This includes a recurrence of any tumour which is being removed
  • Neuromodulation procedures can cause some problems related to the insertion of the small wire electrodes, as well as device failure, pain at the insertion site or damage to nearby structures.

Many of the common side effects associated with cancer pain treatments, such as nausea, fatigue and constipation, can also be treated with additional medications, physiotherapy and simple measures such as ensuring adequate hydration.

Why choose The London Clinic?

Treating cancer pain requires an individualised approach and treatment plan. Here at the London Clinic, our leading experts in pain management and their specialised multidisciplinary team will be able to advise on the most appropriate treatment options for each patient and provide full support throughout.

We offer access to clinical support teams that are second to none and include specialist extended scope practitioners experienced in cancer physiotherapy, dieticians to support nutrition, and strength and conditioning coaches.

Our additional treatment services include:

  • Pre-habilitation services for all cancer patients to prepare them for treatments or surgery
  • Pre- and post-admission physiotherapy
  • Lymphoedema and manual lymphatic drainage services
  • Aquatic therapy
  • Complementary therapies, including Ai Chi, massage therapy and acupuncture.

You can find out more about our full range of therapies at our physical therapies centre.