After treatment for cancer, some people will have ongoing pain for months or years. This is called chronic pain (or persistent pain) and may affect 40% of survivors.
Chronic pain may be caused by cancer treatments, cancer-related changes (e.g. reduced strength, injuries) or other conditions not related to the cancer such as arthritis. Anxiety, depression, fatigue and trouble sleeping can also make pain worse.
Pain management plans
An important part of treating chronic pain is a pain management plan. This is a written document setting out your goals for managing pain, what medicines and other strategies could help, possible side effects, and ways to manage them. The pain management plan should also include details about when and who to call if you have problems.
A pain management plan is developed between the person with pain, their GP and the pain management team. It should be reviewed regularly. This is an opportunity to discuss any new pain, changes to existing pain and any side effects. Make sure you have a copy of the plan and share it with your health care professionals.
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Ways to manage persistent pain after treatment
- Talk to your doctor about suitable medicines such as mild pain medicines and how the physical, emotional and social consequences of chronic pain affect how you cope with the pain.
- Become more actively involved in managing your pain. This has been shown to help reduce pain. Learning how pain works can help you think about the pain differently and increase your confidence to do daily activities.
- Try psychological therapies to change the way you think about and respond to pain.
- Consider complementary therapies, such as creative therapies or meditation.
- Set small goals if pain stops you from enjoying your daily activities. Gradually increase your activity, e.g. if it hurts to walk, start by walking to the front gate, then to the corner, and then to the bus stop up the road.
- Go for a walk and do some gentle stretching every day. Movement will keep your muscles conditioned and help you deal with the pain.
- Pace your activities during the day, and include rest and stretch breaks.
- Include relaxation techniques in your daily routine. These may improve how well other pain relief methods work and also help you sleep.
- Build a network of people who can help you. This may include family, friends and volunteers.
- Read information about living well after cancer and learn how to adjust to life after treatment.
- Listen to our relaxation and meditation podcast Finding Calm During Cancer.
Using opioids for chronic pain
While opioids are sometimes prescribed for chronic pain, research shows that using opioids for a long time is not safe. However, for people with advanced cancer and who are receiving palliative care, opioids usually work well and are safe for managing cancer-related pain.
Evidence shows that opioids are not very useful or safe for managing chronic non-cancer pain. Chronic cancer pain after cancer treatment needs to be managed in a similar way to chronic non-cancer pain. This means looking at the physical, emotional and social impacts of the pain, and managing all these factors.
Your doctor may recommend you see a pain management specialist in a multidisciplinary pain clinic. The specialist can recommend a range of pain-relieving therapies and help create a pain management plan to improve your quality of life and return you to your normal activities. If the pain cannot be well controlled, the focus will shift to improving your ability to function despite the pain.
Pain and advanced cancer
Palliative care aims to relieve symptoms of cancer and improve quality of life without trying to cure the disease. People at any stage of advanced cancer may benefit from seeing a palliative care team.
Pain management is only one aspect of palliative care. The palliative care team may include doctors, nurses, physiotherapists, social workers, occupational therapists, psychologists and spiritual care practitioners. They work together to:
- maintain your quality of life by relieving physical symptoms
- support your emotional, cultural, social and spiritual needs
- provide support to families and carers
- help you feel in control of your situation and make decisions about your treatment and ongoing care.
Your cancer specialist or nurse can put you in touch with a palliative care team for treatment in hospital or at home. This type of care can improve quality of life from the time of diagnosis and can be given alongside other cancer treatments.
You may find it helpful to listen to our Managing Pain when Cancer is Advanced episode of The Thing About Advanced Cancer podcast.
Cancer-related pain can affect every aspect of your life. You will probably experience a range of emotions – fear, sadness, anxiety and frustration are all common reactions. You may think that people don’t understand the pain you’re in and the other emotions you’re feeling.
There are many sources of support to help you, your family and carers cope with cancer-related pain, including:
- access to benefits and programs to ease the financial impact
- home care services, such as Meals on Wheels, visiting nurses and home help
- aids and appliances
- support groups and programs
- counselling services.
The availability of services may vary depending on where you live, and some services will be free but others might have a cost. To find good sources of support and information, you can talk to the social worker or nurse at your hospital or treatment centre, or call us on 13 11 20.
If you are living with pain, you may need help around the home or with children. It may be hard to tell people what to do, so you might prefer to ask a relative or close friend to coordinate offers of help. Your local council may also have volunteers or community services available.
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Understanding Cancer Pain
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Expert content reviewers:
Dr Tim Hucker, Pain Medicine Specialist, Peter MacCallum Cancer Centre, VIC; Dr Keiron Bradley, Palliative Care Consultant, Bethesda Health Care, WA; A/Prof Anne Burke, Co-Director Psychology, Central Adelaide Local Health Network, President, Australian Pain Society, Statewide Chronic Pain Clinical Network, SA, School of Psychology, The University of Adelaide, SA; Tumelo Dube, Accredited Pain Physiotherapist, Michael J Cousins Pain Management and Research Centre, Royal North Shore Hospital, NSW; Prof Paul Glare, Chair in Pain Medicine, Palliative Medicine Specialist, Pain Management Research Institute, The University of Sydney, NSW; Andrew Greig, Consumer; Annette Lindley, Consumer; Prof Melanie Lovell, Palliative Care Specialist HammondCare, Sydney Medical School and The University of Technology Sydney, NSW; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Melanie Proper, Pain Management Specialist Nurse Practitioner, Royal Brisbane and Women’s Hospital, QLD; Dr Alison White, Palliative Medicine Specialist and Director of Hospice and Palliative Care Services, St John of God Health Care, WA.
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The information on this webpage was adapted from Understanding Cancer Pain - A guide for people with cancer, their families and friends (2021 edition). This webpage was last updated in May 2022.