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Overcoming cancer pain

Treating mild pain

Saturday 1 September, 2018

Medicines used to control mild pain include paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs). They are often available over the counter from pharmacies without a prescription. These types of drugs are excellent at relieving certain types of pain, such as bone pain, muscle pain, and pain in the skin or the lining of the mouth. They can also be used with stronger pain medicines to help relieve moderate to severe pain.


Paracetamol is a common drug that comes in many different formulations and is known by various brand names such as Panadol and Panamax. It's recommended that an adult have no more than 4 g of paracetamol in 24 hours (usually 8 tablets), unless approved by their doctor. The dose limit for children depends on their age and weight, so check with the doctor, nurse or pharmacist.

Some stronger pain medicines contain paracetamol in combination with another drug, and count towards your total intake. If taken within the recommended dose, paracetamol is unlikely to cause side effects. In some cases, your doctor will recommend you take paracetamol with other pain medicines, such as oxycodone, to help them work better.

"I could not believe how much better I felt after taking some pain relief. Everything seemed less stressful and I did not feel so angry and upset all the time. I had resisted taking anything for so long...I now wish I had taken something sooner." - Bill

Non-steroidal anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, celecoxib, diclofenac and aspirin, vary in dose, frequency of dose and side effects. They are known by various brand names, such as Advil and Nurofen. You can have these medicines as a tablet or sometimes as an injection. Less commonly, NSAIDs are given as a suppository - a capsule inserted into the bottom (rectum).

Side effects of NSAIDs

In some people, NSAIDs can cause indigestion or stomach ulcers, increase the risk of bleeding in the stomach or intestines, and reduce kidney function. Some studies show that NSAIDs can lead to heart (cardiac) problems, especially with long-term use or in people who already have cardiac problems.

Talk to your doctor or nurse before taking NSAIDs, especially if you have had stomach ulcers, heart disease, kidney disease or gut reflux; are having chemotherapy; or are taking other medicines (such as anticoagulants/blood thinners like warfarin) that also increase your risk of bleeding. If you are taking NSAIDs in high doses or for a long time, it's generally recommended you take them with food to lower the risk of indigestion. You may be given other medicine that is less likely to cause indigestion and bleeding, such as paracetamol.

Listen to a discussion about " Managing Cancer Pain". This podcast episode includes some practical pain relief strategies.

Expert content reviewers:

Dr Tim Hucker, Clinical Lead, Pain Service, Peter MacCallum Cancer Centre, and Lecturer, Monash University, VIC; Carole Arbuckle, 13 11 20 Consultant, Cancer Council Victoria; Anne Burke, Co‑Director, Psychology, Central Adelaide Local Health Network, SA, and President Elect, The Australian Pain Society; Kathryn Collins, Co-Director, Psychology, Central Adelaide Local Health Network, SA; A/Prof Roger Goucke, Head, Department of Pain Management, Sir Charles Gairdner Hospital, Director, WA Statewide Pain Service, and Clinical A/Prof, The University of Western Australia, WA; Chris Hayward, Consumer; Prof Melanie Lovell, Senior Staff Specialist, Palliative Care, HammondCare Centre for Learning and Research, Clinical A/Prof, Sydney Medical School, and Adjunct Professor, Faculty of Health, University of Technology Sydney, NSW; Linda Magann, Clinical Nurse Consultant, Palliative Care and Peritonectomy Palliative Care, St George Hospital, NSW; Tara Redemski, Senior Physiotherapist, Gold Coast University Hospital, Southport, QLD.

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