Breast cancer pain can arise from the cancer itself and the treatment. Common types of pain caused by tumors in the breast are considered to be either nociceptive or neuropathic.
Nociceptive pain is due to injury to body tissue. The pain receptors that send signals to the spinal cord or brain have been stimulated. Neuropathic pain comes from injury or malfunction of the central nervous system (brain and spinal cord), or peripheral nervous system (nervous system outside the brain or spinal cord).
Pain felt by breast cancer patients can be short in duration (acute) or can persist (chronic).
Treating pain is a standard part of managing breast cancer. Most people with breast cancer experience significant relief from pain by taking pain medications called analgesics.
Let your oncologists and nurses know the type of pain you’re experiencing before, during, and after therapy, so the proper medications can be prescribed for you. The types of pain you experience may also change during the course of your treatment.
Track your pain
Keeping a pain diary is a good way to help you talk about pain with your oncologists and nurses. You can keep a record of your pain by writing down the following:
- when you feel pain
- the quality of the pain
- where the pain is located, how severe it is
- to what extent the pain medications were effective
Treat your pain
Bring your pain diary to your doctor’s appointments. Tell your oncologist or nurse if the pain medication you’ve been taking isn’t relieving your pain.
If you have constant severe pain, sustained release or long acting medicines may be prescribed. The sustained release medications should be taken on a schedule, whether or not you are feeling pain.
Sustained release medications can be taken orally, or you may wear a patch that delivers the medication through the skin into your bloodstream.
This type of medication is delivered into your system slowly and evenly throughout the day and night. They also prevent you from having to frequently take medication, which can help you get a good night’s sleep.
Sometimes it takes a little while to get the correct type and dosage of pain medications. But your medical team will work to find the most effective regimen. A pain management team at your hospital or medical center can assist you in developing a pain control plan.
A variety of prescription pain medications are available, and you’ll be prescribed one depending on the type of pain you experience.
Opioids are strong pain medications that may be prescribed for moderate to severe cancer-related and post-surgical acute and chronic pain. Examples of opioid medications include:
Opioids can be taken orally, or worn as patches on the skin. There are also suppository options, or they can be given as injections via a patient-controlled analgesia pump.
It’s important when using opioids to take the medication exactly as your doctor has prescribed.
When taking opioids for pain, there may be side effects that include:
- drowsiness, especially when you begin taking them
- nausea and vomiting at the beginning of therapy
- changes in mood
- itchy skin
If you’re taking opioid medication, don’t take the medication to help you sleep. It’s also important that you don’t drink alcohol. But if you feel constipated while taking opioid medications, you can take laxatives.
When your pain has diminished, your doctor will reduce the dosage gradually and switch you to a different type of pain medication.
Co-analgesics are drugs that were developed for other purposes but have been shown to be effective in treating pain. Some examples are antidepressants and medications used to treat seizures.
NSAIDs are prescribed for pain that is mild to moderate. They are available over-the-counter and by prescription. Over-the-counter oral pain medications include acetaminophen (Tylenol) and NSAIDs, such as aspirin and ibuprofen (Advil).
Side effects of NSAIDs include gastrointestinal (GI) upset and GI bleeding. Due to the risk of bleeding, NSAIDs are not prescribed for patients around the time of surgery.
People with breast cancer who have severe pain may require hospitalization so they can receive intravenous pain medication. The medication may be delivered via the following:
- surgically implanted port-a-Cath
- a peripheral IV
- a central catheter
- patient-controlled analgesia (PCA)
If required, other options are surgically inserted. And computerized pumps deliver medication to areas surrounding the spinal cord. These devices are called epidural pumps and intrathecal pumps. All of these options are for patients admitted to the hospital.
There are also alternative and at-home approaches to relieve pain caused by breast cancer. Some of these options include:
- physical therapy
- heat or cold therapy
- relaxation techniques, like meditation, listening to music, reading, or sitting outside in a scenic place
- visualization of a restful place called guided imagery