Ovarian cancer is one of the deadliest cancers affecting women, in part because it’s often so hard to detect early, when it’s most treatable. In the past, ovarian cancer was often called “the silent killer” because it was thought that many women didn’t have any signs or symptoms until the disease had spread.

Though its symptoms can be subtle and hard to tell from other conditions, ovarian cancer isn’t silent. Most women with this cancer do feel changes like bloating, trouble eating, or an increasing urge to urinate. One of the most common ovarian cancer symptoms is pain, which is usually felt in the stomach, side, or back.

Ovarian cancer pain can start when the tumor puts pressure on organs, nerves, bones, or muscles. The more the cancer spreads, the more intense and consistent the pain can become. In women with stage 3 and 4 ovarian cancers, pain often is the main symptom.

Sometimes pain is a result of treatments meant to stop the cancer’s spread, such as chemotherapy, surgery, or radiation. Chemotherapy can cause pain and burning in the arms, legs, hands, and feet. This type of pain is called peripheral neuropathy. Chemotherapy may also leave painful sores around the mouth.

Surgery causes discomfort and soreness that can linger for up to a few weeks after the procedure. Unlike cancer pain, which gets worse over time, treatment-related pain should eventually improve once you stop the therapy.

Knowing whether pain is caused by cancer or its treatments can help your doctor find the best way to relieve it.

As common as pain is with ovarian cancer, many women don’t report it to their doctor. One reason they keep quiet is because they worry the pain is a sign the cancer is spreading — something they may not be ready to face. Or, they might not ask for help because they’re afraid they’ll get addicted to pain medicines.

You don’t have to live in pain. There are good options for cancer pain relief. Your doctor can help you manage your discomfort and maintain your quality of life while you focus on treating your cancer.

Often, pain therapy will start with an evaluation. Your doctor will ask questions like:

  • How intense is your pain?
  • Where do you feel it?
  • When does it occur?
  • Is it continuous, or does it come and go?
  • What seems to trigger your pain?

The doctor might also ask you to rate your pain on a scale from 0 (no pain) to 10 (worst pain). The questions and scale will help your doctor find the right pain relief method for you.

The main treatments for ovarian cancer are meant to prolong your life and improve symptoms like pain. You may have surgery, chemotherapy, and possibly radiation to remove or shrink the tumor as much as possible. Your doctor may also do surgery to clear a blockage in your bowel, urinary system, or kidney that’s causing pain.

Your doctor also can give you medicine to directly address cancer pain. Which pain reliever your doctor recommends first will depend on how severe your pain is. For mild pain, you may get an over-the-counter analgesic such as acetaminophen (Tylenol). Or, you can try an NSAID pain reliever like aspirin or ibuprofen (Motrin, Advil). NSAIDs both relieve pain and bring down inflammation in the body. Yet they can damage your stomach or liver, so use only the amount you need for the shortest possible period of time.

For more intense pain, you may need an opioid medicine. The most common opioid used to treat cancer pain is morphine. Other options include fentanyl (Duragesic patch), hydromorphone (Dilaudid), or methadone. These drugs also can have side effects, which can include:

  • Sleepiness
  • nausea and vomiting
  • confusion
  • constipation

Opioids also can be addictive. Use them very carefully and only under your doctor’s guidance.

Depending on where your pain is located, another pain relief option is a nerve block. In this treatment, pain medicine is injected straight into a nerve or into the space around your spine for more direct and long-lasting relief.

Other types of medicines sometimes used to relieve ovarian cancer pain include antidepressants, anti-seizure medicines, and steroid drugs. Ask your doctor which pain reliever is best for your kind of pain.

When the pain is very severe and medicine doesn’t help, a doctor may cut nerves during surgery so you no longer feel pain in those areas.

Your doctor might also suggest in addition to medication that you try non-medical treatments such as these to relieve your pain:

  • Acupuncture. Acupuncture uses hair-thin needles to stimulate various points around the body. It can help with pain, as well as with other symptoms like fatigue and depression from your cancer and chemotherapy treatment.
  • Deep breathing. Along with other relaxation techniques, this can help you sleep and might also improve pain.
  • Imagery. This method distracts you from your pain by having you focus on a pleasant thought or image.

Aromatherapy, massage, and meditation are other techniques you can try to relax and relieve your pain. You can use these techniques along with your prescribed pain medicine and ovarian cancer treatment.

To get the relief you need, see a doctor who specializes in managing cancer pain, particularly ovarian cancer pain. Be honest and open with the doctor about how you’re feeling. Don’t be afraid to ask for medicine or other pain relieving therapies if you need them.