Pain can affect people diagnosed with cancer, although not everyone with cancer will experience pain. Individuals with advanced cancer, meaning cancer that has spread to other areas of the body, are more likely to experience severe cancer pain.
Cancer pain is different for each person. It may feel dull and achy, sharp and burning, constant or intermittent, mild or severe. If you have cancer and experience pain, it is important to tell your doctor. Cancer pain is highly treatable, and effective pain control can significantly improve quality of life.
The aim of cancer pain treatment is to relieve pain caused by cancer or cancer treatment. Pain cannot always be completely eliminated, but it can often be controlled so patients can go through treatment more comfortably. At Specialist Pain International Clinic, our pain specialists provide personalised cancer pain treatment plans based on diagnosis, overall health, age, and individual preferences.
What Causes Cancer Pain?
Cancer pain can occur for several reasons:
- The cancer itself: Tumours can press on or damage nearby tissues and organs. For example, a tumour near the spine may compress nerves and cause pain.
- Cancer treatment: Treatments such as surgery, chemotherapy, and radiotherapy can cause pain in some patients.
- Diagnostic tests: Certain tests used to diagnose cancer or monitor treatment response may cause temporary pain.
When to See a Doctor for Cancer Pain Treatment
Make an appointment with your cancer care team or a pain specialist if you experience:
- New pain
- An increase in your current pain levels
- Trouble sleeping due to pain
- Pain that does not improve with treatment
What to Expect During Your Appointment
Your doctor will ask you to describe and locate the pain. If possible, keep a short journal before your visit. Note the intensity of pain, how often it occurs, what it feels like, and what makes it better or worse.
If you have tried over-the-counter pain medication, hot packs, or cold packs, record whether they helped and share this with your doctor.
Your treatment options will depend on factors such as:
- Your specific diagnosis
- Your age
- Your cancer treatment plan
- Your overall health
What Does Cancer Pain Treatment Involve?
Cancer pain treatment often begins with oral medications to relieve symptoms. If over-the-counter pain medicines are not sufficient, your doctor may recommend:
- Nerve pain medications: Many cancer pain conditions include a neuropathic component, where nerve irritation worsens pain.
- Opioid pain medication: For moderate to severe pain that requires stronger pain control.
- Steroids: To reduce pain related to swelling and inflammation.
- Targeted injections: To deliver medication closer to the source of pain.
- Spinal injections: To reduce pain signals reaching affected nerves in selected cases.
- Implantable therapies: To deliver pain medication continuously in cases where oral medication is insufficient or causes unacceptable side effects.
What Is an Intrathecal Implantable Pump?
An intrathecal morphine pump is an implantable device that delivers continuous small amounts of medication into the spinal fluid area through a thin tube called a catheter. Because the medication is delivered closer to the spinal cord, symptoms may be controlled using much smaller doses compared with oral medication, which may reduce side effects.
When Is an Intrathecal Pump Used?
An intrathecal pump may be considered for severe cancer pain when pain does not respond adequately to other treatment options, or when side effects from oral medication limit effective pain control.
Where Are the Catheter and Pump Placed?
The catheter is inserted into the spine through the lower back region. The pump is implanted under the skin of the abdomen. The pump contains a reservoir that holds medication and is programmed to release medication gradually over time. The settings can be adjusted to match changing needs.
When the reservoir is low, the doctor or nurse refills it by inserting a needle through the skin into the fill port on the pump.
What Happens During Intrathecal Pump Placement?
The procedure typically involves placement of the spinal catheter and surgical implantation of the pump under the abdominal skin. Your care team will explain the steps, pain control plan, and follow-up schedule.
Precautions After Pump Insertion
Your doctor will provide personalised instructions. Common guidance may include:
- Take medications exactly as prescribed
- Drink water and eat high-fibre foods to reduce constipation risk
- Use ice packs on the incision area as directed to reduce swelling
- Report unusual symptoms such as worsening headaches, excessive drowsiness, or concerns about medication effects
Activity Restrictions
- Avoid bending, lifting, twisting, or reaching overhead for the first several weeks, as advised by your doctor
- Avoid lifting heavy objects for the initial recovery period
- Avoid strenuous activities until cleared by your care team
- Do not drive until your follow-up appointment and medical clearance
- Avoid alcohol while recovering and while taking opioid medication
Incision Care
- Wash hands before and after touching the incision area
- Avoid soaking the incision in water until cleared by your doctor
- Do not apply lotions or ointments unless prescribed
- Some mild drainage can be normal, but report concerns promptly
How Long Does the Pump Last?
The pump reservoir typically needs refilling on a regular schedule, often every few months, depending on the dose and usage. The battery life varies by device and settings and may last several years. When the battery is depleted, the pump may require replacement.
Advantages of an Intrathecal Pump for Severe Cancer Pain
- Continuous medication delivery for more consistent pain control
- Lower medication doses compared with oral routes in many cases
- Potentially fewer systemic side effects
Possible Complications
All procedures carry risks. Your doctor will discuss your individual risk profile. Potential complications may include:
- Bleeding
- Infection
- Pump or catheter malfunction
- Neurological injury
Living With an Intrathecal Pump
Regular follow-ups are required for refills and dose optimisation. The goal is to achieve the best possible pain control with minimal side effects. Some patients may still need additional oral medication for flare-ups or breakthrough pain.
You may be advised to carry an implanted device identification card, especially when travelling.
Severe Cancer Pain and Breakthrough Pain
Severe cancer pain can interfere with daily activities such as dressing, walking, or working. Some patients also experience breakthrough pain, which is sudden pain that occurs despite ongoing treatment. When breakthrough pain occurs, your doctor may prescribe an additional medication or strategy specifically for flare-ups.
Managing Cancer Pain Treatment at Home
Your pain management plan is designed around your specific needs. It is important to take medications exactly as prescribed. Pain that is not adequately treated can become persistent and harder to manage over time.
If your medication no longer provides the same relief as before, contact your doctor. Your care team can adjust your treatment plan to improve comfort and safety.
