Pain after cancer treatment

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.

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.

Developing a pain management plan

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.

The pain management plan 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 healthcare professionals.

You can download a pain management plan template and bring it with you to appointments.

Dealing with feelings of sadness

If you have continued feelings of sadness, have trouble getting up in the morning or have lost motivation to do things that previously gave you pleasure, you may be experiencing depression. This is quite common among people who are dealing with pain.

Talk to your GP, because counselling or medication – even for a short time – may help. Some people can get a Medicare rebate for sessions with a psychologist. Ask your doctor if you are eligible. Cancer Council may also run a counselling program in your area.

For information about coping with depression and anxiety, call Beyond Blue on 1300 224 636. For 24-hour crisis support, call Lifeline on 13 11 14.

Pain and advanced cancer

Palliative care aims to relieve symptoms of cancer and improve quality of life without trying to cure the disease. It is often called supportive care. 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. 

Learn more about palliative care.