
Cancer spreading to the bone is the most painful type of cancer. Pain can be caused by a tumor pressing on the nerves around the bone. As the tumor size increases, it can release chemicals that irritate the area around the tumor. Cancer may either start or spread to the bone. The degree of pain depends on different factors such as follows:
- Type of cancer
- Stage of cancer
- Tolerance for pain
People with stage IV cancer have the highest degree of cancer pain. Additionally, cancer surgery, treatments, or tests cause cancer pain.
Spinal cord compression: When a tumor spreads to the spine, it can press on the nerves of the spinal cord leading to spinal cord compression. The symptoms generally include back or neck pain. Pain, numbness, or weakness may also follow.
Cancer surgery can also result in pain. Most pain resolves after a while. However, some people may have pain that lasts for months or years.
Radiation therapy causes pain, which resolves after sometimes. Chemotherapy may cause pain and numbness in the fingers and toes called peripheral neuropathy.
Other causes of cancer pain include:
- Arthritis
- Chronic low back pain
- Phantom pain (longer-lasting effect of surgery, beyond the usual surgical pain)
- Spasms, pain, stinging, and itching caused by intravenous chemotherapy
- Medications such as filgrastim or pegfilgrastim cause bone pain
- Medication such as bisphosphonates causes osteonecrosis of the jaw
What are the different types of cancer pain?
Cancer pain can be felt in one of three ways:
- Acute pain: It is severe in the beginning and then eases off immediately. It may be due to an ulcer-like sore on the skin and inside the body that is cancerous.
- Chronic pain: It is a low throbbing or sharp pain that hangs around for a long time. It can be managed with pain medications but cannot completely disappear. It may be due to the destruction of the normal tissue by cancer cells.
- Breakthrough pain: If you treat chronic pain with medications, you may feel a flash of pain every once in a while. This is called “breakthrough pain” because it breaks through the effects of medications.
Can cancer pain be relieved?
Cancer pain can’t be completely relieved; however, it can be controlled and managed to a great extent.
How does the physician treat cancer pain?
The physician chooses to remove cancer with surgery, chemotherapy, or radiation. Medications for pain fall into three categories:
- Over-the-counter and prescription: For mild pain, fever, and swelling, the physician may prescribe acetaminophen, aspirin, ibuprofen, and naproxen.
- Weak opioid: Codeine is a weak opioid prescribed for cancer pain.
- Strong opioid: Fentanyl, methadone, and morphine are the most powerful opioids used to relieve cancer pain.
Antidepressants, anti-seizure drugs, and steroids are also useful in treating cancer pain. A specialized treatment, such as nerve block (local anesthetic), prevents pain messages around or into the nerve pathway from the brain.
Alternative treatment may also be used to treat cancer pain, which includes:
- Acupuncture
- Biofeedback
- Hypnosis
- Massage therapy
- Physical therapy
- Imagery
- Relaxation

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