Page last updated: September 2024
The information on this webpage was adapted from Understanding Cancer Pain - A guide for people with cancer, their families and friends (2024 edition). This webpage was last updated in September 2024.
Expert content reviewers:
This information was developed based on Australian clinical practice guidelines and with help from specialists working in pain management, oncology and palliative care, and people affected by cancer. All updated content has been clinically reviewed by:
- Professor Paul Glare, Chair of Pain Medicine, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW; and
- Dr Tim Hucker, Pain Specialist, Northern Beaches Hospital, Director, Northern Beaches Pain Management, NSW.
This edition is based on the previous edition, which was reviewed by the following panel:
- Dr Tim Hucker (see above)
- Dr Keiron Bradley, Palliative Care Consultant, Bethesda Health Care, WA
- A/Prof Anne Burke, Co-Director Psychology, Central Adelaide Local Health Network, President, Australian Pain Society, Statewide Chronic Pain Clinical Network, SA, School of Psychology, The University of Adelaide, SA
- Tumelo Dube, Accredited Pain Physiotherapist, Michael J Cousins Pain Management and Research Centre, Royal North Shore Hospital, NSW
- Prof Paul Glare (see above)
- Andrew Greig, Consumer
- Annette Lindley, Consumer
- Prof Melanie Lovell, Palliative Care Specialist HammondCare, Sydney Medical School and The University of Technology Sydney, NSW
- Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA
- Melanie Proper, Pain Management Specialist Nurse Practitioner, Royal Brisbane and Women’s Hospital, QLD
- Dr Alison White, Palliative Medicine Specialist and Director of Hospice and Palliative Care Services, St John of God Health Care, WA
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 opiods 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.
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.
Cancer Council may also run a counselling program in your area. For information about coping with depression and anxiety, call Beyond Blue on 1300 22 4636. For 24-hour crisis support, call Lifeline 13 11 14 .
Pain management plans
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.
It should be reviewed regularly. This is an opportunity to discuss any new pain, changes to existing pain and side effects. Make sure you have a copy of the plan and share it with your health care professionals.
Ways to manage persistent pain
- Talk to your doctor about suitable medicines and how the physical, emotional and social consequences of chronic pain affect how you cope with the pain.
- Become more actively involved in managing your pain. This has been shown to help reduce pain. Learning how pain works can help you think about the pain differently and increase your confidence to do daily activities.
- Try psychological therapies to change the way you think about and respond to pain.
- Consider complementary therapies, such as creative therapies or meditation.
- Set small goals if pain stops you from enjoying your daily activities. Gradually increase your activity, e.g. if it hurts to walk, start by walking to the front gate, then to the corner, and then to the bus stop up the road.
- Go for a walk and do some gentle stretching every day. Movement will keep your muscles conditioned and help you deal with the pain.
- Pace your activities during the day, and include rest and stretch breaks.
- Include relaxation techniques in your daily routine. These may improve how well other pain relief methods work and help you sleep.
- Build a network of people who can help you. This may include family, friends and volunteers.
- Read information about living well after cancer and learn how to adjust to life after treatment.
- Listen to our relaxation and meditation podcast Finding Calm During Cancer.
Pain and advanced cancer
Palliative care aims to relieve symptoms of cancer and improve quality of life without trying to cure the disease. 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
- 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.
You may find it helpful to listen to our Managing Pain when Cancer is Advanced episode of The Thing About Advanced Cancer podcast.
Seeking support
Cancer-related pain can affect every aspect of your life. You will probably experience a range of emotions – fear, sadness, anxiety and frustration are all common reactions.
There are many sources of support to help you, your family and carers cope with cancer-related pain, including:
- access to benefits and programs to ease the financial impact
- home care services, such as Meals on Wheels and visiting nurses
- aids and appliances
- support groups and programs
- counselling services.
The availability of services may vary depending on where you live, and some may have a cost.
To find good sources of support and information, you can talk to the social worker or nurse at your hospital or treatment centre or call us on 13 11 20.
If you are living with pain, you may need help around the home or with children. It may be hard to tell people what to do, so you might prefer to ask a relative or close friend to coordinate offers of help.
Your local council may also have volunteers or community services available.
Contact cancer support
