Pain and MBC
Pain is one of the most feared symptoms and side effects connected with any illness, especially an ongoing illness like metastatic breast cancer. Like many things in life, it is hard to know how to handle something when you are unsure what to expect. Different people react to pain differently, and the pain you feel as very intense may feel less bothersome to someone else.
If you feel pain, you should not hesitate to speak with your medical team. Pain can interfere with your treatment, affect recovery from surgery and disrupt sleep. It may diminish your mood, appetite and interest in activities. Pain can affect your ability to concentrate and work, as well as the quality of your relationships.
Using palliative care to address pain related to metastatic breast cancer can enhance the way you cope and support your overall treatment plan. Palliative care is specialized medical care to give you relief from the symptoms, pain and stress of any serious illness.
This page contains information on pain unique to metastatic breast cancer. Get more general information about pain here.
There are many causes of pain in metastatic breast cancer. Treatments and metastases all may cause pain.
Surgery can produce ongoing pain from tissue and nerve damage, scars, or phantom pain, pain that feels like it’s coming from one or both of your breasts removed by mastectomy. Chemotherapy and hormonal therapy may cause painful side effects, such as mouth sores or bone and joint pain.
Ongoing treatment for metastatic breast cancer may mean having to manage treatment-caused pain over a long time. If pain persists despite pain treatment, you may want to consider changing to another breast cancer medicine or therapy, or possibly ending that treatment.
Metastatic tumors may cause pain in bones, tissue and elsewhere. There are several types of treatments to shrink metastases, which can reduce pain.
Breast cancer itself can cause pain. Tumors may press on nerves and organs or constrict other areas. Metastases can cause pain within bones or other places the cancer has spread.
There are different kinds of pain, and it’s common to have more than one kind:
- Acute pain is pain that is happening right now.
- Intermittent pain comes and goes.
- Chronic pain might increase and decrease in intensity over time, but it is always there.
- Phantom pain is pain you feel in the breast that is no longer there. It is rare in breast cancer but can be treated.
Because your experience of pain is unique to you, describing or measuring it can be difficult. Doctors and other medical providers use a subjective pain scale, or range, to measure pain. When you describe your pain, your doctor will measure it on the same scale over and over, so your medical team can track your pain over time.
That scale might look like this:
- 0–1 no pain
- 2–3 mild pain
- 4–5 discomforting – moderate pain
- 6–7 distressing – severe pain
- 8–9 intense – very severe pain
- 10 unbearable pain
You may want to keep a pain journal as a record of when you have pain and what it feels like. Describe any patterns of pain you notice during treatment cycles or daily activities. Use words such as “prickly,” “burning,” “stabbing” or “numb” to describe your pain.
Although cancer-related pain cannot always be completely relieved, it is possible to use different methods to treat and lessen pain. These include
- prescription and non-prescription medicines
- bisphosphonates and other osteoclast inhibitors, for pain from bone metastases
- anesthetics and anesthetic procedures. Anesthetics are medicines that relieve pain by reducing or removing feeling
- radiation therapy, for pain caused by metastasis to the bone
- interventional radiology techniques, for pain in the spine
These methods can be used strictly for reducing pain, although they may address other symptoms and side effects as well.
Complementary approaches may supplement your medical pain control methods.
You may want to try
If your pain cannot be relieved, you may consider changing treatment. Sometimes people don’t want to report side effects because they are worried that if the dose or timing of the medicine changes, the treatment will not be as effective. But most treatments have recommendations built-in to lower the dose or change the timing of the medicine if symptoms are of concern. Studies show that even if the dose is lowered or changed, the treatment will still work as well against the cancer. If the dose or change would not be effective, your healthcare providers would then change you to a different treatment.
Although one goal of your treatment is to keep the cancer under control for as long as possible, a second, equally important goal is to allow you to live a good life. Remember, your needs are an important part of your treatment plan. Open communication with your providers is very important. You and your providers will decide together whether continuing with a certain treatment is right for you.
Emotional support can be an important part of helping you manage pain. You may develop skills and strategies for coping with pain through short-term psychotherapy, structured support and other methods. You may also find relief from your spiritual or religious communities, social groups or other activities.