Treatment Side Effects - Pain

Reviewed by: HU Medical Review Board | Last reviewed: February 2018

People with blood cancer may experience pain, both as a result of the cancer itself as well as from procedures and treatment. However, pain isn't something that anyone has to just put up with. There are remedies that can help, and most pain can be controlled or managed. Managing pain is important as chronic pain can contribute to wearing down the immune system, slowing the body's ability to heal, and may lead to or contribute to depression.1,2 In addition, pain can greatly impact a person's quality of life, making it difficult sleep or to participate in daily activities including work and social life.3

Types of pain in blood cancer

Pain may be acute or chronic. Acute pain is usually due to a definable injury or illness. Acute pain is usually experienced for a limited duration and is predictable. It may be associated with clinical signs such as increased heart rate, high blood pressure, sweating, and pale skin.2,3

Chronic pain may be a result of the same causes as acute pain but it is experienced for a much longer duration. Chronic pain can last for months or years. Chronic pain differs among different people. Some people experience constant pain, others have pain that may come and go. Some people experience chronic pain that worsens over time. While chronic pain doesn't typically impact a person's heart rate or blood pressure like acute pain does, chronic pain can potentially lower the effectiveness of the immune system and can create an emotional and physical burden for the person living with it as well as their caregivers.2,3

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Some people who receive treatment for pain may experience breakthrough pain, which is pain that "breaks through" the pain medication the patient may already be taking. Breakthrough pain is characterized as a brief and sudden flare, and it can be severe. Breakthrough pain cannot always be predicted and is often not managed by the regular pain medicine the person is taking. However, breakthrough pain can be managed by other medications.2,3

Pain as a side effect of treatment for blood cancer

Some treatments for blood cancer may cause pain as a side effect, such as:

  • Chemotherapy - Chemotherapy drugs may cause mouth sores that can cause pain in the mouth and throat. Some chemotherapy medications can also cause peripheral neuropathy, a type of nerve damage that causes pain, burning, tingling, numbness or weakening of the arms, hands, feet, or legs.3
  • Surgery - Some people with blood cancer need a splenectomy, a surgical procedure to remove the spleen. Other surgical procedures that people with blood cancer may experience include removal of lymph nodes or bone marrow aspirations and biopsies. All surgical procedures can cause pain. Generally, pain from surgery lasts from a few days to a few weeks.3,4
  • Radiation - Radiation therapy can cause skin burns at the site that's receiving treatment. In addition, the organs or tissue underneath the skin at the site of radiation therapy may also be injured and cause pain.3

Ways to treat and manage pain

There are a variety of medications that are available both over-the-counter and by prescription that can help someone with blood cancer manage pain. Recommendations for pain medication are determined by the type of pain (acute, chronic, or breakthrough), as well as the patient's age, general health, and other medications. Mild pain can potentially be managed with certain over-the-counter pain medications, but patients should always check with their doctor before taking any over-the-counter medications for pain to make sure they are safe to take. For moderate to severe pain, stronger medications may be used, such as opioids like morphine, codeine, hydrocodone, oxycodone, methadone, or fentanyl. Some people may be prescribed a combination of medicines to treat their pain.2

In addition to medications, there are other complementary practices that can help manage or lessen pain, including acupuncture, relaxation or breathing techniques, hypnosis, meditation, massage, Reiki, exercise, or heat or cold packs. Patients should talk to their doctor about all approaches they are considering using to manage their pain.2,3