Pain after 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 health care professionals. You can download a pain management plan template and other self-management resources here.

Ways to manage persistent pain after treatment

• Talk to your doctor about suitable medicines such as mild pain 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 also help you sleep.
• Build a network of people who can help you. This may include family, friends and volunteers.
• See our ‘Living Well After Cancer‘ booklet.
• Listen to our relaxation and meditation podcast ‘Finding Calm During Cancer’ on our website or call 13 11 20 for a free copy of our relaxation and meditation recordings.