Sometimes secondary breast cancer can cause you pain, but this can be treated

There’s no need for you to be living in pain, as there are many effective treatments to relieve it. Throughout your care, your treatment team will ask whether you’re in any pain, where it is, how bad it is, and the impact it’s having on your life.

If you’re in pain, let your treatment team know so they can provide pain relief for you.

Painkillers

If your cancer is causing you pain, you’ll be offered painkillers (analgesics). You’ll probably be recommended to take your pain medication all the time, rather than waiting for pain to come on first. This is so you don’t experience pain unnecessarily.

Types of painkiller

The strength and type of pain killer you are prescribed will be tailored to the level of pain you have:

Level of pain

Analgesics such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen)

Weak opioids, such as codeine, tramadol or dihydrocodeine

Strong opioids, such as morphine

Mild

x

x

Mild to moderate

x

Moderate to severe

x

Opioids are not only prescribed near the end of life – they can be useful earlier too. Opioids are a very helpful pain relief when other pain medications are insufficient. If you need a strong opioid, your doctor will prescribe oral morphine as a first choice, but other opioids are available if needed (which may be given using a patch, injection or drip).

Dealing with breakthrough pain

You may get occasional bouts of pain despite taking your usual pain medication – this is called breakthrough pain. Your doctor will explain what additional medications or higher doses of painkillers you can take to treat breakthrough pain.

Side effects of painkillers

The side effects of painkillers differ depending on which you take. Your doctor will explain the side effects you might experience and how these can be managed.

NSAIDs can cause gastrointestinal side effects such as ulcers. If you’re at particular risk of these, your treatment team can prescribe a medication to reduce your risk.

Opioids can have strong side effects, including nausea, vomiting, diarrhoea, itching, difficulty emptying your bladder, drowsiness and confusion.

This is why they’re only recommended when your pain is moderate or severe. If you’re taking opioids, you’ll be given laxatives to help with constipation. Other medications (anti-emetics) can help with nausea and vomiting.

Other types of pain control

Depending on what is causing your pain, other treatments may help too.

For example:

  • If you have bone pain, radiotherapy, surgery, bone strengthening drugs or steroids may help reduce this
  • If your pain is caused by damage to nerves, some antidepressants and anticonvulsants can help to reduce this
  • Severe pain can be relieved by numbing areas of your body by injecting medications into your spine or other nerves

There is little evidence that complementary therapies can help to improve pain.

Rashpal talks about her experience of pain and what can help:

Tips and advice

Advice on getting the best care

To help you feel confident you’re getting the best care, you may want to:

  • Ask for an assessment of your pain, so that you and your treatment team can plan the best way to treat it
  • Keep a diary of your pain to discuss with your treatment team
  • Let your treatment team know how well your pain is being managed – sometimes you may need to change medication or dose

Information Standard

Information last reviewed: October 2015

Next review due: October 2018

Breast Cancer Now's health information is covered by NHS England's Information Standard quality mark. Find out how this resource was developed.