If pain is being caused by a tumour, treatments such as surgery, radiotherapy, chemotherapy or hormonal therapy may help to treat the tumour and reduce the pain.
Surgery can be used to remove part, or all, of a tumour to relieve pressure on organs or a nerve. Sometimes, laser treatment can be used to reduce the size of the tumour.
Radiotherapy is sometimes used to shrink a tumour. This can reduce pain and other symptoms.
Radiotherapy is an effective way of controlling pain in the bones - especially the spine, thigh bones (femur), pelvis and ribs. It can help relieve pain and allows the bone to build up its strength again.
Usually only one or two sessions of radiotherapy are needed. The treatment doesn’t work immediately; it usually takes 7-10 days before it has an effect. You will need to keep taking your other painkillers during this time. The dose of radiotherapy used to treat pain is quite low, and the treatment has very few side effects other than tiredness (fatigue).
Sometimes radioisotopes may be used to help control pain in the bones. Radioisotopes are mildly radioactive substances that are taken up (absorbed) by the bones. The isotope is given as a liquid injected into a vein in the arm. When the isotope reaches the bone affected by cancer, it releases a dose of radiotherapy, which can help relieve pain. Strontium-89 is an example of a radioisotope. It can often take several weeks or even months for this type of treatment to work, so you’ll need to carry on with your ordinary painkillers in the meantime.
In some people, chemotherapy can shrink tumours to reduce pain and help people feel better, but it may cause side effects that are difficult to deal with. However, for others the treatment doesn’t work, and they will have the side effects of the treatment without the benefits.
Some chemotherapy drugs cause hair loss, and many of them can reduce your resistance to infection and cause tiredness, a sore mouth or diarrhoea. A few chemotherapy drugs can cause nerve pain.
Your doctor can discuss with you whether chemotherapy may be helpful for your pain. Ask your doctor how likely it is to work and what the side effects may be, so that you can decide whether chemotherapy would be helpful in your situation.
Hormonal therapy can be used to reduce pain for some types of cancer, such as breast and prostate cancer. Hormonal therapies can shrink these cancers by altering the levels of particular hormones in the body or by preventing certain hormones from attaching to cancer cells. There are many different types of hormonal therapy, and the side effects of each vary. However, hormonal therapies do not tend to cause severe side effects.
Your doctor can discuss with you whether hormonal therapies may be useful in controlling your pain, how likely the treatment is to work for you and what the possible side effects are.
Making decisions about treatment
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Making decisions about treatment in these circumstances is always difficult. You may like to discuss the benefits and side effects of treatment with your doctor before making a decision about whether or not to have the treatment. You can also discuss these issues with our cancer support specialists or you may want to contact some other support organisations.