My name is Sarah Slater. I'm a medical oncologist at Barts and the London hospitals and Homerton hospital.

Advanced cancer is when a cancer has spread from its original organ to somewhere else in the body.

When a patient has advanced cancer we think about different ways of trying to make them feel better,

through good medication, radiotherapy and sometimes chemotherapy.

Patients with advanced cancer can sometimes develop pain.

That might be because the organ itself is painful,

or that it's spread to somewhere else in the body which causes pain through pressure.

We also get conditions called referred pain.

A pain, for example in the shoulder, may have started somewhere else, perhaps in the liver area.

We also sometimes have situations where people have what we call emotional pain,

which means that the diagnosis in itself is so distressing it can cause almost physical pain.

Not all patients with advanced cancer can develop pain.

Sometimes patients do develop pain, but don't tell their doctors or nurses through fear.

That obviously is a barrier, unfortunately, to treatment

and I would always recommend that people were open and honest with their teams looking after them.

Pain and cancer can be on a wide spectrum, from mild aching to severe, sharp, stabbing pains.

But all are potentially treatable.

A patient with pain needs a lot of detailed assessments through asking clinical questions such as

Where is the pain? What does it feel like?

How often do you get it in a day? How severe is it?

And we often use a scale that allows us to decide, with the patient, how severe a pain is in interfering with their lives

The way that we manage pain depends very much on what information we get from the consultation.

We might recommend simple remedies, such as paracetomol on a regular basis.

We might recommend types of morphine drugs, of which there are a variety available these days, with much lower risks of side effects.

We might use different treatments such as radiotherapy if, for example, there was pain in the bones.

So there are a variety of ways that we can help patients with pain.

My advice to anyone with pain, whether or not they are on any treatment for that, is to always let their teams know.

It isn't a sign of weakness, and it is not necessarily as sign that the treatment isn't working.

It sometimes means that there might have been confusion about what medication to take,

or it might mean that for a while there needs to be an increase in that medicine.

But it is incredibly important that pain is controlled extremely effectively.

If you have good pain control it snowballs into affecting every other part of your life.

It can increase your energy to do things with your family, improve your appetite, increase your ability to sleep at night.

So having good pain control is, I think, essential for any patient with advanced cancer.

[New speaker] For information, help, or if you just want a chat,

call the Macmillan Support Line on 0808 808 00 00 or visit macmillan.org.uk