Surgery and medical treatments for pain

Other treatments can help relieve pain caused by cancer. These include surgical and medical treatments:

  • Surgery can be used to remove part or all of a tumour. This reduces pain by relieving pressure on organs or a nerve. Surgery may involve inserting a stent (a hollow tube) if you have a blockage in a tube-shaped organ such as the gullet. This relieves the obstruction and can reduce pressure.
  • Radiotherapy can be used to shrink a tumour. A special type of radiotherapy known as radioisotope therapy can also be used to control bone pain.
  • Chemotherapy and targeted therapies reduce pain by shrinking the tumour.
  • Hormonal therapy may be used to treat certain cancers and help reduce pain.
  • Nerve blocks relieve pain by blocking pain messages from getting to the brain.
  • Radiofrequency ablation (RFA) uses heat to destroy cancer cells. It’s sometimes used to relieve bone pain caused by small secondary bone tumours.

Your doctor or specialist nurse will be able to advise you about which method of pain control is most suitable for you.

Managing cancer pain with other treatments

As well as being on the right painkillers, there are lots of other things that can help manage your pain. These include surgery and medical treatments.


Surgery

Some people may have an operation to remove part, or all, of a tumour. This can help to relieve pressure on organs or a nerve. Surgery can also be used to repair damaged bones. These treatments can sometimes help to relieve or improve cancer pain.


Radiotherapy

This treatment uses high-energy rays, such as x-rays. It is sometimes used to shrink a tumour, and can help reduce pain and other symptoms. Radiotherapy can be used to control pain in the bones – especially the spine, thigh bones, pelvis and ribs. This is known as palliative radiotherapy.

Usually only one to five sessions of radiotherapy are needed.

The treatment doesn’t work straight away and the pain may be a little worse for the first 24 to 48 hours. It often takes up to three or four weeks to reduce your pain. You will need to keep taking your other painkillers during this time. The dose of radiotherapy used to treat pain is low and the treatment usually has very few side effects, other than tiredness. If it is likely to cause any sickness, you will be given medication to take before treatment.

Sometimes, a special type of radiotherapy called radioisotope therapy may be used to help control bone pain. This can be used if there is pain in more than one bone.


Chemotherapy and targeted therapies

Chemotherapy and targeted therapies are drug treatments that can shrink tumours, which can often help reduce pain. Your doctor can tell you whether these treatments may help you. Ask how likely they are to work and what the side effects may be. This will help you decide whether the treatment would be helpful for you.


Hormonal therapy

Hormonal therapy can be used to reduce pain for some types of cancer, such as breast and prostate cancer. It can shrink these cancers by changing the levels of certain 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 usually cause severe side effects.

You and your doctor can talk about 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.


Nerve blocks

Nerve blocks may help relieve pain by preventing pain messages getting to the brain.

Nerves can be blocked using drugs such as local anaesthetics (sometimes given with steroids) or other chemicals, such as alcohol or phenol. Alcohol and phenol deliberately damage the nerve.

Local anaesthetics produce a short-lasting nerve block. Although alcohol or phenol give a long-lasting block, they are less commonly used because of the side effects they cause.

Nerve blocks involve specialist techniques and are carried out by a pain specialist. This is usually an anaesthetist who will discuss the benefits and potential risks with you. Your GP or hospital specialist can refer you to a pain team.


Other treatments for bone pain

Radiofrequency ablation (RFA) uses heat to destroy cancer cells. It can help to relieve pain when radiotherapy isn’t working. It is usually only used to treat small secondary bone tumours.

There may be other treatments that can help strengthen bones and relieve pain. Your doctor or specialist nurse will be able to tell you more about these.